Senate Democrats Aim to Keep Caucus Together on Health Care

Even after a successful vote in the Senate Finance Committee on Tuesday, October 13, that attracted one Republican, Democrats face challenges in putting together enough support to push abroad health care reform bill through Congress this year.

The Senate panel approved a measure, 14-9, that addresses most aspects of the health care system—mandating that individuals obtain health insurance and ensuring that it cannot be denied because of illness or pre-existing conditions.

Sen. Olympia Snowe, R-Maine, the only committee Republican to support the bill, cautioned that she was only trying to move the legislative process forward.

“My vote today … doesn’t forecast what my vote will be tomorrow,” Snowe said.

Observers were hanging on Snowe’s decision because she has been the only congressional Republican so far to indicate willingness to support any of the health care measures that have come through three House and two Senate committees.

Several Finance Committee Democrats also outlined reservations about the panel’s bill, which had been in development for months and required eight legislative days of committee markup. They supported the measure in order to advance to Senate floor debate, where they plan to offer amendments to shape a final bill.

Most Finance Committee Republicans asserted that the measure was too costly and represents a government takeover of health care.

“We can now see clearly that the bill continues its march leftward,” said Sen. Charles Grassley, R-Iowa and ranking Republican on the panel.

The House labor, tax and commerce committees as well as the Senate health committee all approved bills over the summer that feature an employer mandate and so-called public option, or government-run health care plan for people under 65. The Senate Finance bill does not include either provision.

The bills contain similar insurance market reforms. Each House measure tallied more than $1 trillion over 10 years, according to the Congressional Budget Office.

The Senate Finance bill would cost $829 billion and reduce the deficit by $81 billion, the CBO said. In a September speech to Congress, President Barack Obama said that a health care bill must not add “one dime” to the federal deficit.

The successful Finance Committee vote was a breakthrough for the issue of comprehensive health care reform, which has now made significantly more progress than an attempt early in the Clinton administration 15 years ago.

But the biggest obstacles remain, as Democratic leaders now meld their various bills into one measure in each chamber.

That process gives Snowe pause. Over the course of the 4½-hour Senate Finance meeting, she emphasized that the combined Senate bill must adhere to the deficit-reduction parameters of the Finance Committee’s measure in order to maintain her vote.

She urged that the CBO conduct a cost analysis of the merged bill before the Senate takes final action, a demand that could push Senate floor debate off until late October.

The omnibus Senate bill will be cobbled together largely by Senate Majority Leader Harry Reid, D-Nevada; Sen. Max Baucus, D-Montana and chairman of the Finance Committee; and Sen. Christopher Dodd, D-Connecticut, of the Senate health committee.

Snowe will be watching closely. “I’m going to take it step by step every day,” she told reporters after the Finance Committee vote.

In addition to keeping Snowe on board to maintain at least minimum bipartisan support, Democrats must hold their own side together. The Senate Democratic caucus totals 60, exactly enough to squelch a filibuster.

But Democratic health care fissures surfaced during the Finance Committee vote. Sen. Charles Schumer, D-New York, said that he will fight to add a public option on the Senate floor.

“To cut costs, we must have a public option in the final bill,” he said. “It will hold the feet of insurers to the fire.”

Schumer also said that he will work to change the excise tax on high-cost insurance plans contained in the Finance Committee bill. That 40 percent levy is one of the primary ways that Baucus seeks to contain health care costs.

Sen. John Kerry, D-Massachusetts, expressed concern about the lack of an employer mandate in the committee’s bill and said that he would push for one during debate in the full Senate.

But Baucus said his bill is balanced and provides the best chance to achieve a filibuster-proof majority.

“We need 60 votes,” he told reporters after the Finance Committee meeting. “That’s the real imperative here.”

—Mark Schoeff Jr.  

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