So, where are we at on health care reform

[TayTay]

Friday, July 10, 2009

http://voices.washingtonpost.com/ezra-klein/2009/07/an_inside_look_at_the_senate_f.html?hpid=news-col-blog">Ezra Klein at the WaPo has a very good article on ways the Senate Finance Committee is looking for pay for health care reform:

The biggest-ticket item under consideration on the health side is an increase of 0.3 percent on the employer and employee Medicare tax. That would raise $275 billion over 10 years. Another option would be to apply the Medicare tax to investment income above the Social Security tax cap. (That seems like a really good idea.) There's also a potential flat tax on insurance companies tied to their number of members or premium payments. That could bring in $75 billion to $100 billion over 10 years. Then there are a couple much smaller revenue options relating to fees on pharmaceutical companies and the medical itemized deduction cap.

http://online.wsj.com/article/BT-CO-20090709-716694.html">Wall Street Journal reports that Sens Reid and Schumer have made progress on health co-ops as a "publicly funded" option

WASHINGTON (Dow Jones)--Senate Democratic leaders Thursday claimed progress in talks on forming a public competitor to private health insurers, though senators appeared to make little headway on finding a way to pay for health-care legislation.

Senate Majority Leader Harry Reid, D-Nev., and Sen. Charles Schumer, D-N.Y., said they're amenable to making a non-government health cooperative part of health-care legislation, perhaps in lieu of a controversial proposal to form a government-run health insurance plan.

Schumer, who has led efforts to find a middle ground between opponents and supporters of a public plan, said it is most important for the public competitor "to keep the companies honest, to be available right at the beginning to everybody, and have the strength to borrow."

"If it can do those things in a co-op form, I think we're open to it," he said.

Reid told reporters that "we're going to have some type of public option - you can call it cooperative or whatever you want."

An article from July 7 in the http://www.nytimes.com/2009/07/08/health/policy/08health.html?_r=2&hp">NYTimes detailed what concessions the White House is making for health care:

As part of their deal with the White House, pharmaceutical companies say they won an agreement from Mr. Baucus to oppose efforts by House Democrats to sharply reduce what the government pays for drugs for some Medicare recipients previously covered by Medicaid.

The deal with doctors could come at a steep price: a $250 billion fix to a 12-year-old provision in federal law intended to limit the growth of Medicare reimbursements. The American Medical Association and other doctors’ groups have sought to change or repeal the provision, and they are likely to try to extract that as their price for boarding the Obama train, people tracking the negotiations said.

Wal-Mart, the nation’s largest private-sector employer, agreed recently to support requiring all big companies to insure their workers. In exchange, Wal-Mart said it wanted a guarantee that the bill would not “create barriers to hiring entry-level employees” — in effect, code words to insist that lawmakers abandon the idea of requiring employers to pay part of the cost for workers covered by Medicaid, the government insurance plan for the poor.

“It’s kind of a give-and-take, quid pro quo kind of environment,” said Tom Daschle, President Obama’s first choice for health secretary, who remains in touch with the White House on health care issues. “I think that the stakeholders wouldn’t do this if they didn’t think there was something in it for them.”

http://www.mcclatchydc.com/homepage/story/71584.html">McClatchey has an article that takes the Dems to task for doing health care reform deals in secret (and notes that Sens. Kerry and Snowe are meeting in private over financing issues)

The private sessions continue, however.

Four Senate Republicans met for an hour and a half Wednesday to discuss health care with Senate Majority Leader Harry Reid, D-Nev. Separately, Sens. Olympia Snowe, R-Maine, and John Kerry, D-Mass., have been in intense discussions. White House Chief of Staff Rahm Emanuel and Office of Health Reform director Nancy-Ann DeParle are in constant, private contact with key players.

The House of Representatives could vote on a plan before the August recess. The Senate is poised for a longer debate. Assuming they pass differing plans, any final product would emerge from a conference committee, whose negotiations typically offer even less public scrutiny.

Lawmakers, health care interests and public policy experts acknowledge that Obama's campaign vision hasn't exactly come to pass.

"Sometimes for people to say what's really on their mind, it helps to do it outside the public eye," said Senate Finance Committee member Thomas Carper, D-Del. "Could the process be more transparent? I suppose it could be."

http://firstread.msnbc.msn.com/archive/2009/07/06/1987433.aspx">MSNBC had a pretty good timeline of what is supposed to happen in the Senate this month. I seriously wonder if this timeline will hold however:

THE SENATE
Starting this week, the Senate meets for five weeks before summer recess. The leadership is planning to spend the fifth week (Aug. 3rd) on Sotomayor floor debate and vote. And it hopes to spend the two previous weeks on Sotomayor (July 20 & 27), as well as debating and voting on the health-care reform bill.

This essentially gives the two committees (Health and Finance) two weeks to finish their bills and merge them into one bill before taking it to the floor.

The Finance Committee is THE committee to watch. If the committee gives up its efforts for a bipartisan bill, it will likely trigger Dem leaders to use a procedural tool called "reconciliation." That would prevent a GOP filibuster and allow Dems to push a bill through with a simple 51 majority vote. (That said, reconciliation involves a complex set of rules that could still make for an perilous road to final passage.)