Image: Baucus
Susan Walsh  /  AP
Liberals continue to question the absence of a government-run insurance plan to compete with private industry in Max Baucus' proposal
updated 9/18/2009 11:14:06 AM ET 2009-09-18T15:14:06

Senate Democrats see plenty of room for improvement in a sweeping health care overhaul bill, starting with changes to a tax on high-cost insurance policies that could hit middle-class Americans hard.

Senate Finance Committee Chairman Max Baucus, D-Mont., unveiled his much-anticipated bill this week, and senators who've been waiting for months lined up to offer a bevy of contentious changes. One senator said the bill "needs more than just a few tweaks."

Democrats are concerned about affordability. Republicans almost uniformly oppose the measure and may be loath to hand President Barack Obama a victory on his biggest domestic priority, legislation to rein in skyrocketing health care costs and extend coverage to many of the 50 million uninsured.

After months when health care negotiations in the Senate were confined largely to Baucus meeting privately with five other Finance Committee senators to try to craft a bipartisan deal — ultimately without success — the dynamic was noticeably altered Thursday, a day after Baucus produced his long-awaited bill.

Many more senators were in the mix, and many of them had something to say.

"I can find a handful of things that trouble me," said the Senate's No. 2 Democrat, Dick Durbin of Illinois. He cited a new tax on high-value insurance plans.

The Baucus plan "needs more than just a few tweaks," said Sen. Maria Cantwell, D-Wash., a member of the Finance Committee, saying she wanted stronger measures to control health care costs over the long term.

"Put it in perspective," Durbin added. "For months, the debate over health care in the Senate consisted of six people sitting in a room. Now it's been expanded.

"So we have a lot of people who need to become informed, express themselves, ask for changes if they can," Durbin said.

Underscoring how every lawmaker is under intense scrutiny, the liberal blog Firedoglake.com planned to begin TV ads in Arkansas next week criticizing two of that state's Democratic members of Congress for not fully supporting the health care drive. The $78,000 campaign — a significant sum in that state — was aimed at Sen. Blanche Lincoln, a member of the Finance committee, and Rep. Mike Ross, a leader of the House's moderate Blue Dog Democrats who have sought to keep the bill's price tag modest.

"Senator Blanche Lincoln and Congressman Mike Ross have stood with the health insurance industry and their allies," the commercial says, adding, "Stand with Democrats now, or we'll find someone who will."

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Video: Debate turning dangerous? That was happening in earnest Thursday as Baucus convened a full committee meeting on his bill. Senate Democrats met later, and Republicans from the Finance Committee gathered with Senate Minority Leader Mitch McConnell, R-Ky., to go over strategy for next week, when Baucus will bring his bill up in committee for amendments — there will be many — and votes.

Democratic concerns focused on the new tax on generous insurance plans and on whether subsidies to help lower-income people buy newly required insurance are ample enough. Liberals also continued to question the absence from Baucus' proposal of a government-run insurance plan to compete with private industry. That's a feature of four other health bills in Congress but Baucus omitted it as one of numerous gestures meant to win support from Republicans and moderate Democrats. Baucus included nonprofit cooperatives instead.

His bill also would set up new purchasing exchanges in which individuals not otherwise covered could shop for insurance, and it would bar insurance company practices like denying coverage to people with pre-existing conditions.

Finance Committee Republican Orrin Hatch of Utah was asked on his way out of a meeting with Baucus and others on the committee whether he'd heard anything to lessen his opposition.

Video: Obama’s participates in another media blitz "Actually I've got even more concerns," Hatch said, contending that the cost of the bill would end up being much greater than the $856 billion over 10 years that Baucus has cited. Hatch noted that the cost was kept down partly by limiting to one year an expensive fix to avoid scheduled payment cuts to doctors under Medicare. That change is made permanent in the House Democrats' health legislation, which carries a much heftier price tag over $1 trillion.

Nonetheless, the release of the bill put new momentum behind Obama's push for a health care overhaul, and Democratic leaders in the House and Senate hope to move to floor action in the fall. Obama himself pumped up the plan at a rally at the University of Maryland on Thursday, and is set to appear on Sunday talk shows to push for action.

"There's now agreement in Congress on about 80 percent of what needs to be done," Obama told the crowd.

That last 20 percent could still be tough.

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Video: ‘Gang of six’ turns to four?

  1. Closed captioning of: ‘Gang of six’ turns to four?

    >>> "morning meeting." hopes for a bipartisan health care bill alive amid the criticism from the right and left over senator max because cuss reform plan. two democrats , one republican and one independent vowing to put party aside and craft a better health care package. chuck todd on the beat with the details. hi, chuck.

    >> dylan, look. i think we now see the end game . we now see how this bill is going to become a law. you see olympia snowe and put up up with lieberman and nelson and mccaskill. all of them tells us a couple of things. number one, snowe is in play. we sort of known that and sort have seen it but this is her one public way of doing it. second, is that the democrats are going to need her, the president is going to need her to keep all of the democrats together. but take a listen to what olympia snowe said yesterday about her openness to the bill.

    >> obviously, i'm a republican but, you know, i'd like to have more republicans .

    >> you'd like to, but do you have to some.

    >> well, no. i'm going to support the right policy. i think that is what guides me and governs me. it always has. and i think the right policy will garner the votes.

    >> so as i said the end game is here. we see -- i think we all know how the movie is going to end. the question is what is going to be in the final bill? the movie is going to end and snowe is going to support it and democrats looking like they are coming together. but are they going to do to satisfy both snowe -- keeping snowe on board and keeping those that are in favor of the public option happy? how that compromise is done. is it that trigger? and then how robust is the trigger? all of this stuff. but ultimately, i think sometimes we can play up the drama. we see out how this movie is going to end and pretty good day as far as the white house is concerned.

    >> karen finney, to put up on chuck todd is saying, the very least, a road to the passage of legislation and now the question is does the wyden choice amendment make it and the public option make it end? it feels those are the two big pieces that get a lot of conversation and also generate a healthy amount of debate and health insurance doesn't want full competition or the public option and a lot of people probably want both.

    >> no, i think that's exactly right but i think those are the kind of details and chuck is right. the baucus bill is in a draft form and looks like we will get support on. it's pretty clear something is going to pass and we will get health care reform but agree we can see the end of this movie but i feel this is part one. part two going into the 2010 electio elections, how soon will the american people feel like something has changed? that is going to be critical whether or not people can campaign on this in 2010 . secondly, chuck, he i wonder if you'd a i -- agree on this. who does the job of selling what is in the final package. if democrats don't get out there ahead of republicans and convince theme ps this nair interest we could see this flipping back on us and republicans using it against democrats in 2010 .

    >> dylan, to jump in here. karen is absolutely right. this is the next game here as far as the politics of all this is. we saw how the democrats basically won this fight for the stimulus bill but lost the pr battle. the fact is they've lost that pr battle. poll after poll shows that the country doesn't see what the stimulus bill did. they don't see it as a benefit yet. maybe they will. but so far, the republicans won that pr war. there are two things that karen brought up. i agree. i think the implementation of this thing once they get something pass, how does it get implemented that make people feel like they have change for the better.

    >> two things i'll say there. absent a real exchange everybody can choose from so people like us or anybody else that would want to look at all of our health care options as congress is able to you would feel that immediately and everybody would be able to see that. that is a digital platform. then, obviously, the public option. a mandate, they have to do more and they are going to feel like they are not getting that much for a while unless you get real choice or a public option from what i can see, chuck.

    >> not just that. i mean, look. a lot of major companies are going to, you know, what is going to happen is a lot of people that work, that have insurance, are going to hear from their companies. they are going to hear from the corporate hr departments in ten and 11:00 saying we're going to reconfigure things here a little bit and shop around because it will become a good time to shop around because private insurers will respond to the new rules and there will be different things. how people react to that. some people will react favorably and some people will react unfavorably because maybe they like what they have.

    >> brad, if you accept chuck todd 's analysis that there is a road to legislation to kind of come back to some of your comments which speak to the democrats ' ability to drive the legislation one way or another particularly if they can get a republican on the board. if republicans accept a road to legislation how do the republicans push on the legislation to put their view on it on a way that is constructive to that party and the country?

    >> we've already told the democrats , told the white house what would be acceptable to the republicans and if the president is right, right now, there's 80% agreement my 'tis to the president and the democrats in congress why don't you go with 80%? tell the more radicals in your party and let's get tort reform and portability and let's let people sell and buy across state lines. let's get rid of fraudness management and abuse in the health kir care we already provide. here is the hidden message here. the democrats trigger for legislation to take effect no matter what that legislation is in tlen 2013 has to create mischief what the implementation will be. the democrats will be smrt smarter to move up. they don't want a record to run on whatever health care is passed.

    >> brad makes an interesting point, karen . which is there is all of this talk of the health reform and without real competition and a real exchange for everybody to look at suddenly you can logon and say who is the cheapest plan. everybody gets to do that. not just the freelance graphic artist or some kid out of school but all people absent a real impact like that you would think the democrats are vulnerable to all sorts of attacks because of the time lines and the mandates.

    >> look. i don't disagree with that. that's why i say i think it's important when the final bill is passed there should be a political calculation people need to feel something has changed for the better fairly quickly. back in the '90s initially the clinton pan they were trying to get it passed in six months. obviously, that didn't happen. people need to feel when they get this information from various insurance companies there will be confusion potentially. how this is rolled out to people so they understand what happened and how it affects them and what they need to do is critical.

    >> i don't see -- affiliate carrying on if you don't deliver real choice to everybody, i think it would be a political disaster.

    >> even if you have choice and you don't know it.

    >> right. that's why you have to create a choice platform and you have to sell that platform day one, even if it won't be implemented for some time or people will feel like they got a bunch of new rules and not much else. one last piece of business i want to take care of. brad, i called you an idiot which is totally inappropriate on my part because i think very highly of you and i lost my temper there and i apologize and i enjoy having you in this conversation. i'm sorry, brad.

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