Senate Finance Committee Chairman Max Baucus, D-Mont., said today that the Senate is unlikely to approve major health care legislation this year that includes a pure form of the controversial government-operated insurance program, following White House signals over the weekend that President Obama did not consider the public option essential to passage of legislation this year.
House Speaker Nancy Pelosi, D-Calif., and many liberal Democrats in the House and Senate, are pressing for inclusion of a robust "public option" in health care reform legislation, saying it is essential to compete with the private insurance industry to drive down costs, but the Senate Finance Committee twice rejected that approach before voting out a health care bill early last week.
Baucus is meeting behind closed doors with Senate Majority Leader Harry Reid, D-Nev., and Sen. Christopher Dodd, D-Conn., to negotiate a compromise health care bill to send to the Senate floor. This compromise plan will meld provisions of bills passed by the Finance Committee and Health, Education, Labor and Pensions Committee and is expected to be sent to the Senate floor later this month.
Baucus told reporters today that it is highly unlikely Democrats could muster the 60 votes needed to overcome a GOP filibuster and pass health care legislation that includes a public option.
"There are various versions of the public option bandied about ... [and] we're trying to see what makes the most sense," Baucus said. "The goal is health care reform … that can get 60 votes. … I don't know if there are 60 votes for the pure kind of" public option proponents are demanding.
Baucus took questions from reporters during a conference call sponsored by Families USA, a nonprofit health care advocacy group. During the session, he charged that the insurance industry hurt its credibility with members of Congress by releasing what he termed was a badly flawed and one-sided study, which concluded that the Finance Committee bill, if enacted, would drive up insurance premiums. "It galvanized, solidified a lot of feelings in the Senate against the insurance industry," Baucus said.
He also said the negotiators are reviewing a provision of the Finance Committee bill that would impose a $4 billion-a-year tax on medical device manufacturers, based on their market share, to help finance the expanded health insurance program. Lawmakers from Minnesota, Indiana and other states with heavy concentrations of these industries have opposed the measure, saying it would harm their region's economies. "Frankly, the device manufacturers are divided and they're all over the lot," Baucus said. He added that all sectors of the health care industry should share in the cost of health care reform, and "no group should be exempt."
But by far the most contentious issue facing Senate negotiators is whether the final version of the health care overhaul should include a public option. There are a number of different approaches to a government-run insurance program that have emerged from committees in the Senate and House.
The toughest version, strongly advocated by liberals, would link reimbursement rates for health care providers to those paid by Medicare -- an approach that would bring down overall health care costs by $110 billion over the coming decade, according to the Congressional Budget Office. Another approach, favored by centrist Democrats, would mandate the government to negotiate reimbursement rates with providers. CBO says this approach would save about $25 billion over 10 years.
The Finance Committee version would use privately operated insurance cooperatives to provide affordable coverage to uninsured Americans, bypassing the government option altogether, while the Senate HELP bill calls for creation of a strong government insurance program that would negotiate rates.
Sen. Thomas Carper, D-Del., is promoting another model that would leave it up to the states to decided whether to establish a public plan or not. Sen. Chuck Schumer, D-N.Y., has embraced the idea, saying that it would allow states to opt in or out of a public plan.
Over the weekend, Obama administration officials said that the president continues to support the concept of a government sponsored insurance option, but is not demanding that it be included in the final legislation. White House Chief of Staff Rahm Emanuel, in two television appearances on Sunday, said that the public option could provide much needed competition, but that "it's not the defining piece of health care."
Baucus said today that "Personally, I want any mechanism that keeps the insurance industry's feet to the fire." But he questioned whether a robust public option would survive on the Senate floor, in light of the concern of Republicans and some conservative Democrats that it would be a dangerous step toward government control of the health care industry.
As for the "opt in, opt out" approach, Baucus said: "That's new, that's interesting ... We're trying to figure out what some of the unintended consequences [of it] will be."