Sen. Max Baucus (D-Mont.) on Tuesday blasted the Republican substitute amendment to the tax extenders bill, particularly its proposed changes to the healthcare reform law. Sen. John Thune (R-S.D.) seeks to enlarge the pool of people who could opt out of the requirement to buy health insurance, which would save the federal government $11 billion over 10 years because people who choose to forgo insurance would not be eligible for federal subsidies.
"This expansion would eliminate coverage for millions of Americans," Baucus said on the Senate floor. "This would strike at the heart of healthcare reform. And [the Congressional Budget Office] tells us that it would also increase premiums for everyone else."
Thune's amendment would allow people who have to spend more than 5 percent of their income on their premiums to opt out of the individual mandate, down from 8 percent in the healthcare law. It would also reallocate the healthcare law's $8 billion boost in Medicaid rates for primary doctors in 2013 and 2014 to a state grant program.
The GOP substitute does not include $24 billion in enhanced Medicaid payments to states. And it caps medical malpractice payments, a non-starter for Democrats.
Thune would also nix a proposed increase in drug rebates for safety-net hospitals, but his bill is more generous than the Democrats' when it comes to Medicare payments for physicians — he proposes 2 percent pay bumps for the remainder of this year and for 2011 and 2012, versus Democrats' 19-month "doc fix" with a 2.2 percent hike for rest of the year and an extra 1 percent bump in 2011.
Senate Democrats say they're not sure they have 60 votes to pass the tax extenders bill — the House passed its version before the Memorial Day weekend — and may have to cut some provisions. The Medicaid payments are not part of the Senate bill unveiled by Baucus but are part of a pending substitute from Majority Leader Harry Reid (D-Nev.).