Today, the the Senate Health, Education, Labor, and Pensions (HELP) Committee passed its reform bill on a party-line vote, thirteen to ten. Yesterday, the three House committees writing healthcare legislation released the final text of their bill. Left behind in the dust, the Senate Finance Committee remains bogged down as Committee Chairman Senator Max Baucus vainly struggles to engineer a “bi-partisan bill.” (And yes, I mean “vainly” in both sense of the word.)
I suspect Senator Baucus is about to discover that he is not as important as he thought he was. As I have been suggesting in recent weeks, in the end he will not be the ultimate architect of health care reform. That job belongs to President Barack Obama.
What’s most interesting about the two pieces of legislation put forward by HELP and House Democrats this week is what they tell us about President Obama’s priorities.
There is a public insurance option in both plans. Despite recent media reports that the administration is “backing away” from public insurance, I remain convinced that the White House will insist on the public sector alternative “to provide choices and keep private sector insurers honest.”
The president would like bipartisan reform, and is happy to both listen to and include Republican suggestions in the final legislation. But he will not water down reform in order to win Republican votes—as both Rahm Emanuel and David Axlerod, Obama’s senior political strategist made clear when talking to Bloomberg here.
The president also won’t be rushed. The House version of healthcare legislation lays out a timetable: the subsidies and the public insurance option do not kick in until 2013. As the President has always said, his goal is to roll out national health reform “by the end of my first term.”
The details of the House bill make it clear that Medicare reform will pave the way for healthcare reform as Medicare leads the way by changing what we pay for, how we pay for it and how healthcare is delivered.
The House bill will tax the very rich to help raise the needed funds.In the Senate, the Finance Committee is charged with figuring out how to raise the money—and that Committee will not be happy with the House suggestion. But from the beginning, the president has suggested that it may well be necessary to hike taxes for the wealthy
The basic plan guaranteed to all Americans would be more than “good enough”—it would be quite comprehensive.
Private insurers will be regulated
Payments to primary care providers will rise. Payments to other providers will not be cut across the board.
Medicaid will not be forgotten. Indeed, the federal government will pick up the tab for expanding Medicaid—which could be a first step toward turning Medicaid into a fully-funded federal program.
As for Senator Baucus, earlier this month The Senate Agenda blog warned that, “What Baucus is ignoring at his own peril is that other Senators like Sen. Sanders will not support a plan that taxes health benefits and lacks a public option. He’s also ignoring the possibility that the Republicans are stringing him along to run out the clock on health care in order to prevent a health care debate before the August recess.
“Sen. Reid said he wants the bill passed out of his chamber by July 31st.”
Today, President Obama reiterated the importance of getting legislation passed before August 1.Does Baucus really want to be the person who foiled that plan?
The advice from Senate Agenda: “Time to swallow your pride Mr. Baucus and get in line with the prerogatives of the Democratic Caucus”
In part 2 of this post I will elaborate on those items in the HELP and House plans that reflect the goals that President Obama has stressed from the very beginning.