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THE PROGRESSIVE REVIEW - November 30, 2009
Senate Health Care Bill About to Enter a Political Minefield
by: David Lightman
McClatchy Newspapers
Washington - The Senate is ready to begin a volatile, high-
stakes health care debate that's sure to be punctuated by
tense and unpredictable battles over some of the most
incendiary issues in American politics today.
Debate on the $848 billion bill to overhaul the nation's
health care system is expected to start next week, after
the Senate returns from its Thanksgiving recess, and many
lawmakers already consider it a golden opportunity to win
long-sought projects and local aid for their constituents.
The flashpoints will be familiar: abortion, federal
deficits, government involvement in health care decisions
and other hot topics - and many Democrats already have
said they want to see, and are well-positioned to seek,
changes in the bill.
In fact, the legislation is moving ahead only because it
got 60 votes Saturday night to proceed, the minimum needed
just two weeks after the House of Representatives? version
squeaked through by five votes.
"I, along with others, expect to have legitimate opport-
unities to influence the health care reform legislation
that is voted on by the Senate later this year or early
next year," said Sen. Blanche Lincoln, D-Ark., who was
Saturday's 60th vote to break a Republican filibuster
and start debating the bill.
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Sen. Mary Landrieu, D-La., was the 59th vote, and the bill
could provide her state with an estimated $300 million in
help for health care for the poor.
Sen. Ron Wyden, D-Ore., got the bill altered Friday so more
people would have access to its health exchanges, market-
places where consumers could shop for coverage and rates.
Sen. Ben Nelson, D-Neb., was said to be pleased that the
bill lacked changes in federal antitrust law protection
for the insurance industry.
They all voted yes Saturday, saying they were motivated by
a desire to let debate proceed, but many Democrats still
had qualms.
"There is a great deal more work that needs to be done,"
Landrieu said, particularly to help small businesses.
Democrats can expect little help from Republicans, who
stuck together Saturday to oppose proceeding and vowed
that Democrats would pay a political price if the bill
remained largely intact.
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"This 20-pound bill is the size of most people's turkeys
next week," said Sen. Richard Burr, R-N.C., "and that's
what most people in North Carolina think of this bill."
The measure would require most people to obtain insurance
coverage. It would set up health insurance exchanges and
offer them the alternative of a government-run program, or
public option. In most cases, people would pay fines if
they didn't get coverage.
At least four areas are likely to be major flashpoints:
* Abortion. At least four Democratic senators are
considered staunch abortion foes, and they're likely to be
uncomfortable with the Senate bill's provisions that allow
abortion coverage in federally subsidized plans, as long
as only private funds are used to pay for such coverage.
The House legislation is more restrictive.
* Public option. The plan in the Senate bill, which would
allow states to opt out, makes a lot of Democrats nervous;
at the moment, it lacks the 60 votes needed to overcome
procedural hurdles.
"Who pays if it fails to live up to expectations?" asked
Lincoln.
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* Budget deficits. The nonpartisan Congressional Budget
Office estimates that the bill would cut $130 billion
from the deficit over 10 years, but many experts and
legislators are skeptical that it can achieve that without
cuts in Medicare and other programs that politicians are
unlikely to make.
* Affordability. "Many Americans will be required to
purchase health insurance that is more expensive... than
the coverage they currently have," said Sen. Susan Collins,
R-Maine, a GOP moderate.
The CBO did find that people enrolling in the public option
"would typically have premiums that were somewhat higher
than the average premiums for the private plans" people
could buy through the new exchanges.
Despite all these controversies, Democratic leaders said
that near-universal coverage legislation, a goal of party
leaders since the 1940s, has now proceeded farther than
ever before.
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