Health Care Reform is Tricky Balancing Act for Obama

A group of powerful senators on the Finance Committee passed their version of a health care reform bill in a 14 to 9 vote this week, putting Congress one step closer to reforming the American health care system, which is said to account for one-sixth of the nation's economy. 
 
Most experts agree that something must be done to control costs, or everyone will soon be spending a large portion of their income on doctors, hospital care and medicine -- hindering the economy as a whole.

At the same time, millions of Americans do not have the health insurance they need to stay healthy or get treatment when they become sick.

Few Republicans support proposals

	Majority Leader Sen. Harry Reid and House Speaker Nancy Pelosi have spent months in negotiations hankering for Republican support of their bills.

For President Obama and Democratic leaders, the negotiations in the next few weeks will be a tricky balancing act of trying to get a few Republicans to support a plan, while not alienating more liberal Democrats. 

Senate Majority Leader Harry Reid hailed the Finance Committee's bill as "bipartisan," even though only one Republican voted for it: moderate Senator Olympia Snowe of Maine.

President Obama called the successful vote “a critical milestone” toward improving health care.

But the Committee's top Republican senator, Charles Grassley of Iowa, said the bill goes too far. "This bill is already moving on a slippery slope to more and more government control of health care," Grassley said. 

Will this health care bill become law?

	Both chambers of Congress must merge two separate versions of legislation in what is called a conference committee.

President Obama has made health care reform one of his top domestic policies, but there are several steps that such major legislation must take before Congress sends him legislation to sign into law.

The Senate Finance Committee is the last of the five congressional committees to pass a health care reform bill. The Senate Health Committee and three committees in the other chamber, the House of Representatives, have also approved separate measures.  
 
Now that both the Senate Finance Committee and the Senate Health Committee have passed health care reform bills, top Senate Democrats will negotiate a merger of the two versions to create a compromise bill that would have enough votes to pass the whole Senate. 
 
At the same time, House Democrats are working to merge the health care reform bills of three different committees with the hope of sending one House version to the floor for debate.

If both the Senate and House pass their own bills, members of both chambers would meet for a conference committee to discuss and merge those two bills.  The compromise bill must then pass both chambers again before it goes to President Obama for him to sign into law or veto.

President Obama has said that he hopes sign health care legislation by the end of 2009.

Health care reform proposals create deep divides

	President Obama initially supported a public option for his plan, but the White House later said it would not have to appear on any bill for him to sign it.

Members of Congress are deeply divided on a number of controversial issues that have been raised amid the goal of dramatically overhauling America's health care system.  
 
Many progressive Democrats, for example, have pushed for a so-called "public option," a government-funded health insurance alternative for people who can’t afford private insurance or don't receive insurance through their employers.

Conservative Democrats and Republicans worry that a public option would cost too much taxpayer money and would give the government too much power over individual health care.

Insurance companies, who spend millions of dollars lobbying Congress, argue that a public option would have an unfair advantage over their plans. 
 
Since the Senate Finance Committee's proposal does not include a public option and the other proposals do, it is likely to be the major issue for congressional leaders attempting to eke out a compromise in the coming weeks.

Cost is a concern

	The bill drafted by Sen. Max Baucus and passed by the Senate Finance Committee requires all Americans to purchase insurance.

Republicans have also argued that while some kind of reform is necessary, the cost of the president's ambitious agenda -- which could cost more than $800 billion over the next 10 years -- would add greatly to the national deficit and place and undue burden on middle-class taxpayers.  
 
Another controversial provision is that of the "individual mandate," which would require all Americans to purchase health insurance. Critics of this proposal argue that it would place difficult financial strains on poor Americans and young people who should be able to choose whether they want health insurance or not.