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Health On The Hill: Baucus Asks Finance Committee For Truman-Like ‘Courage’

Health On The Hill: Baucus Asks Finance Committee For Truman-Like 'Courage'Jackie Judd: Good day, I’m Jackie Judd with Health on the Hill. The Senate Finance Committee has spent the day wading through the many proposed amendments to the Chairman’s health care reform legislation. Reporter Eric Pianin of Kaiser Health News has been there, too. Eric, bring us up to date.

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Eric Pianin: Hi, Jackie. Today’s the second day of deliberations of Max Baucus’ proposal for health care reform that the Senate Finance Committee is now scrutinizing. Baucus at one point had called for members to do what Harry Truman admonished others to do in the past, which is to show some courageous, skillful leadership, and seize the opportunity to change things for the better. So far though we’ve seen little of that great statesmanship, and instead a lot of old-fashioned partisan politics. Throughout the morning and early afternoon, Baucus and his Democratic committee members have been mowing down a handful of Republican amendments. For example, one is by Jim Bunning of Kentucky, demanding final CBO estimates before the committee could vote, an amendment that might put off a final vote for two more weeks.

JJ: And the Republicans there were arguing that that’s the kind of transparency the committee should be striving for?

EP: Exactly, and it was an extended debate. They spent almost two hours on it – the Republicans arguing that ‘this is such an important vote that we ought to take a little more time and make sure we have all the numbers, that we know the full implications of it,’ and the Democrats, including Baucus, arguing that ‘there will be plenty of accurate numbers available through the members by the time they vote.’ And Bunning’s amendment, if taken literally, could add two more weeks to the deliberations.

JJ: And was the vote along party lines?

EP: It was pretty much along party lines. But I should note a couple of things. One, Olympia Snowe, who is probably the only Republican the Democrats have a chance of getting to support the bill, sided with Bunning. And asked the question, “What’s the rush? Why don’t we wait another couple of weeks if it means getting the most accurate estimates from CBO, and then we can vote?” And she almost made it a litmus test for her support. At one point she said this is her bottom line. So Max Baucus offered an alternative, which would provide a lot of assurances that the members would have good numbers from CBO to use before they cast their final vote in committee. But clearly Snowe and the other Republicans were not satisfied with that.

JJ: So that went to the point of timing and transparency. What happened the rest of the day in terms of the actual substance of the bill?

EP: Well, there was a lot of talk about the proposed cuts in Medicare to help finance the underlying bill and pay for the extended coverage for the uninsured Americans. And also try to address the runaway costs of Medicare and other entitlement programs.

JJ: Particularly Medicare Advantage?

EP: Medicare Advantage would take the biggest hit. Overall, the Baucus bill is proposing over $500 billion in Medicare-related savings over the next 10 years. And the Republicans, including Sen. John Kyl from Arizona and Pat Roberts of Kansas, cast themselves as champions of seniors in arguing that these proposed cuts were too draconian; that extending health care coverage to the uninsured should not be done ‘on the backs of seniors.’ And so they offered a number of amendments that tried to knock out these steep cuts in Medicare, and in all cases they failed.

JJ: And how did Democrats answer that criticism from Republicans?

EP: Well they argued that in a lot of ways the savings will advance the larger cause of trying to slow the rate of growth of spending on entitlements, in Medicare in particular. They’re also arguing that because a lot of the cuts would be directed to Medicare Advantage, that they would be focusing more on bells and whistles in addition to the basic Medicare plan. And that nobody would really suffer.

But the cuts would affect a segment of seniors who are seeking a higher end Medicare coverage program. And basically, they were saying this is part of an overall drive to try to bring down the cost of health care, to try to bend the cost curve, and they feel it’s a legitimate approach.

JJ: Eric, is it possible to say based on the pace of events yesterday and today, when there actually may be a vote on the final bill?

EP: Well, they’re clearly going to have to speed up the process. There are probably over 500 amendments that have been offered. Realistically many of those will have to fall away if they’re going to conclude their deliberations within the coming week. It doesn’t seem realistic at this point to think that they can wrap everything up by Friday or even the weekend. I know that Baucus is pushing very hard. He’s being a lot more aggressive than he has been in the past. He’s beyond that point of being conciliatory, trying to bring together the Republicans and Democrats. Right now it’s clear that the Republicans are not going to support this bill, with the possible exception of Olympia Snowe. So he’s trying to move this train along as quickly as possible.

JJ: Okay, well thank you very much. We will check back with you later in the week. Eric Pianin of Kaiser Health News. I’m Jackie Judd.

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