Sen. Conrad says health bill getting cheaper

Senate Finance Committee members working to bring the cost of healthcare reform below $1 trillion are getting closer but have not reached their goal, a key Democratic senator said Tuesday.

“The costs have come down quite markedly but we still have a lot of work to do,” said Sen. Kent Conrad (D-N.D.), one of the lawmakers at the center of the talks.

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Finance Committee Chairman Max Baucus (D-Mont.) postponed the release of a draft of the healthcare reform bill and the panel’s markup of the legislation last week after the Congressional Budget Office (CBO) reported that the measure’s price tag came in at around $1.6 trillion.

Baucus vowed to modify the bill to get its cost below $1 trillion — and to pay for that new spending with cuts and revenue increases in order to obtain a CBO score showing the measure would not add to the deficit over 10 years.

Conrad said that senators are looking at a number of changes to dial down the new spending but conceded they were not finished. “We’re not there yet,” he said. “We’ve made very significant progress toward that goal and we’re continuing to work.”

In spite of their efforts to lower the amount of new spending in the bill, Conrad said that the measure being written would extend health insurance coverage to nearly all Americans. “That’s probably the best news. We’re still at very high rates of coverage — 96 percent,” he said.

The fact that the Finance Committee has not resolved the cost question — among other troublesome issues — makes it all but certain that Baucus will not begin the markup of the bill until after the July 4 recess. That schedule could jeopardize the vows by congressional Democratic leaders that the House and Senate would each pass healthcare reform bills before July 31.

Conrad said the bipartisan group of Finance Committee members working on the bill were looking in a “wide array of places” to reduce spending. Foremost among them is reducing the subsidies available to assist people with purchasing health insurance. “That’s one of the biggest. I’d say it’s probably one of the key areas,” Conrad said.

The Senate Health, Education, Labor and Pensions (HELP) Committee similarly reacted to a high CBO score of a partial draft of its bill by making subsidies available to people with income up to 300 percent of the federal poverty level, not 400 percent, as HELP Committee Democrats originally hoped.

The HELP Committee continued its two-week markup Tuesday, which Democrats hope to have completed by the end of the week despite not having settled on positions about what type of government-run “public option” insurance program or what type of requirement that employers provide health benefits will be in the bill.

Finance Committee members are also still wrestling with these issues, which are the most politically difficult in healthcare reform.

Republicans like Finance Committee ranking member Chuck Grassley (R-Iowa) steadfastly oppose the public option, saying it threatens the existing health insurance marketplace that serves most middle-class workers.

The health insurance industry, other healthcare interests and big business groups agree. “A government-run plan — no matter how it is initially structured — would dismantle employer-based coverage, significantly increase costs for those who remain in private coverage, and add additional liabilities to the federal budget,” America’s Health Insurance Plans and the Blue Cross Blue Shield Association wrote to HELP Committee Chairman Edward Kennedy (D-Mass.) Friday.

Liberals, however, view the public option as an essential component of healthcare reform that is needed as a bulwark against for-profit private insurers.

President Obama restated his support for the public option Tuesday. “The public plan, I think, is an important tool to discipline insurance companies,” he said at a press conference.

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Obama refused, however, to declare whether a public option must be part of healthcare reform. “We have not drawn lines in the sand, other than that reform has to control costs and that it has to provide relief to people who don’t have health insurance or are under-insured,” he said. “Right now, I will say that our position is that a public plan makes sense.”

Conrad, who has positioned his proposal to create not-for-profit healthcare cooperatives that would be owned and run by their members as a compromise, said flatly that a public option cannot pass the Senate.

“The key is votes on the floor. And it’s very clear. Look, Republicans — every single Republican is opposed to [a] public option, with one exception,” Conrad said, referring to Sen. Olympia Snowe (Maine), who has floated the idea of having a public option kick in only if private insurers fail to serve the market.

“And there are a number of Democrats,” Conrad said, “who have announced publicly that they are opposed to public option. So if one just does the numbers, it’s very clear to get the votes you’ve got to find some compromise here.”

Asked whether abandoning the public plan would cause liberal senators to vote against the bill, Conrad replied, “Probably it’s not useful for me to go down that trail.”

Sen. Charles Schumer (D-N.Y.), a leading proponent of the public option, and Conrad have tried to find common ground. Though they are still talking, Conrad indicated they have not yet succeeded.