Senate Health Bill Negotiators Discussing, Debating Versions Of Public Option

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Senator Max Baucus says there is still the possibility for some sort of public option in the Senate health bill, though he doubts it can get 60 votes, as Majority Leader Harry Reid negotiates to shape the final legislation.

Kaiser Health News reports that Baucus told reporters Monday that he views it as unlikely that Democrats could get to 60 votes - a filibuster majority - to pass a public option. "I don't know if there are 60 votes for the pure kind of" public option proponents are demanding," Baucus told reporters during a conference call sponsored by Families USA, a liberal health care advocacy group. He also said he favors any mechanism that "keeps the insurance industry's feet to the fire" (Pianin, 10/19).

The Wall Street Journal: "So far, no one is talking about a nationwide Medicare-like plan of the sort sought by many liberals, but several variations short of a national plan are being considered." One idea is to include a trigger that would create a public option if insurers fail to rein in costs, another would allows states to opt out of a public plan or create their own." Even as these considerations continue, the Journal reports that "conservatives warn that even a watered-down public plan would give the government too much control over health care and won't help lower costs." Reid's negotiators are considering what plan to put in the final merged Senate bill (Hitt and Adamy, 10/20).

Roll Call reports that, meanwhile, negotiators made no major decisions Monday on the legislation. They will meet again Tuesday evening. "The negotiators did not speak to reporters following the meeting, which lasted about an hour. Asked if progress was made, (White House chief of staff Rahm) Emanuel said 'yep' as he quickly exited Reid's office and headed out of the Capitol" (Drucker, 10/19).

The New York Times has an analysis story on the different tenets of the bill merger. Aides said they are aiming to have a merged bill "mostly baked" by the end of the week. The CBO will then score the bill again and Senate floor debate can begin (Herszenhorn, 10/19).

The Hill has a similar story on how the two Senate measures might be merged: "White House officials and Senate Democratic leaders are attempting a balancing act. They want to meet the goal of extending health insurance to nearly all Americans while reforming the system to rein in runaway costs. But they can't burst the budget in doing so." The Hill also looks at tenets such as affordability and the public option and the particulars of what lawmakers are likely to decide on in the Senate bill merger (Young, 10/20).

And making these decisions has proven to be a difficult task.

Politico reports that tensions among the negotiators are rising. "As the Democratic players huddle behind closed doors to hammer out a deal, tempers are a little shorter, tongues are a little looser, nerves are a little more frayed and egos are a little more bruised than during the usual course of Senate business" (Thrush, 10/19).

Reid's staff is working overtime to control public opinion on the public option and negotiations, Roll Call reports in a second story. An aide said Democrats are crafting an offensive after the merged bill is revealed: "The aide said that Democratic leaders this week will roll out an 'organized push' to promote President Barack Obama's health care agenda and that Reid's leadership team is planning to add voices to a more unified messaging assault" (Drucker, 10/20).

But as the negotiators work on the bill, leadership is making sure their states stand to benefit from whatever comes out of negotiations, Bloomberg reports. Nevada - Reid's home state - would get help with its Medicaid bills. "The number of special provisions is likely to grow as the full Senate begins debating the measure in coming weeks. Because Democrats are unlikely to win many Republican votes, individual lawmakers will have leverage to demand changes to satisfy parochial interests" (Faler, 10/20).

And, CongressDaily reports that a "little-noticed" part of Sen. Max Baucus' Senate Finance Committee bill would mean that fewer middle-income families would qualify for tax breaks to buy health coverage. Baucus changed the definition of income, which would allow individuals to qualify for the credits if they make between 100 and 400 percent of poverty, from "modified adjusted gross income" to "modified gross income." In effect, it would count people's retirement investments as part of their income, and so would push some people beyond the tax credit threshold or lower the credit they receive. The moved saved $1.8 billion over 10 years in the CBO score (Cohn, 10/20).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.