The House and Senate continue to wrestle with health care reform, with significant developments in the past few days. The Congressional Budget Office raised concerns over the bill’s long term ability to control costs, and now centrist Senators are demanding more budget discipline. But the Obama administration’s reform outline has the support of the American Medical Association, and so the White House is not advocating greater cuts on payments to doctors. Labor union support has likewise resulted in the administration putting taxation of health benefits “off the table.” Senate Democrats are considering taxing the most generous employer-provided benefits, while House Democrats have proposed an income tax surcharge on Americans who earn more than $280,000. Approval in committees of the House's 800-page bill (HR 3200) is expected this week. In the Senate, the HELP Committee has moved its bill. However, the critical stop at the Senate Finance Committee awaits Chairman Max Baucus’ success crafting a bipartisan approach. The administration may have to get more involved in negotiating the details than it has been willing to do to this point.