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Update From Mary Agnes Carey: What Baucus’ New Bill Means

Kaiser Family Foundation’s
Jackie Judd and KHN’s Mary Agnes Carey discuss Senate Finance Committee Chairman Max Baucus’ new health care bill, which was released today.

Listen to interview


As expected, a health care overhaul proposal from Senate Finance Committee Chairman Max Baucus, D-Mont., includes a system of health care “co-ops” over a government-run health care plan. Most individuals would be required to purchase coverage and the measure includes subsidies to help low-income people buy health insurance. Small business would receive tax credits to help offset the cost of covering workers. The measure, which Baucus said would cost $856 billion over 10 years, would be financed with payment reductions to Medicare Advantage plans, an excise tax on high-end health insurance policies and fees on medical device manufacturers, drug makers and health insurers.


Jackie Judd: Good day, I’m Jackie Judd with Health On The Hill. Senator Max Baucus, Chair of the Senate Finance Committee, this morning introduced his long-awaited health care reform bill. Let’s get right to it. Mary Agnes Carey of Kaiser Health News, give us the headlines.

Mary Agnes Carey: OK, it’s an $856 billion bill over the next 10 years, and Sen. Baucus stressed it would not add to the deficit. And of course as we know, last week when President Obama spoke to Congress he said he did not want a bill that would add to the deficit, so that’s a very important point here. There is an individual mandate for coverage with some exceptions; there are subsidies to help individuals purchase coverage. Tax credits for small businesses 50 or over to get coverage. Insurance market reforms: these are the things about can’t be denied coverage based on a pre-existing medical condition, can’t be canceled when you’re sick, no lifetime caps, no annual caps for coverage – very important things. Insurance market exchanges to allow people to try to buy affordable coverage for them. No public plan is in the House bill – here we have a system of co-ops that would be conducted all over the nation. Medicaid would be expanded to about 133 percent of the poverty level. Those seem to be the top provisions of the bill.

Jackie Judd: Now, Baucus released this after many months of negotiating with a core group of other Democrats and Republicans on Senate Finance. Is there any sense yet of whether there is support for what he issued this morning?

Mary Agnes Carey: It does not seem that any of the Republicans are with him. Last night, Charles Grassley, who is the ranking Republican on the Finance Committee, said he expressed concerns about, in his words, an artificial deadline being set by a Democratic leadership and the White House on negotiations for the bill. He and other Republicans, I’m thinking chiefly here of Mike Enzi from Wyoming, who is also part of that Gang of Six, have talked about their concern about they want more medical practice reform in the bill, they’re worried about immigration, they’re worried about abortion, so it doesn’t seem they are with him. Olympia Snowe was quoted in some news reports today saying she would continue to work with Baucus on the bill. It is unclear whether or not she is supporting this bill. So I think we’ll see today and the days ahead, where are the Republicans and where are also other Senate Democrats. Again yesterday, Jay Rockefeller of West Virginia, a Democrat member of the Finance Committee, said there is no way he could vote for this bill in its current form. He doesn’t like the co-ops; he prefers the public plan. He would like a broader Medicaid expansion. He’s also worried about some language in the bill that deals with children and the children’s health insurance program going into the exchanges for their coverage.

Jackie Judd: Instead of the SCHIP program?

Mary Agnes Carey: Right, they would be transitioned over time. And of course, there is also language in the bill – I have talked to the Baucus folks about this – they feel protect those CHIP kids and would get them the same level of coverage. But obviously, Sen. Rockefeller is extremely concerned about this. So we have to see how this plays out and where the votes are.

Jackie Judd: Let’s go back to the lack of a public option in this plan, which is not a surprise, but there has been so much focus – and you and I have talked about it in earlier weeks – on Olympia Snowe, who was talking about setting a trigger in the legislation: no public option in the front-end, but if certain conditions don’t prevail after a certain number of years, a public option could be triggered. That was expected to be the draw for her. It’s not in here – why?

Mary Agnes Carey: I think it might be too early in the game to do that. Proponents of a public plan option are pushing vigorously to get this in the bill. Even though it’s not in the Senate draft here, it is in the House bill. We’ve heard Nancy Pelosi, who is the Speaker of the House, come out and say she can’t pass a bill in the House without a public option. So I think that people who want a strong public option will continue to push, and it’s not here now, but that doesn’t mean that it couldn’t be added over time.

Jackie Judd: And one final question, what should we look for over the next week or so? What happens from here?

Mary Agnes Carey: The Senate Finance Committee will begin its markup next week. And I think as you listen for the next few days, different members will come out and talk about this bill. As we sit down to the markup and listen to the opening statements, you’ll begin to see where the votes are. You’ll also begin to see where members might want to amend the bill. As the Senate Finance Committee markup, the consideration, occurs, you’ll begin to see changes that members may want to make to the bill. If they can’t make it in committee, they may try to make it on the floor. So, I think that’ll give us a good preview of how the debate’s going to unfold this fall.

Jackie Judd: OK, we’ll check back with you later. Thank you so much. Mary Agnes Carey of Kaiser Health News. I’m Jackie Judd.