Healthcare reform advances

Congressional Democrats moved the ball forward on healthcare reform Tuesday, introducing a $1 trillion bill in the House as a key Senate panel inched closer to a deal.

Three House committees will begin marking up their legislation before the end of the week, setting up what would be a historic vote on President Obama’s signature domestic issue in just over two weeks.

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In the Senate, the Health, Education, Labor and Pensions (HELP) Committee was poised to complete its four-week-long markup of its portion of the upper chamber’s bill Tuesday evening. Meanwhile, the Finance Committee would begin its markup as soon as next week.

These concrete signs of progress on healthcare reform come after weeks of setbacks that threatened Obama’s goal of House and Senate passage of bills before Congress departs for its August recess.

Tuesday’s moves took place after Obama stepped in Monday to push Democrats to get their bills passed by hosting leaders and committee chairmen at the White House.

The 1,018-page bill rolled out by House Speaker Nancy Pelosi (D-Calif.) and other Democratic leaders features a government-run “public option” health insurance plan and a tax on the wealthy to pay the costs of the overhaul.

A preliminary Congressional Budget Office (CBO) analysis pegged the cost of the bill at about $1 trillion, which Democrats would pay for with the tax and expected savings in Medicare and Medicaid. CBO stated the bill would leave 17 million people uninsured.

Obama lauded the House legislation, saying in a statement that key panels “have engaged in unprecedented cooperation to produce a healthcare reform proposal that will lower costs, provide better care for patients and ensure fair treatment of consumers by the insurance industry.”

Republicans blasted the bill as a government takeover of healthcare that will worsen unemployment.

“During a deep economic recession, it is criminal malpractice for Democrats to push a government takeover of healthcare and a new small-business tax that will destroy more American jobs,” said House Minority Leader John Boehner (R-Ohio).

The new bill includes numerous changes from an earlier “discussion draft.” Markups will begin Thursday with the Ways and Means Committee.

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The bill was delayed several days by objections from centrist Blue Dog Democrats, who said the draft didn’t do enough to cut costs and put unfair burdens on small businesses. They also objected to a “Medicare-like” public option.

To protect small businesses from an employee mandate, the bill introduced Tuesday would exempt employers with payroll of $250,000 or less.

But Blue Dogs say they want many more changes and will try to make them when the Energy and Commerce Committee takes up the bill.

Rep. Baron Hill (D-Ind.) said Blue Dogs want to control costs and address regional disparities in Medicare payments. He would not say whether the Blue Dog amendments would make changes to the “public option.”

“I don’t want to give away any of our plans,” Hill said. Asked if the House could pass a bill that includes a public plan and pleases both Blue Dogs and liberals, Hill said, “I don’t know.”

Rep. Raúl Grijalva (D-Ariz.), co-chairman of the Congressional Progressive Caucus, emerged from a meeting with Pelosi on Tuesday saying he wasn’t worried about leadership’s efforts to win Blue Dog support. He said Pelosi assured him it won’t affect the Progressive Caucus’s top priority of a public option.

“I don’t think any accommodation for Blue Dogs is at the expense of a public option,” Grijalva said. “I’m optimistic. I feel very, very comfortable with what the Speaker said today.”

The surtax on the wealthy will also be controversial. The surtax would start at 1 percent on individuals making more than $280,000 and would rise to 5.4 percent on incomes of more than $1 million. The tax is expected to raise $540 billion during the next 10 years. Democrats are hoping for nearly that much in savings from Medicaid and Medicare.

Republicans blasted the tax, saying it will hit not only the wealthy, but also many small businesses. But House Majority Leader Steny Hoyer (D-Md.) rejected that criticism.

“I don’t know of any small-businessmen or -women making $280,000, so I don’t think it will hit very many small-businessmen or -women,” Hoyer said.

Interest groups reacted swiftly to the House announcements. Labor unions and the seniors’ lobby the AARP praised the Democrats’ legislation, but a coalition of business groups led by the U.S. Chamber of Commerce slammed it.

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In the Senate, the biggest remaining obstacle to beginning floor debate is the Finance Committee, where Chairman Max Baucus (D-Mont.) has been engaged in bipartisan negotiations for months.

On Tuesday, Baucus presented an outline of where the panel is headed to the entire Democratic Conference during its weekly lunch. He planned additional meetings Tuesday evening and Wednesday with Finance Committee ranking member Chuck Grassley (R-Iowa) and with the committee’s Democrats.

Baucus declined to specify a timeline for getting agreement or scheduling a committee markup. Sen. Kent Conrad (N.D.), one of the key Democratic negotiators on the committee, told reporters that it was imminent.

“We’ll be in markup in the Finance Committee next week,” he said.

Underscoring the uncertainty of the Finance Committee talks, however, Republican Sen. Olympia Snowe (Maine), another central figure in the process, said she would not be held to any “arbitrary deadlines that are not realistic,” adding, “At this point, no agreement has been reached and no decisions have been made.”

Baucus indicated that the work has become more urgent. “And I believe that if this drags out past the recess and over into September, that’s going to allow the naysayers much more time and opportunity to work their mischief. And all they want to do is just kill it,” Baucus said before a meeting with Snowe.

Even were Conrad’s prediction of a markup next week to prove true, he acknowledged that merging the Finance and HELP committee bills would be challenging. Among other differences, the HELP measure includes a public option, while any bipartisan Finance package would not.

“The question is, how fast can the bills be melded? You know, that’s really the challenge to getting it done on the floor,” Conrad said. “And how long does it last on the floor?”