Sen. Max Baucus is touting his healthcare plan as a road map for agreement. (Haraz N. Ghanbari / Associated Press)
Sen. Max Baucus unveils his healthcare overhaul plan
Baucus' proposal would require all Americans to get insurance, but it does not include a public option. Key Republicans reject the plan.
By Noam N. Levey and Janet Hook
8:32 AM PDT, September 16, 2009
Amid fresh signs of tensions among Democrats over healthcare, a leading senator today released the last major proposal that Congress will consider as it attempts to refashion the American healthcare system, a $856-billion bill that includes a mix of sweeping new insurance regulations but no new government insurance plan.
The legislation from Sen. Max Baucus (D-Mont.) fell short of his goal of charting a legislative course that could bring Republicans and Democrats together for the most ambitious overhaul of the health system since the 1960s.
Under the bill, nearly everyone would be required to get insurance or pay a penalty. But insurers, in turn, would not be able to deny coverage to people with preexisting medical conditions or to cancel policies after people got sick, as happens in the current system.
And the federal government would offer subsidies to help lower-income people buy coverage.
Three key GOP lawmakers who had been working with Baucus for months have rejected his bill, all but ensuring that any healthcare legislation that passes this year will win no more than one or two Republican votes.
There are also signs that Baucus' proposal faces trouble among liberal Democrats, who have demanded that Congress allow the government to offer health insurance plans to the public in competition with private insurers.
The completion of Baucus' bill marks the end of one phase of the healthcare debate in which senior congressional Democrats developed a series of three healthcare proposals -- one in the House and two in the Senate. Now, Democratic leaders on Capitol Hill will work to unify their party behind a final bill that could pass the House and Senate and make it to President Obama's desk.
Baucus today touted his plan as a road map for agreement.
"We worked to build a balanced, common-sense package that ensures quality, affordable coverage and doesn't add a dime to the deficit," the senator said. "Now we can finally pass legislation that will rein in healthcare costs and deliver quality, affordable care to the American people."
Few expect that will happen with much GOP support.
Senate Minority Leader Mitch McConnell (R-Ky.) blasted the Baucus bill. "Americans don't think a bigger role for government in healthcare would improve the system," he said. "Yet despite this, every proposal we've seen would lead to a vast expansion of the government's role in the healthcare system."
Many Democrats already believe that Baucus' bill does not have enough of a role for government, arguing that a government-sponsored health plan would be the best way to ensure that consumers who are not covered through work will be able to find an insurance plan they can afford.
Healthcare bills developed by senior House Democrats and by the Senate health committee both include provisions to create a so-called public option.
The Baucus bill instead would create of a series of private health insurance cooperatives, which Baucus and other centrist Democrats say could offer the same protections as a new government plan.
Other debates are flaring over how to penalize employers who do not provide coverage, how much aid the government should give to consumers to help them buy insurance and how to pay for the final package.
To help pay for his bill, Baucus is proposing a series of new excise tax on insurance plans worth more than $8,000 for singles and $21,000 for families, and new fees on insurers, drug makers, device makers and clinical labs.
In contrast, House Democrats rely heavily in their healthcare legislation on a new surtax on high-income taxpayers.
Despite some substantial differences with the other Democratic health bills, however, Baucus' proposal also underscores the broader consensus about how to revamp the nation's ailing health system to expand coverage and tackle rising costs.
The Baucus legislation -- like the other two Democratic health bills -- is designed to largely preserve the current system of employment-based health coverage.
Layered on top of that system, the legislation would create a series of highly regulated, state-based insurance marketplaces, or exchange, where millions of people who do not get coverage from their employer or from the government would be able to shop for insurance.
These people would be able to select from a range of plans offered by private insurers, as well as one potentially offered by a member-owned cooperative.
Like other legislation, the bill would also substantially expand eligibility for Medicaid, the 44-year-old state-federal health insurance program for the poor, which in some states currently covers only poor children and their families.
Under all the Democratic bills, Medicaid would be opened to all of America's poorest residents, regardless of their family status.
Provisions in Baucus' bill would also set up a series of new initiatives in Medicare to make that gargantuan federal program more efficient, including incentives for hospitals to reduce re-admissions and for doctors to do more to coordinate their patients' care.
These initiatives, though the least controversial parts of the healthcare legislation, are seen by many experts as crucial to reducing the growth in Medicare spending, which threatens to essentially bankrupt the program by 2017.
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