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Health Reform Vote Set for Senate Finance Committee

October 8, 2009 at 12:00 AM EDT
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The Senate Finance Committee will vote next week on revamping the nation's health care system. Kwame Holman reports.
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JIM LEHRER: Democrats and Republicans began gearing up today for key votes on health care reform. That’s after the leading Senate bill won a favorable report on cost and coverage.

NewsHour congressional correspondent Kwame Holman begins our “Lead Story” coverage.

MAN: The Senate will come to order.

KWAME HOLMAN: At the start of business this morning, Senate Majority Leader Harry Reid named the date for final action in the Finance Committee.

SEN. HARRY REID, D-Nev., senate majority leader: That bill will be voted on by the Finance Committee on Tuesday morning and be reported to the Senate.

Mr. President, since Harry Truman was president, Democrats have fought to make it more affordable to live a healthy life in America. Every day, we come closer to achieving that goal. Yesterday was a landmark occasion.

KWAME HOLMAN: That occasion was a newly published estimate on Senator Max Baucus’ bill. The Montana Democrat chairs the Finance Committee.

The Congressional Budget Office projected the cost at $829 billion over 10 years, about $70 billion less than Baucus’ own estimate. The CBO said the bill would ensure coverage of 94 percent of eligible Americans, more than Baucus expected, and it would reduce the deficit.

But Senate Republican leader Mitch McConnell answered, the CBO’s accounting is irrelevant. He said the Baucus bill ultimately will be merged with other, more expensive versions.

SEN. MITCH MCCONNELL, R-Ky, senate minority leader: It doesn’t tell the whole story. The fact is, the bill it’s referring to will never see the light of day, and we all know that.

The other numbers we have seen are intended to explain how much this bill will cost over 10 years. What most people don’t realize is that the new plans won’t go into effect for another four-and-a-half years. So, what’s being sold as a 10-year cost is really a five-and-a-half-year cost. That means you can take the numbers you are getting and nearly double them.

KWAME HOLMAN: Beyond the numbers debate, the fate of a public option remained in doubt. It is not included in the Baucus bill, but, on the House side today, Speaker Nancy Pelosi said it will be the bills the House submits to the Congressional Budget Office.

REP. NANCY PELOSI, D-Calif., speaker of the souse: We’re in a very good place, because we have many good options. And that’s why I’m so pleased about where we are. Through consensus, through discussion and the rest, the members have rallied to a place where they will have — there will be the votes for a public option. Now it’s a question of which one.

KWAME HOLMAN: Pelosi also said she’s considering adding a windfall profits tax on health insurance companies to pay for the bill.

But House Republican Leader John Boehner quickly condemned that idea.

REP. JOHN BOEHNER, R-Ohio, house minority leader: Listen, I used to run a small business. If somebody raised my costs, what am I going to do? I have got to pass it on. And that’s exactly what is going to happen here. And, so, Americans who have policies today will end up paying higher premiums to cover the cost of this tax. It’s just — it’s not appropriate and it’s unnecessary.

KWAME HOLMAN: At the White House, Press Secretary Robert Gibbs welcomed the CBO report on the Baucus bill, but he did not commit to pushing for the public option.

ROBERT GIBBS: The head of that process is obviously going to be the Senate majority leader working with members of relevant committees in the Senate. And I presume that we will get a chance to look at and have some comment on those bills.

KWAME HOLMAN: For now, the outcome in the Senate Finance Committee hinges on key members from both sides. It was unclear today how they will vote.

Baucus bill 'gets a boost'

Norman Ornstein
American Enterprise Institute
This gives Max Baucus -- it's his bill -- a big boost, compared to other alternatives that are out there.

JIM LEHRER: And to Judy Woodruff.

JUDY WOODRUFF: We take a closer look now at the impact of the past 24 hours, as well as the hurdles ahead.

And, for that, we turn to two people who watch Congress closely. Julie Rovner is a health policy correspondent for National Public Radio. And Norm Ornstein is resident scholar at the American Enterprise Institute.

Thank you both for being here.

Norm, I'm going to start with you.

Why does this calculation from the Congressional Budget Office matter?

NORMAN ORNSTEIN: It matters because everybody has accepted the Congressional Budget Office as the arbiter here on the costs that are involved.

It matters on the floor of the Senate, potentially. If Senate Democrats decide that they want to use budget rules in a particular way, these numbers will govern it. But it also matters politically in a couple of other ways, Judy. This gives Max Baucus -- it's his bill -- a big boost, compared to other alternatives that are out there.

A bill -- a rival Senate bill that emerged from the Health, Education, Labor and Pensions Committee actually runs into big deficits over 10 years, even though it covers more people, and the same with the bill that first emerged in the House.

So, Baucus has a little bit of comparative advantage now to say, look, I can do it.

And, secondly, President Obama set down as a bottom line when he gave his address to a joint session of Congress that this bill should be below $900 billion, and it should be balanced, period, at least over 10 years.

To come in with something that shows that it could actually reach a surplus, with some problems we can talk about later, over 10 years, and then actually save more money over a longer period of time, whether it's true or not puts everybody in a position where they can justify the bill.

Effect of CBO report

Julie Rovner
National Public Radio
These are numbers that -- that do not do any harm to this bill. It will certainly get this bill out of committee, which, after all, is the next most important step in this entire process.

JUDY WOODRUFF: Julie, how do you see this affecting the fate of health care reform?

JULIE ROVNER: Well, I think the one thing that was important about the CBO report, it doesn't necessarily to that much for the bill, but it certainly could have sunk it.

What everybody was really worried about was that the -- the numbers were going to come in very high, perhaps over a trillion dollars -- that didn't happen -- or that it was going to not cover that many people. That didn't happen, although, in fairness, the House bill would cover many more people, about eight million more people after 10 years, than the Senate bill would.

But, certainly, these are numbers that -- that do not do any harm to this bill. It will certainly get this bill out of committee, which, after all, is the next most important step in this entire process. That was the main thing, was that the CBO report do no harm to the Senate Finance Committee bill.

JUDY WOODRUFF: Julie, what about the complaint from the Senate minority leader, Mitch McConnell, that this is irrelevant, that the final bill is not going to look anything like the Baucus bill?

JULIE ROVNER: Well, that's probably true. I mean, what will happen next is that there will be a final vote on Tuesday in the Senate Finance Committee.

One presumes that, thanks to -- in part to these numbers, that there will be enough votes to get the bill out of the Finance Committee. Even the Democrats who don't particularly like this bill for one reason or another will probably vote to get it at least to the next step.

Then, what happens is that they go into Harry Reid's office and it is merged with the Senate Health Committee bill in some fashion. We don't yet know what fashion. Then that merged bill will come to the floor. So, the minority leader is right that there will be some -- some mixing of the bill from both committees that we will then next see on the Senate floor.

JUDY WOODRUFF: So, Norm, look ahead with it, so it does -- so, the bills at some point are merged, assuming it does come out of Finance -- the Finance Committee.

NORMAN ORNSTEIN: Yes.

JUDY WOODRUFF: What happens on the floor? What are the expectations there?

NORMAN ORNSTEIN: Well, we're going to see Harry Reid, along with Baucus, Tom Harkin, Chris Dodd, and other key senators, mostly on the Democratic side, but with an eye towards Olympia Snowe, who's a key player on this committee, try and...

JUDY WOODRUFF: A Republican.

NORMAN ORNSTEIN: A Republican, so that they can make it bipartisan -- try and come up with a package that will pass CBO muster in some fashion, probably not as well as this, as Julie said, and that can get the votes on the floor.

We still don't know whether they're going to aim to get 60 votes -- that's what they would like to do, because that's what's required to overcome a filibuster -- or whether, in the end, they will fall back on a budget rule that enables them to go for 50 votes with a narrower package.

We're probably going to see that emerge over the next two weeks or so. On Tuesday, we get a vote on the Finance Committee bill. There's some talk that Harry Reid is going to do a test vote that evening in the Senate to see if they're close to 60 votes.

JUDY WOODRUFF: That quickly?

NORMAN ORNSTEIN: They're not going to do much with it, but it will be a couple weeks later down the road. At the same time, the House of Representatives, as Speaker Pelosi suggested, is trying to come up with its own bill, a very different one, that it will bring to the floor along the same track.

JUDY WOODRUFF: And I want to get to that in just a second, but, Julie, what about the substantive hurdles that have to be overcome on the floor of the Senate? What are the main things that are going to be -- that you're -- we're going to see debated before there's a vote?

JULIE ROVNER: Well, of course, the first thing, there are a lot of senators -- this is going on in the House, too -- there's this desire to actually see legislative language for 72 hours before there's a vote.

So, they have to put this bill together. Now, the Senate Finance bill, it's important to mention, is not in legislative language yet. It's still in what we call this conceptual form. They have been -- they went through two weeks of amending from basically, you know, paragraphs, just, you know, this bill, paragraph, this section of the bill would do X. And they actually haven't had the legislative language yet.

And CBO was a bit cranky about trying to do a cost estimate when they hadn't seen legislative language. So, it's going to have to be drafted into legislative language. They need to get what's called a motion to proceed. That will take probably 60 votes. So, that could take a week or so to just get to the bill.

So, this could take many, many weeks. People, you know, are talking about getting this bill done by Thanksgiving. They will be lucky to get it off the Senate floor by Thanksgiving.

Obama's next move

Norman Ornstein
American Enterprise Institute
The White House will clearly be stepping in with some preferences, but they're not going to endorse something that might not be in the final package.

JUDY WOODRUFF: And, meanwhile, there are disagreements over the cost, over how to pay for it, the cost, the subsidies to people who can't afford, who's covered. I mean, all those things are -- are very much a part of the argument.

NORMAN ORNSTEIN: And they divide the Democrats, even as much as you have got some strong Republican opposition.

One of the ways in which, of course, this bill that is coming out of the Finance Committee reached balance and surplus was by taxing these so-called Cadillac health care plans, the very expensive ones. But many of those plans actually go to people in states like Maine, where Olympia Snowe comes from, because it's such a high-cost state.

And they're not CEOs getting all of these tremendous benefits. You have unions that are upset about this possibility and the fact that, even if the level is high now, if it's not indexed for inflation, maybe it will hit middle-class people later on.

You have got taxes on providers, which are dividing Democrats as well. So, we have got a lot of areas of controversy not over what the plan delivers, but how it's paid for.

JUDY WOODRUFF: How do you see those main areas of controversy getting resolved or not?

JULIE ROVNER: And, of -- and, of course, and you still have this question about the public option. Will there be a public option and government-run plan for people to choose? It did not pass the Senate Finance Committee.

There were two different variations that were offered. They both failed. This will come back on the floor. It's a way, senators say, proponents say, to bring down health care costs. The Congressional Budget Office says in the House that it would bring down health care costs. So, it is a -- it is a big issue.

Moderate Democrats do not want to vote for it.

JUDY WOODRUFF: Right.

JULIE ROVNER: So, it affects their ability to get 60 votes. But there are some more liberal Democrats who don't want to vote for a bill that doesn't have it, exactly what they're going through in the House.

JUDY WOODRUFF: And we just heard the president's spokesman not going so far as to say that the president is going to go -- go all the way to back the public option.

So, Norm, what role does the president play in the weeks to come?

NORMAN ORNSTEIN: We -- I would expect the president will step in, but not while we're going through these -- these negotiations in the Senate, although I would expect Joe Biden and Rahm Emanuel to be there while they're trying to put this package together.

And one element of this is not just whether you have a public option, but whether you can do something that's a little bit short of a full-fledged public option that satisfies Olympia Snowe. A trigger is something that she talked about. If you don't reach a certain level, you can have a trigger -- maybe something that works state by state.

They may find some way of bridging the gap here. The White House will clearly be stepping in with some preferences, but they're not going to endorse something that might not be in the final package.

JUDY WOODRUFF: Julie, you have been covering this issue from the beginning, even before the beginning.

JUDY WOODRUFF: How does it feel to you right now?

JULIE ROVNER: Well, you know, it does feel like it's kind of moving inexorably forward. For all the -- the -- everything that they went through in August, all the efforts to really try to stop it -- I described it as this blob that is moving forward very slowly, three miles an hour. But all these efforts to shove it off track really don't seem to have worked.

So, it's not going very fast, but it does seem to be going forward.

JUDY WOODRUFF: So, think of this as a big blob.

JUDY WOODRUFF: All right, on that note, Julie Rovner, Norman Ornstein, thank you, both.