After a long and difficult gestation, the Senate Finance Committee has finally given birth to its plan for overhauling the nation’s health care system. Like many newborns, it may not be particularly pretty, but it has potential.
Although it’s the last entry into the health reform sweepstakes, the plan fashioned by Committee Chair Max Baucus is widely seen as the most important. That’s because Baucus, with President Obama’s explicit blessing, tried harder to win Republican backing for comprehensive health care reform. Even if he didn’t immediately succeed, his bill lies nearer the nation’s center of political gravity.
In today’s rancorous climate, that naturally means that Baucus is getting hammered from both ends of the political spectrum. Liberals hate his bill because it embraces (costly) nonprofit health care coops rather than the public option. Senator GOP leader Mitch McConnell wasted no time blasting the bill as partisan and senseless, even though three of his fellow Republicans were part of the “gang of six” who labored with Baucus for months to find common ground.
One of them, Sen. Chuck Grassley, was more circumspect than McConnell. Noting that the “chairman’s mark” is merely the starting point for committee deliberations on the plan, he added, “So if you don’t have the whole thing worked out yet, it would be intellectually dishonest for me to say, you know, I couldn’t vote for it or vote for it. Let’s see what the final package is.”
Whether any Republicans wind up supporting the bill, however, is less important than holding together the coalition of insurance companies and other key players in the health industry who this time around have lined up behind reform. His bill is also calculated to appeal to the moderate Democrats Obama will absolutely have to win in order to pass any reform of consequence.
With a price tag of $856 billion, the Baucus blueprint is cheaper than other Congressional plans. Best of all, it’s paid for — though the particulars will spark fierce debate. The financing package includes $507 billion worth of cuts in public health programs, mainly Medicare and Medicaid. Hospitals will take a big hit, and some providers may stop taking Medicare patients if reimbursements are cut. The bill also envisions $349 billion in new taxes. Most of that would come from taxing the most expensive health insurance policies, though medical device makers would also get nicked.
Complaints about these and other provisions of the bill are piling up thick and fast. Democrats say it doesn’t extend subsidies for buying taxes far enough up the income scale, forcing many families with modest incomes to pay more for coverage or face penalties if they couldn’t. That’s because most people will be required to buy insurance, regardless of how much subsidy they receive.
Republicans don’t like this mandate, or another one on larger businesses that don’t provide their employees with coverage. And with consummate chutzpah, given his party’s ferocious opposition to government-run health care, McConnell has shed crocodile tears over the bill’s Medicare cuts.
The Baucus bill will be, and should be, substantially modified as it runs the gauntlet of the Finance Committee, the full Senate and then a House-Senate conference. But it contains the insurance market changes, subsidies and mandates that are the guts of health reform, and it meets President Obama’s demand that reform seek to restrain health care cost growth while adding nothing to the federal deficit. And conservatives can sleep easy in the knowledge that it contains no death panels, no abortion funding and no insurance for illegal immigrants.
Most important, it moves the arduous legislative process forward, giving critics not only a target to attack, but a mark to beat.