Congressional negotiators returning to start conference talks on health reform bill

Democratic lawmakers will begin this week to try to hammer out a compromise between the House and Senate versions of a health care reform bill as they keep an eye on votes for the measures.

Bloomberg reports that Senate Democrats will have the "upper hand as U.S. lawmakers return to Washington this month to confront the last major hurdle" to passing health reform legislation. "Senate Democrats have more clout because they have no room for defections, analysts and lawmakers said. Even so, House members will push for their provisions, including the public insurance program, likely making the negotiations among the most complex in congressional history." Senate Democrats say there isn't much room to move away from the Senate plan as "Finance Committee Chairman Max Baucus of Montana called the coalition in his chamber 'fragile' and Nebraska Senator Ben Nelson, the last Democrat to sign onto the legislation, said his continuing support wasn't guaranteed" (Jensen and Gaouette, 1/4).

Los Angeles Times: When the conference does convene, "Senate and House negotiators could choose to meet in a formal conference committee to work out the differences or instead work out a deal in a looser, give-and-take fashion. Even though the conference committee would ostensibly be a more public forum, the nitty-gritty will be worked out in private no matter what" (Oliphant, 1/3).

Roll Call reports that House Democratic leaders are returning this week to start talking to their Senate counterparts on a compromise. "House Democratic leaders and committee chairmen will be on the Hill 'discussing differences in the bills and priorities for the final bill,' a senior House Democratic aide said. It remains unclear whether lawmakers will convene a formal House-Senate conference, as conversations have already been taking place by telephone" (Bendery, 1/4).

Among the provisions getting a second look, The New York Times reports, is a last-minute addition that "singles out the construction industry for special treatment, in a way that benefits union members and contractors who use union labor." The provision in the Senate bill would exclude construction companies from the small businesses that would not be penalized if they failed to provide insurance (Pear, 1/4).

Other groups, including the American Medical Association, are pushing to change the final product, American Medical News reports. Among the concerns of the AMA is the Medicare advisory board proposed in legislation. The AMA "is asking for revisions that would more fairly spread out the burden of reducing Medicare spending," ensure transparency in the board and allow legitimate spending increases (Glendinning, 1/4).

Business Insurance reports that some expect the negotiations to be completed "sooner rather than later." Moreover, "the measure the Senate approved Dec. 24 appears more palatable," to employers, observers say (Hofmann, 1/4).

Finally, negotiators still have to reconcile how the two reform bills treat the Children's Health Insurance Program, The New York Times reports. "The Senate bill would preserve the program, known as CHIP, and would extend federal financing through 2015, two years past its expiration date under current law. … The House bill, by contrast, would end CHIP and redirect the millions of children either to Medicaid, the federal-state insurance program for the poor, or to new health insurance exchanges where moderate-income Americans would be able to buy private coverage using new federal subsidies to help offset the cost."

Some worry that children could fall through the cracks and become uncovered, but others say that providing subsidies for whole families to purchase insurance makes defending the maintenance of CHIP difficult (Herszenhorn, 1/3).