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As Lawmakers Craft Health Care Reform, Concerns Rise Over Costs

June 17, 2009 at 6:50 PM EDT
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Concerns over the possible costs of health care reform are growing louder on Capitol Hill as lawmakers begin to hammer out legislation. Betty Ann Bowser recaps the latest developments on where the reform debate.
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JIM LEHRER: And finally tonight, the Washington struggle to craft a health reform plan. NewsHour correspondent Betty Ann Bowser reports for our Health Unit, which is a partnership with the Robert Wood Johnson Foundation.

BETTY ANN BOWSER: Work on health care reform legislation began in earnest on Capitol Hill today, but concern over how to pay for it loomed large.

SEN. JUDD GREGG, R-N.H.: How do you mark up a bill that you don’t know how much it costs when you’re trying to amend the bill and you’re concerned about the cost?

BETTY ANN BOWSER: On the Senate side, the Health, Education, Labor and Pensions Committee began to mark up its bill, a process in which Democrats and Republicans try to reach consensus on what the final bill should contain. The bill is one of two being hammered out in the Senate.

SEN. CHRIS DODD, D-Conn.: This bill affects everybody; 100 percent of our fellow citizens will be affected by what we do in the area of health care, every consumer, every business, every provider, as well. And so this is truly historic, the journey that we’re beginning this morning in this committee to deal with this issue. It may be that none of us will ever work on another issue as significant as the one that we’re charged to respond to.

BETTY ANN BOWSER: Connecticut Democrat Christopher Dodd is leading the committee in the absence of chair and sponsor of the bill, Sen. Edward Kennedy, who’s being treated for brain cancer.

SEN. CHRIS DODD: He’ll be missed during this markup, but he wanted to warn all of us that he’s watching on C-SPAN.

Millions would remain uninsured

BETTY ANN BOWSER: Negotiations over this bill and others have been roiled by sky-high estimates this week from the nonpartisan Congressional Budget Office. The CBO found that the Kennedy bill alone would cost about $1 trillion over the next decade and would still leave about 37 million Americans without health insurance. Currently, there are nearly 50 million uninsured in the country.

The final numbers may change, because key details on some of the most contentious issues have not been plugged into the 600-page-plus Kennedy bill, including: a new public insurance plan that would compete with private insurance companies and whether employers would be mandated to provide health care for their employees.

At today's markup, several senators spoke out about the cost. Arizona Republican John McCain.

SEN. JOHN MCCAIN, R-Ariz.: So how in the world do we expect to reasonably address this when we now have CBO estimates that this bill would be some trillions? Others estimate more than $1.6 trillion, others as much as $4 trillion.

How in the world do we expect to reasonably authorize -- maybe there's good things, maybe there's not in this -- without a cost estimate? It is a joke if we run through this stack of papers here without having some provision, and I suggest we not move forward until we have some provision as to how we're going to pay for it.

SEN. CHRIS DODD: Well, Senator, the point is, I think we've already gotten numbers on a lot of the scoring, a good part of it. The areas that we have not yet...

SEN. JOHN MCCAIN: You do?

SEN. CHRIS DODD: Yes, we do. And we have CBO scores for the bill as filed.

SEN. JOHN MCCAIN: We have new CBO scores, as just -- a couple of days ago, the CBO says that it's likely to -- coverage of the uninsured is likely to dig the nation deeper into debt unless policymakers adopt politically painful controls on spending, et cetera, et cetera. And, obviously, the CBO estimates that came out yesterday are much, much higher than we had been originally estimated, and we have yet to pay for them.

Debate over saving money

BETTY ANN BOWSER: While senators convened with Dodd, another key committee was negotiating.

In the Senate Finance Committee, Democrats and Republicans met behind closed doors, going over a draft of what would be a bipartisan bill. And here, cost, too, was on the table, as legislators tried to get the cost of their version of the bill down to $1 trillion.

Democratic Senator Max Baucus, chairman of the Finance Committee, had earlier indicated the bill would be ready for scrutiny today, but now says that may have to wait until after the July 4th congressional recess.

SEN. MAX BAUCUS, D-Mo.: We'll have a mark when we're ready. And I'm doing my doggonedest to be ready. We're not ready yet.

BETTY ANN BOWSER: Republican Senator Orrin Hatch said, in light of the CBO cost estimates, the committee needs to take a deep breath and slow down.

SEN. ORRIN HATCH, R-Utah: We at least ought to take the time to do this right. We at least ought to listen to both sides. We at least ought to find some ways of working out the past mistakes and trying to correct them well into the future.

BETTY ANN BOWSER: Democrat Kent Conrad has floated the idea of creating nongovernmental cooperatives that would offer low-cost health insurance to Americans. He said that's one way money could be saved and that members are talking about it.

SEN. KENT CONRAD, D-N.D.: Co-op model has the advantage of being membership-run, membership-controlled, and also a very successful business model for a long time in this country across many industries.

BETTY ANN BOWSER: Meanwhile, House Republicans known as the GOP solutions group outlined their plan to solve the nation's health care crisis. Their plan calls for tax breaks on insurance premiums both for people who get their plans individually or from their companies and a provision that would allow people to keep their insurance regardless of job change or loss.

House Minority Leader John Boehner.

REP. JOHN BOEHNER, R-Ohio, House minority leader: We take the current health care system and improve it to make it work better for all Americans, provide easier access to health insurance for those who can't afford it, to make sure those with pre-existing conditions have access to affordable health insurance.

And if you look at this plan, it really will insure most Americans. It really will improve the quality of our health care system and maintain the innovation that we have in our current system.

BETTY ANN BOWSER: It's unclear how much the Republican plan would cost. House Democrats could unveil a draft of their health care reform bill this week.