Health Care Reform Moving Again – Or Is It?

July 29, 2009 ( - Published reports suggest that Democrats have worked through a compromise on a health care reform bill that had been stalled due to cost concerns by a group of fiscally conservative Democrats (a.k.a. "Blue Dogs).

Of course, that agreement – reached with four of those conservative Democrats – sparked immediate grumbling from liberals (who didn’t like what had been stripped out), Republicans (who didn’t like what had been left in), and – a number of the OTHER Blue Dog Democrats (who are still concerned about the costs).   Still, Congressman Mike Ross (D-Arkansas) told reporters the bill would be considered by the Energy and Commerce Committee on Wednesday but the full House would not take up the issue until September, when it returns from its month-long break.  

As for those cost concerns?   Well, Ross said the deal, which followed lengthy negotiations with party leaders and the White House, would shave $100 billion off the price tag of at least $1 trillion.   According to the Washington Post, the Blue Dogs won a new exemption from taxes on businesses that do not provide insurance to employees, doubling the original exemption for companies with less than $250,000 in annual payroll to $500,000.  

Senate Finance

Those concessions notwithstanding, all eyes were really on the Senate Finance Committee, where moderates hoped a more fiscally conservative package might emerge.    

Senator Charles Grassley (R-Iowa), said in an interview with Reuters that although negotiators had reached significant agreement, difficult issues remained to be resolve in financing and cost savings.   He cited tentative agreement on issues of importance to Republicans including no mandates on employers to provide insurance and no new “government run insurance program.”

Senator Max Baucus (D-Montana), the chairman of the Senate Finance Committee, announced that his committee's bill had also been trimmed below the trillion dollar mark, but only to $900 billion - and even that reflects a bit of accounting gamesmanship, according to the Associated Press, which notes that it includes only the cost of the first year of a 10-year, $245 billion program to increase doctor fees under Medicare. House Democrats used a similar sleight of hand, excluding the entire $245 billion when claiming their measure wouldn't add to the deficit, according to the report.

Senator Mike Enzi (R-Wyoming), who along with Grassley and Senator Olympia Snowe (R-Maine), are the only Republicans negotiating with Baucus, said the group is nowhere near a deal.   "We haven't even gotten through the little issues," Enzi said, according to Bloomberg News. Even if the small negotiating group reaches an agreement before the Senate's planned Aug. 7 recess, there won't be time for the full committee to debate, Enzi predicted. "I don't see any way we can finish before the recess."

"Reports in this morning's newspapers are off the mark, and are not helpful to the process," Enzi said in a  statement . "Bad information damages the work we are doing to improve our health care system."