After months of closed-door negotiations, Senate Finance ranking member Charles Grassley indicated Tuesday evening he will not sign on to Finance Chairman Max Baucus' healthcare overhaul mark set for release today.
"Unfortunately, we're operating under an artificial deadline set by the Democratic leadership and the White House," Grassley said in a statement. "I'm disappointed because it looks like we're being pushed aside by the Democratic leadership so the Senate can move forward on a bill that, up to this point, does not meet the shared goals for affordable, accessible health coverage that we set forth when this process began."
Democratic leaders gave Baucus until Tuesday to come up with a bipartisan package. Grassley said he has concerns that federal funds could be used for abortions, that illegal immigrants could gain access to federal subsidies meant to help afford insurance and that the cost of health insurance will still be too high.
The Finance Committee's top Republican wants stronger changes to the medical malpractice system than the grant program for state pilot projects the bill will endorse.
"On top of all that, there's no guarantee that a Finance Committee bill, even if it becomes bipartisan, will stay that way after it leaves the committee," Grassley said.
Senate Health, Education, Labor and Pensions ranking member Michael Enzi and Sen. Olympia Snowe, D-Maine, did not reveal Tuesday whether they could support the mark.
Grassley said he plans to continue meeting with Baucus and the two other Finance Democrats who have worked to negotiate a bipartisan package.
Senate Democrats will meet Thursday to go over the measure Baucus releases today.
Senate Majority Leader Reid said Tuesday he believes he can get a bill to the Senate floor by Sept. 28. Senators will first vote on a compilation of the Finance and Health, Education, Labor and Pensions committees' overhaul bills with input from the White House to determine whether they can gain 60 votes, Reid added.
Getting a bill to the floor by Sept. 28 could be complicated by the need to pass FY10 appropriations bills before the end of the fiscal year. The Senate's work on the FY10 Transportation-HUD appropriations bill could extend into next week, Democratic aides said Tuesday. Even with passage of that measure, the chamber will have passed just five of 12 FY10 spending bills and will likely need to pass before Oct. 1 a continuing resolution to keep federal agencies running, Reid and Majority Whip Durbin have acknowledged.
Some Democrats are not happy with Baucus' proposal, either.
"The way it is now, there's no way I can vote for the Senate package," Senate Finance Health Subcommittee Chairman John (Jay) Rockefeller, D-W. Va., said in a conference call with reporters on Tuesday. Rockefeller, who backs "a robust public option," said he plans to offer "many, many, many amendments" when the committee votes on the proposal. Baucus' proposal does not include a public option, but creates a co-op system of coverage.
If the plan does not win GOP support, and Rockefeller is not appeased by changes to the bill, his opposition could endanger Democrats' narrow majority on the committee. His concerns also suggest that after Baucus made concessions in hopes of winning Republican votes, the bill's passage might be endangered more by opposition from liberals angry over exclusion of a public option than by conservatives.
"The problem isn't with Democratic moderates," a senior Senate aide said Monday. "The problem is with the liberals."
In one potential bright spot, the senators negotiating Baucus' mark seemed to allay governors' concerns with a Tuesday evening conference call that their state budgets would not hold up under the strain of a proposed Medicaid expansion.
"I think it's fair to say they were quite pleased," Baucus said.
The National Governors Association did not respond for comment. Baucus said the senators were able to craft a Medicaid expansion that would increase average state spending 0.89 percent above the baseline they pay now.
Senate Budget Chairman Kent Conrad said about 10 governors, both Democrats and Republicans, participated in the call. They want to see more detail on the proposal, he added.
Conrad said the bipartisan group of six senators will continue to meet beyond the unveiling of the mark today. "We have had, after the discussion on Medicaid, an extensive discussion on how we take further steps to reduce premiums," he said.
Finance Democrats raised objections during a Monday meeting that federal assistance under the package would not be adequate compared to what individuals and families would have to shell out for health insurance.
White House senior adviser David Axelrod made a visit to House and Senate Democrats Tuesday. And HHS Secretary Sebelius, Assistant to the President for Legislative Affairs Phil Schiliro, health policy czar Nancy-Ann DeParle and OMB Director Orszag all met with House Democratic leaders.
Rockefeller said Axelrod's message was that the administration wants a bill to call health reform, even if it is not as comprehensive as the administration originally set its sights on.
"David's in there, Axelrod, trying to say we've got to get something so that the new benchmark [is], if we do something, if we do anything, then we can say we did healthcare reform," Rockefeller said.
"And you can make an argument for that if you just get rid of short-term lifetime caps, rescissions, you know, pre-existing conditions, all of that, you can make that into a really big deal," he added. "The question is, in comparison, if you do this once every 30 years or 25 years, is something like that enough, and I don't even know."
Senate Republican Conference Chairman Lamar Alexander of Tennessee made a similar push Tuesday, urging Democrats to back off their comprehensive effort and go after more piecemeal legislation. "It's time for Congress to admit that we don't do comprehensive well," Alexander said. "It's time for us to admit that the era of the 1,000-page bill is over."
Axelrod did not offer much insight into his message for Democrats, but did counter Rockefeller's claim the administration will take any bill at this point. "Our goal is not motion for motion's sake," he said. "It's to help people that have insurance gain security and help those that don't have insurance get insurance."
Baucus characterized Axelrod's message as an attempt to prod Democrats into talking about an overhaul in clearer terms.
This article appears in the September 19, 2009, edition of NJ Daily.