Lawmakers working to overhaul the U.S. health care system face a pressure-filled July after leaving town this week without resolving the biggest questions dividing Democrats and Republicans.
When lawmakers return July 6 after a weeklong recess, the push will be on to overcome differences over issues ranging from whether to set up a new government entity to compete with private insurers to how much to tax the most generous employer-provided insurance plans to generate revenue.
Much of the focus will be on the Senate Finance Committee, the likeliest place for a bipartisan agreement. Committee Chairman Max Baucus is hailing progress made on reining in the cost of the legislation and on Congress’ role in overseeing cuts in Medicare, even after missing two deadlines he set for his panel’s work. Republicans are sounding less optimistic.
“We don’t know what’s in the bill,” said Sen. Orrin Hatch, a Utah Republican and member of the group Baucus dubbed the “coalition of the willing” trying to reach a compromise.
Baucus, D-Mont., intended for his panel to vote before this week’s recess; then he said he wanted the committee to finish draft legislation before going home. Neither happened.
While the Congressional Budget Office said options under consideration by the committee can keep the cost within Baucus’ goal of $1 trillion over 10 years, how to pay for the plan remains unsettled. So is structuring some kind of government-run competition for insurers.
President Barack Obama is pressing Congress to send him legislation by October that would expand coverage to the estimated 46 million uninsured and reduce costs. The Senate plans to work five weeks after the July 4 holiday before taking a four-week recess and then coming back for another five weeks.
Democratic leaders will likely need the support of their more conservative members as well as at least a handful of Republicans.
Still, many Republicans are grumbling about being left out.
“I’ve seen no real effort by the administration or Democrats to reach out in a substantive way,” said Indiana Rep. Michael Pence, chairman of the House Republican Conference.
House Democrats released their plan June 19, and three committees held hearings last week. The proposal includes a government-run option for health insurance as well as a requirement that employers either insure employees or pay a penalty.
Meanwhile, the Senate Health Education, Labor and Pensions Committee, run by Connecticut Democrat Christopher Dodd as Chairman Edward Kennedy, D-Mass., battles brain cancer, last week failed to meet a self-imposed deadline to finish debating its version.
Those delays have prompted advocates to look for Obama to take a greater role in fashioning his top legislative priority. That will happen, said former Senate Democratic leader Tom Daschle, an Obama confidant. After Obama returns from a July 5- 12 trip to Russia, Italy and Ghana, he’ll “ramp up” efforts to help Congress come up with a bill, Daschle said.
Committee members say the legislation will probably call for imposing taxes on employer-provided health benefits. Baucus has proposed a ceiling on the level of benefits exempt from taxation. The committee has considered alternatives, including capping benefits in the range of $15,000 to $17,000.
