Washington state's Cantwell wants changes made to Baucus health care bill

McClatchy NewspapersSeptember 16, 2009 

WASHINGTON — Sen. Maria Cantwell said unless significant changes were made she would be unable to support a major health care reform bill unveiled Wednesday by the chairman of the Senate Finance Committee.

The Washington Democrat, a member of the Finance Committee, said the measure from Sen. Max Baucus, D-Mont., did not include a government-run insurance option and failed to overhaul the Medicare reimbursement formula which is critical to Washington state.

"I wouldn't vote for a bill that doesn't have Medicare reform and the public option," Cantwell said in a telephone interview. "What would I tell the people in Washington state?"

Baucus has spent months trying to negotiate a bipartisan bill with Republican committee members, but in the end he failed to gain any GOP support. Cantwell's opposition may be an early sign Baucus could have trouble from some Democratic committee members. The committee is expected to consider the legislation next week.

Baucus' bill would extend health care coverage to 29 million of the estimated 47 million people who don't have it, expand Medicaid to cover some of them, require everyone to have health insurance and create new state insurance exchanges, or marketplaces, where consumers could shop for a plan. The bill would also bar insurance companies from denying coverage based on pre-existing conditions.

The Montana senator said his bill would cost about $862 billion, a lower price tag than any of the other health care reform bills currently floating around Capitol Hill.

As Baucus unveiled his plan, the White House released a new analysis of U.S. Census numbers which showed the number of uninsured people in Washington state had grown from 763,000 to 808,000 in 2008. The number includes people who haven't had insurance for an entire year and does not include those who have lost their coverage because of the recession.

Cantwell has faced some criticism because she had not spoken out decisively in favor of the so-called public option.

But Wednesday she made clear it was critical if she was to support the bill. The senator said such an option would likely lower premiums by creating competition for private insurers and provide a much needed safety net for people living in poverty or near-poverty.

"The public plan would be cheaper than subsidies for the insurance companies," Cantwell said.

Cantwell and the other Democratic members of the state's congressional delegation have long-insisted any reform bill has to include changes in the Medicare reimbursement formula. Medicare reimbursements for doctors and hospitals in Washington state are among the lowest in the nation. The current formula punishes states like Washington which have efficient health care systems and rewards those that have inefficient systems, Cantwell said.

If the efficiencies already adopted by Washington state were imposed nationally, Cantwell said it could save Medicare roughly $100 billion a year.

Cantwell said she and others will likely offer amendments when the Senate Finance Committee meets next week.

"It's a long process," she said. "We will see what happens."

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