Skip to content

Transcript: Health On The Hill – How Will Senate Committees Combine Health Bills?

JACKIE JUDD:  Good day.  I am Jackie Judd with Health on the Hill, a conversation about efforts to pass health care reform legislation.  Joining me, as always, Mary Agnes Carey of Kaiser Health News and Eric Pianin, also of Kaiser Health News.  In the middle of the night, late last week, the Senate Finance Committee finally worked through all of the amendments to the Chairman’s bill.  Bring us up to date.  What happens this week, Mary Agnes?

MARY AGNES CAREY:  The Congressional Budget Office, also known as the CBO, the office scorekeeper of Congress, has to determine how much the bill will cost.  If that score comes back and it’s higher than $900 billion, which is the figure that Finance Chairman Max Baucus has said he doesn’t want the bill to go beyond, and also President Obama has put that $900 billion target out there as well; if the bill is too expensive, they will have to do some cutting.

JACKIE JUDD:  And is there a certainty at this moment that it will pass?  There are some Democratic Senators who are balking at the moment, (Jay) Rockefeller, Blanche Lincoln of Arkansas, and (Ron) Wyden, Eric?

ERIC PIANIN:  I think the expectation is that the bill will get out of c but it could be very close and if all ten Republicans on the Committee hang together and oppose it, then Max Baucus, the chairman, has very little wiggle room. If two Democrats decide to balk, it could be problematic for him. 

I think that Jay Rockefeller’s biggest concern is that the bas it emerges from the Committee doesn’t include a public insurance option.  He and Chuck Schumer are going to fight to add that once the Bill gets to the floor.  Blanche Lincoln is facing a very tough reelection campaign in Arkansas. 

She is from a very conservative state.  She has got to be very careful on how she votes on this and in fact she has voted with Republicans a couple of times in committee on questions of transparency, how much is this bill going to cost, in other measures that resonate with her constituents back home.  So, it is not a slam dunk, but I think the bill will get out of committee.  The question is: what happens once it reaches the floor and then what happens once it reaches the larger arena of the conference?

JACKIE JUDD:  And before it would even reach the floor, there has to be some kind of reconciliation or marriage between the Senate Finance Bill and the Bill that came out of the HELP Committee.  What is the common ground between those two bills and what are the starkest differences? 

MARY AGNES CAREY:  The starkest differences include the affordability provisions Eric was just talking about.  The subsidies are a little bit higher in the HELP Bill, the Senate Health, Education, Labor and Pensions package.  They also have a much stronger employer mandate than is in the Finance package.  We were just discussing the public option.  The public option provision is much stronger.

There basically isn’t one in the Senate Finance package.  There is a series of co-ops and there was an amendment passed–if we talk about the late night deliberations–from Senator Maria Cantwell, who is a Washington State Democrat, who would give states some flexibility to negotiate health insurance packages for those who are about 133-percent of Medicaid, of federal poverty level rather, up to 200-percent.  So you have some very, very strong differences there. 

Both bills want to make changes in the way health care is delivered and paid for, tie more payments to the quality of care delivered.  They will have some common ground there but there are a lot of differences to be taken care of before that bill goes to the floor. 

JACKIE JUDD:  And ultimately Eric, how much say will the Senate leadership finally have?  Our focus so many weeks over the past couple of months have been on Senate Finance, but at what point do we begin to shift our sights to Harry Reid?

ERIC PIANIN:  I think fairly soon.  I think that Harry Reid, the majority leader, Dick Durbin, the number two Democrat, Chuck Schumer, another very influential Democrat, are all beginning to brainstorm and try to figure out what this package is going to look like. 

In the end, it’s going to be a combination of pragmatism and politics and what is the best approach to extending insurance to millions of uninsured Americans, but also politically how can you get this thing through the House and the Senate?  And so that’s really the big question that they are going to be facing.

JACKIE JUDD:  There was some reporting over the weekend on the public option, that the Administration has not given up the ghost on that, that there is some lobbying being done behind the scenes on Capitol Hill, have you seen evidence of that? 

MARY AGNES CAREY:  I think that both Senator Schumer, Senator Rockefeller, for example, talked very positively about the option–the public option.  Both their amendments failed at the Finance Committee, and they failed with some Democratic votes helping to fail them, if you will, to defeat the amendments.  They are very optimistic that they can get some sort of version of this done.  They said that their moderate Democratic colleagues are very interested in this. 

White House officials, Nancy-Ann DeParle, head of the White House Office of Health Reform, Peter Orszag, head of the Office of Management and Budget, have definitely been seen on Capitol Hill.  President Obama’s been having his own conversations with members of Congress and this is going to continue because there are many, many people in the Democratic base that feel this Bill is their best option for a public option and they are just not ready to give up. 

JACKIE JUDD:  Okay and one final question, either of you can jump in, and that is the House, what is happening on the House side?  Is it pretty much status quo, waiting to see what happens on the Senate side?

ERIC PIANIN:  I think that they are continuing to try to refine their bill.  Remember three separate committees of the House passed versions of health care reform.  Those three have to be melded together and I think that Nancy Pelosi, the Speaker of the House and Steny Hoyer, the number two Democrat, are working on this now to try to put together something that is palatable and that could pass in the House but I think it is fair to say that they are hanging back now.  They want to see what happens in the Senate.

Their preference is to let the Senate go first and stick its neck out a little and try to resolve the whole question of whether or not to include a public option, what level of coverage, how expensive will the bill be, and then I think they are prepared to take something to the floor of the House.  

JACKIE JUDD:  Okay, thank you both so much as always, and thank you for joining us.  I’m Jackie Judd.