Democrats' draft health bill delays GOP confrontation

Kaiser Health NewsJune 9, 2009 

WASHINGTON — Democrats on the Senate Health, Education, Labor and Pensions released their health care proposal Tuesday, but left out for now the two elements Republicans dislike the most — a new government-run insurance plan and a requirement that employers provide coverage or pay a penalty.

Sen. Christopher Dodd, D-Conn., who's managing the bill, said he'd confer with Republicans this week in hopes of working out some differences before the markup next Tuesday. Dodd is managing the bill due to the absence of the panel's chairman, Sen. Edward Kennedy, D-Mass., who's undergoing cancer treatment. Dodd said he conferred with Kennedy over dinner on Sunday and that he plans to try to wrap up the process before the July 4 recess.

"I have every hope Senator Kennedy will be back to take part," Dodd said. "I much prefer to be sitting next to the chairman rather than acting as a manager."

Even as Dodd said he'd try to work with Republicans, however the panel's ranking member, Sen. Michael Enzi, R-Wyo., said Tuesday that the draft bill was "a partisan wish-list that will put us on the road to government-rationed health care." The final bill, Enzi said, would need to look "very different" before Republicans could support it.

Senate Republican leader Mitch McConnell of Kentucky said that "the sooner we get the government plan off the table, the sooner we can get a (health care) program for the American people."

The bill, according to a committee summary, would allow individuals to maintain their current coverage, while providing "new, more affordable options" for health insurance.

The bill also would promote preventive services such as early screening for heart disease, cancer and depression, and provide increased funding for training of physicians, nurses and other medical personnel. Elderly and disabled people would receive more resources to help them live at home, such as ramps in their homes or an aide.

Separately, the chairmen of the three House panels briefed their fellow Democrats on their bill, which included requirements that individuals and employers purchase health insurance, a government-run plan and an insurance "exchange" to help individuals and small employers purchase coverage.

The House plan also would include subsidies to help individuals and families with incomes up to 400 percent of the federal poverty level, currently about $22,000 a year for a family of four, afford coverage and would prohibit insurers from denying coverage based on pre-existing medical conditions.

The measure also would replace Medicare's "sustainable growth rate" method of paying physicians, who face a 21 percent cut in January unless Congress takes action. While making that change could increase the cost of the bill, it's a necessary step, said Rep. Charles Rangel, D-N.Y., the chairman of the House Ways and Means Committee.

"If we don't have the doctors on board, we're in trouble," Rangel said. "We have to address this in this bill."

Rangel said the bill would call for a "public plan" immediately rather than waiting to see if the private market offers affordable coverage, an idea advanced by a group of fiscally conservative Democrats known as the Blue Dogs.

"We're going to have a public plan. We're not going to wait two, three, five years to see what happens," Rangel said.

While he's previously expressed opposition to the idea of taxing employees' health insurance benefits as a way to finance a health care overhaul, Rangel said the idea remains on the table.

House Democrats plan to mark up the bill late this month or just after the July 4 recess.

(Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care-policy research organization that isn't affiliated with Kaiser Permanente.)

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