Health reform effort picks up momentum

Sen. Max Baucus, D-Mont., hopes that revisions to a health care reform bill will increase support for the measure. PHOTO: AP PHOTO

WASHINGTON—Congressional progress in drafting health care reform legislation has been much slower than top lawmakers predicted, but the pace of activity soon could pick up.

Only a few weeks ago, Sen. Max Baucus, D-Mont., the chairman of the Finance Committee, said he expected the committee to begin considering a reform bill in mid-June. Sen. Baucus' panel is widely considered to as have the best chance of hammering out a bill that could pick up some Republican support.

After that, Sen. Baucus said, the full Senate would begin work on the bill sometime in July and complete action just before the August congressional recess.

But the Finance Committee has yet to produce a bill, with Sen. Baucus now not making any predictions on when a bill will be ready for action.

“Sen. Baucus recognized there was a need to slow down,” said Chantel Sheaks, a principal with Buck Consultants L.L.C. in Washington.

At the same time, another Senate panel—the Health, Education, Labor and Pensions Committee—has been slowly and with great difficulty considering a measure proposed by panel chairman Sen. Edward Kennedy, D-Mass., and Sen. Chris Dodd, D-Conn.

Republican members of the panel, who are strongly opposed to the measure, have been proposing dozens of amendments—with few, if any, likely to pass—considerably slowing down the committee's consideration of the measure.

“Republican members feel they need to underscore their differences with the majority,” said Paul Dennett, vp-health care reform with the American Benefits Council in Washington.

In the House, progress also has been slow. While the chairmen of three House committees earlier this month released an 852-page discussion draft, many key issues were put aside, such as what employers, due to their size, would be exempt from a requirement that they provide coverage or be hit with a hefty financial assessment.

In addition, no committee votes have been scheduled on that proposal.

And last week, health care reform backers received an unexpected jolt with the Congressional Budget Office reporting that the HELP Committee bill would require $1.6 trillion in new federal revenues over a 10-year period, while the measure still would leave roughly 30 million of the nation's 46 million uninsured without coverage.

Receiving those grim numbers was very “sobering” for congressional reform leaders, Mr. Dennett said.

Those figures sent legislators “back to the drawing board,” he added.

But just before legislators left Washington last week for a one-week break, reform advocates received encouraging news.

Sen. Baucus said the CBO estimated that a newly revised proposal would cost $1 trillion over 10 years and ensure near-universal coverage. Details of the proposal have not yet been released.

With those new estimates, “I'm even more confident in our ability to move forward,” Sen. Baucus said at a news briefing.

While lawmakers will be out of town, Finance Committee staffers will remain in Washington, working to assemble a bill that will attract widespread support.

“Staff is actively engaged on a daily basis. If an agreement can be reached behind the scenes, a committee markup won't have to take that long or be that difficult,” said Frank McArdle, a consultant with Hewitt Associates Inc. in Washington.

In fact, while the legislative timetable may have slipped, “The fast-moving reform train has not derailed,” Mr. McArdle said.

Observers say the factors driving reform—a president for whom enactment of reform legislation is a top legislative priority and Democrats having substantial control of both branches of Congress—haven't changed, making the odds of a bill being enacted very high.

“Too many people have invested too heavily for them to come up empty-handed,” Mr. McArdle said.

Still, decisions on many key issues have yet to be made. Observers say legislators are trying to decide up to what level income federal health insurance premium subsidies would be available to the uninsured.

Other key issues before legislators is how an employer health coverage mandate would be structured and what portion of employer-paid health insurance premiums would be included as taxable income to employees.

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