Nearly one month after the end of a tumultuous August, one might ask about health care reform: “Are we there yet?” This question raises both the element of time and of content. Are we close to having reform legislation that is ready for President Obama’s signature? Do we know what that legislation might look like?
Over the last week, most of the focus has been on the Senate Finance Committee bill. Senate Finance Committee Chairman Max Baucus (D-Mont), is preparing his committee to finish its bill by Thursday or Friday of this week. If this timetable holds, then Senate leaders predict that a merged Senate bill between the Finance and Health, Education, Labor and Pension (“HELP”) Committees could be ready for a vote on the Senate floor by mid-October. However, the Finance Committee bill is far from a done deal as the Committee must wade through numerous proposed amendments and, perhaps more importantly, Senate Democrats remain divided and no Republican supports it.
Despite predictions of its demise, the oft-maligned government- run public option is still on the table in discussions of both Senate and House legislation. It is expected that, on Tuesday September 29, Senators Charles Schumer (D-NY) and Jay Rockefeller (D-WV) will offer two different amendments to the Senate Finance bill to add alternative versions of a public option – Senator Schumer signaling that one proposal may be more “robust” than the other. Also, the liberal Democrats in the House have not softened their resolve for a robust public option, a call which was echoed throughout the ballroom last Thursday evening during a reception held in honor of Congressional Black Caucus members.
In the Senate, Majority Leader Harry Reid (D-NV) and his aides are making it known that they are bracing for the daunting challenge of melding the two competing Senate proposals into a single bill that will garner the votes of both liberal and moderate Democratic Senators and, perhaps, pick up the vote of one or two Republicans – namely Senator Olympia Snowe (R-ME) who has not rejected the Senate Finance bill and Senator Susan Collins (R-ME) who is still being wooed by the White House. At this juncture, Senator Reid is signaling that it will require the direct involvement of President Obama to mediate the disputes among the sharply-divided Senate Democratic caucus.
Meanwhile in the House of Representatives, House leaders are still trying to combine the three versions of the Tri- Committee bill, addressing some of the provisions which have drawn the most fire and are trying to bring down the bill’s cost. Each version of the Tri-Committee bill includes a government-run public option and some form of public option that will likely survive in a House bill brought to a floor vote. However, opposition to a public option by the Blue Dog Coalition members has stiffened since the Senate Finance Committee released a bill without a public option. Now, some are questioning whether House Speaker Pelosi has sufficient votes to pass the bill with, or without, a public option.
The bottom line is that there is still a lot of heavy lifting to be done in both the House and the Senate before floor votes in the Congress. All of this occurring in the next couple of weeks is a laudable goal. Perhaps Karen Ignagni, the President of America’s Health Insurance Plans, was correct last week when she suggested that health care reform stands a better chance of being decided in December (if not later) than October.