House, Senate Committee Chairs Could Affect Health Care Reform Through Budget Process

Main Category: Health Insurance / Medical Insurance
Also Included In: Public Health;  Medicare / Medicaid / SCHIP
Article Date: 11 Mar 2009 - 4:00 PDT

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Less than two weeks after President Obama released his fiscal year 2010 budget, five congressional committee chairs have started the budgetary process by questioning some details of Obama's proposal, including some health care reform aspects of the plan, the New York Times reports. According to the Times, Senate Finance Committee Chair Max Baucus (D-Mont.) "has welcomed Mr. Obama's determination to overhaul health care this year." However, Baucus already has drafted his own plan to reduce costs and expand coverage, "putting him in potential conflict" with both Obama and Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.), the Times reports (Calmes/Hulse, New York Times, 3/10).

Baucus is opposed to Obama's proposal to limit tax deductions for higher-income U.S. residents to offset the cost of health care reform. The Times reports that as committee chair, Baucus "has a lead role on the health care and tax issues on President Obama's agenda." As a result, "[c]olleagues will be watching how he performs, given memories of his defections in support of President George W. Bush's tax cuts and Medicare drug benefit," according to the Times. Before Obama was elected president, Baucus "indicated that overhauling health policies would be his priority," calling health care reform "the challenge of my career" (New York Times [1], 3/10).

Senate Budget Committee Chair Kent Conrad (D-N.D.) -- who "has long been defined by his crusades against deficits" -- "was quick to criticize the Obama budget as not doing enough to reduce debt," the Times reports (New York Times [2], 3/10). According to the Times, the "political problem" with Obama's budget proposal is that "the upfront costs of health care reforms are huge while the promised cost savings are years in the future" (Calmes/Hulse, New York Times, 3/10).

Although House Ways and Means Committee Chair Charles Rangel (D-N.Y.) "is eager to help Mr. Obama, one of [Rangel's] first acts -- questioning the president's proposal to limit deductions by rich taxpayers to help pay for overhauling health care -- underscores that Mr. Rangel's priority is New York," where state lawmakers "typically oppose limiting [tax breaks]," the Times reports (New York Times [3], 3/10).

House Budget Committee Chair John Spratt (D-S.C.) claims that Obama's budget would not do enough to curb spending on entitlement programs including Medicare and Medicaid (Calmes/Hulse, New York Times, 3/10). In addition, Spratt is seeking to reduce the federal deficit beyond Obama's proposal, although he would be satisfied if Obama's proposed levels could be achieved. He said, "If we can achieve the deficit reduction that is projected, going from $1.752 trillion to $533 billion in four fiscal years, I think that it is an ambitious accomplishment" (New York Times [4], 3/10).

House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) "will have a prime role in deciding two of Mr. Obama's chief objectives: a health care overhaul and new energy legislation." Waxman said, "They are both issues that I have been involved with my whole career in Congress," adding, "We might be in that unique historical moment when we can get health care for all Americans, and deal finally with the energy security questions and global warming threat." Although Waxman "supports Mr. Obama's goals," that support "offers no guarantee that the president will always get his way," the Times reports. Waxman said, "The president has given us his proposals," adding, "That doesn't mean we have to accept every one of those proposals" (New York Times [5], 3/10).

Congressional lawmakers intend to complete a nonbinding budget resolution in April. The budget resolution, which does not require Obama's approval, serves as a blueprint for congressional committees when drafting appropriations bills, which do require Obama's approval (Calmes/Hulse, New York Times, 3/10).

Democratic Dissent
The Washington Post on Tuesday examined how "Democratic leaders in Congress did not expect much Republican support as they pressed President Obama's ambitious legislative agenda," but "the pushback they are receiving from some of their own has come as an unwelcome surprise." The Post reports that the "internal revolt has served as a warning to party leaders pursuing Obama's far-reaching plans for health care, energy and education reform."

Although Obama's priorities, including health care reform, "continue to enjoy broad Democratic support ... as the ideas develop into detailed legislation, they will transform from abstract objectives into a tangle of difficult trade-offs," according to the Post. As such, any policy included in Obama's budget, including Medicare radiology rules, which "are all currently niche concerns, ... could become the next crisis for party leaders, with the potential to derail a major agenda item," the Post reports. According to the Post, some of those issues include limits on tax deductions for higher-income U.S. residents to fund health care reform and means testing in the Medicare prescription drug benefit (Murray, Washington Post, 3/10).

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