Lawmakers Focus On Public Plan And Details Of Paying For Reform

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Sen. Kent Conrad, who has proposed a cooperative insurance marketplace for Americans and small businesses to pool and purchase health insurance, told The Washington Post's Ezra Klein yesterday that his co-op proposal worked from the premise that a public plan to purchase health insurance doesn't have the votes to pass the Senate.

The North Dakota Democrat Conrad also said he worked on the alternative on behalf of the G-11, a group of powerful legislators working on health care reform. "'The co-op structure came to mind because it seems to fulfill at least some of the desires of both sides. In terms of those who want a public option because they hope to have a competitive delivery model able to take on the private insurance companies, a co-op model has attraction. And for those against a public option because they fear government control, the co-op structure has some appeal because its not government control. It's membership control, and membership ownership,'" Conrad said.

Conrad said he thinks the reconciliation process, which relies simple majority, won't work as a vehicle to pass health reform because it was designed to reduced the deficit, not for substantive legislation. "'And so, the way it works, under current rules, if your in reconciliation, you have to be deficit neutral over five years. Under the budget resolution, health care can be deficit neutral under 10 years. That's a big difference. Two, under reconciliation, you're subjected to the Byrd rule. The Byrd rule says that anything that doesn't cost money or save money, or that only costs money or saves money in a way that's incidental to the policy, are subject to strike. The result, for instance, is that all the insurance market provisions are subject to strike. All the wellness and prevention provisions are subject to strike. The Senate parliamentarian said to us that if you try to write substantive health reform in reconciliation, you'll end up with Swiss cheese,'" Conrad said (Klein, 6/11).

Sen. Mary Landrieu, D-La., is deflecting criticisms leveled at her that she's flip-flopped on reform after signing a letter supporting a public plan and later coming out against it, Politico reports: "But (Landrieu spokesman Aaron) Saunders sought Thursday to clarify Landrieu's position after she seemed to contradict the pledge when she told reporters this that she doesn't support the public option. Although she agrees with many ideas in the letter, Saunders said, it shouldn't be interpreted as a roadmap for her health care views. Where Landrieu comes down on the issue could prove significant as Democrats search for a filibuster-proof majority, and the Health Care for America Now is now planning a TV campaign in Louisiana to exert pressure on her (Brown, 6/11).

Efforts to derail the reform package won't be successful, Sen. Tom Harkin, D-Iowa, said Thursday in the Des Moines Register: "'We're going to bring the bill out, it's going to be open for debate and open for amendment. That's bipartisan,' Harkin said. He later added: 'I think, when I talk about bipartisan, is that we have an open system that allows the minority to offer their ideas and, by the way, some of them are pretty good and we've adopted some of them. But that doesn't mean that we're held hostage by the minority in order to not do something'" (Clayworth, 6/11).

And Rep. Pete Stark, D-Calif., says a 2 percent income tax surcharge would pay for a health insurance program, The San Francisco Chronicle reports: "Stark predicted that when it comes down to paying for health care reform, 'it'll be, "Swallow hard, take the tough vote."' Stark, chairman of the House Ways and Means Committee's health panel and a member of his party's liberal wing, argued against paying for health care by taxing employees for employer-paid health coverage, or by ending the income tax deductions that employers now take for the cost of providing health insurance to their employees" (Lochhead and Lewis, 6/12).

House Speaker Nancy Pelosi, D-Calif., said Thursday that tax increases could remain in the mix as lawmakers look for ways to reform health care, and that reform will be fully paid for, Roll Call reports. "Still, when pressed about whether taxes would go up because of health care reform, Pelosi said, 'No. But I'm saying that everything is on the table'" (Bendery, 6/11).

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.

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