Senate Committee Finally Digs Into Health Reform Language

The Senate Finance Committee -- the final of five congressional committees that must pass a health reform bill -- has started marking up the proposal presented by Sen. Max Baucus, its chairman.

Baucus, D-Mont, tried to produce a bipartisan plan through months of negotiation, though when he finally unveiled it recently, no Republicans supported it (BestWire, Sept. 16, 2009). His 220-page legislative summary is the focus of this week's markup -- the committee process of modifying legislation through amendments. The committee is -- so far -- dealing with 564 such amendments, and it started its first day of markups with senators' opening statements.

"The cry of impatience has won out," said Sen. Chuck Grassley, R-Iowa, who was a member of the bipartisan negotiating group known as the "Gang of Six." "They have put moving quickly over moving correctly."

Sen. Tom Carper, D-Del., praised Baucus' effort, which was criticized by members of both parties. "Sometimes when you get attacked by either end of the political spectrum, you've come to a pretty good starting place," he said.

But even as the committee gets into those suggested amendments, Baucus himself has said he's changing his own initial proposal. Responding to criticism of his bill from colleagues, he changed the proposal, looking to lessen costs for middle-class people who will be required to purchase insurance. That makes the bill -- which at some estimates could cost less than $800 billion over 10 years -- a little more expensive. The original expense was already difficult to stomach for Republican critics.

"This proposal has major flaws," said Sen. John Cornyn, R-Texas. "This proposal taxes too much and grows government too much."

In Baucus' opening remarks, he said, "This is no government takeover. ... And we paid for every cent."

The first day's arguments demonstrated the partisan divide on the committee.

Sen. John Ensign, R-Nev., said it's important in the reforms to make sure everybody -- even low-income people -- have some level of cost, some "skin in the game," he said. The bill should get patients "more involved in the financial accountability loop." One idea, he said, is to open up transparency across the country, so consumers can see how much plans cost everywhere and how effective they are. "They can shop for cost and quality." He said he doesn't want "government solutions on government-caused problems."

"I think the broad construct of this legislation accomplishes the objectives we all want to accomplish," said Sen. Jeff Bingaman, D-N.M., one of the three Gang of Six Democrats. "It tries to reform the things that don't work. It reduces the cost of health care going forward. And it provides coverage to an awful lot of Americans that currently don't have coverage."

The committee will work on the legislation this week before potentially passing it for wider consideration on the Senate floor as early as next week. Whether the final committee bill will have any Republican votes behind it is still unclear.

"Health care reform will affect the lives of every single American and have a dramatic impact on our economy," said Sen. Mike Enzi, R-Wyo., who was another member of the Gang of Six that Baucus had hoped could be convinced to vote for reform. "Unfortunately, the efforts of Chairman Baucus were ultimately unable to produce a bipartisan bill. I regret that we ran out of time and we were unable to resolve certain key issues."