WASHINGTON — The Senate Finance Committee will hold a landmark vote on health-care reform legislation today that is expected to underscore the deep partisan divisions that have emerged and hardened over five months of debate.
With few, if any, Republicans expected to support the bill sponsored by Chairman Max Baucus, D-Mont., Democrats have already begun their own internal negotiations aimed at reconciling the various measures passed by House and Senate committees. As part of that exercise, lawmakers are reviving ideas that had been discarded, including a new approach to a government insurance plan that appears to be gaining support with party moderates.
The finance panel's vote marks a watershed in the quest to overhaul the country's health-care system. Not since President Theodore Roosevelt proposed universal health care during his 1912 campaign has any such bill ever come this far.
As the action shifts to the House and Senate floors in the coming weeks, a handful of major issues and many smaller ones remain unresolved. The two chambers disagree on how to pay for the legislation, with the Senate preferring a tax on high-value insurance policies as the main revenue-producing measure, and the House a surcharge on millionaires. Liberal Democrats want to penalize companies that do not provide coverage to their employees; moderate Democrats would take a less punitive approach. And many lawmakers remain unconvinced that the insurance policies Congress would require people to buy would be affordable.
But so far, negotiators are trying to smooth out wrinkles before they become major rifts. "We are much closer than we've ever been. I think we're going to make it," said House Energy and Commerce Chairman Henry Waxman, D-Calif., a co-sponsor of the House legislation.
In the Senate, negotiations are shifting from the public forum of the Finance Committee to a more cloistered setting: the seating area in front of the marble fireplace in the office of Majority Leader Harry Reid, D-Nev. After today's vote, Baucus will retreat to Reid's office along with Sen. Christopher Dodd, D-Conn., and a handful of top White House officials to meld the finance panel's package with an alternative bill that Dodd shepherded through the Senate health committee in July.
The Finance Committee bill is the only legislation on the table that meets President Obama's objectives of providing coverage to the uninsured and barring insurance discrimination based on sex and pre-existing conditions, among other factors – all for less than $900 billion over 10 years, and without adding to the deficit.
Many liberal Democrats, however, view the panel's effort as too meek in key areas.
The measure does not mandate that businesses provide coverage to their workers. Committee members defeated two versions of a government insurance option. And the bill would tax high-value policies that, to the dismay of many liberal lawmakers, could affect some union households.
Senior Democrats, including Sens. John Kerry, Mass., and Charles Schumer, N.Y., both liberal members of the finance panel, are urging Reid to address these perceived shortcomings before the merged bill reaches the Senate floor. But Reid has told colleagues that he is reluctant to produce a measure that proves too divisive within his caucus. Regarding a government-funded, or public, insurance option, in particular, he has said he wants proof that a provision would attract broad support within the party before it is included.
One proposal attracting considerable attention originated with Sen. Thomas Carper, Del. and would allow states to decide whether to create their own insurance plans or join forces to provide coverage in collaboration with neighboring states. Other Democrats want to take the state-based approach a step further, creating a national public plan that states could join.
"I think something like that is likely, and...
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