After months of being poked and prodded by an array of specialists at the committee level, healthcare legislation is about to be examined by hundreds of general practitioners who will decide its fate on the floors of the House and Senate.
The Senate Finance Committee is expected to vote this week on its version of healthcare overhaul legislation, and Democratic leaders in that chamber have already started working on merging that proposal with a bill approved earlier by the Health, Education, Labor and Pensions Committee.
Combining the bills and having CBO score the Finance bill will clear the way for floor debate over the next few weeks. Senate Majority Leader Reid said he hopes to begin debate Oct. 13, when lawmakers return after the Columbus Day holiday.
House leaders will resume negotiations aimed at finalizing details of their healthcare overhaul. Still at issue are regional disparities in Medicare reimbursement rates, how to trim $200 billion from the cost of the bill, revenue raisers to keep the bill deficit neutral and the final shape of the public option.
While the healthcare work takes place off the floor, the floor schedule in both chambers will be dominated by continued work on FY10 appropriations bills.
Senate Finance Chairman Max Baucus said his committee will convene again Tuesday. Sen. Olympia Snowe, R-Maine, the only committee Republican who might cross sides to vote for the health bill, remained on the fence late last week.
"Obviously, there's some things that require significant improvement, for example, on the individual mandate," Snowe said. "I'm going to review the document and all that's been added and modified and go from there."
Snowe and Senate Democratic Conference Vice Chairman Charles Schumer of New York were instrumental in making changes last week to Finance's proposal that will make health insurance more affordable. Members on both sides of the aisle have worried the cost of insurance and the penalties for not obtaining it were too high in Baucus' mark, particularly when the measure mandated coverage.
Snowe would like to see the penalties come down even further, she said.
While most of the work so far has fallen to committees and party leaders, the wait for the bills to get to the floor provides a window for President Obama to play a bigger role in the debate, some lawmakers said.
"The role of the president to this point in time has been more to steer the boat, not as much to row the boat," Sen. Thomas Carper, D-Del., said last week. "I think going forward the administration needs to do a little more rowing."
Senate leaders have said they will lean on the administration when it comes to some of the thornier issues. The most pressing question is whether that merged bill will include a public option.
Carper has been trying to sell moderate and liberal members on a compromise that would allow states where competition is scarce to choose whether to implement a public option similar to HELP's bill, a co-op insurance system like the one in the Finance bill or another alternative, such as opening the state-based employee health insurance to residents.
The Finance markup highlighted many other issues that need to be resolved, such as the value of "Cadillac" insurance plans and the amount insurance companies are allowed to charge older people for coverage above policies for younger people.
The original House bill required the public plan to pay providers 5 percent more than Medicare reimbursement rates. But as part of a package of concessions to the Blue Dogs Coalition, the House Energy and Commerce Committee accepted an amendment that would require the HHS secretary to negotiate rates with providers. According to CBO estimates released by House Speaker Pelosi's office, negotiated rates would offer $25 billion in savings over 10 years, while Medicare-based rates will save $110 billion.
But a number of Blue Dogs have continued to oppose the Medicare-based public plan despite the savings, and Pelosi suggested last week that leaders are looking for a middle ground that will save more money and still use negotiated rates. Leaders sent alternatives to CBO for scoring.
Leaders are also facing increasing opposition to a proposed excise tax on high-value insurance plans. Rep. Joe Courtney, D-Conn., is circulating a letter opposing the idea and has more than 90 co-sponsors. The plan slaps a 40 percent tax on coverage worth more than $8,000 for an individual and $21,000 for a family. It is included in the Senate Finance Committee's bill and would raise an estimated $200 billion over 10 years. Democrats are concerned the tax would hit an increasing number of middle-class families as medical costs rise in coming years.
On the appropriations front, last week's passage of a one-month continuing resolution to continue funding the government at last year's levels takes some of the pressure off lawmakers to act quickly on the spending bills.
The Senate is set to take up the $64.9 billion FY10 Commerce-Justice-Science Appropriations bill, while the House is expected to turn to the final version of the $23.3 billion FY10 Agriculture spending bill.
The House has completed its versions of all 12 bills; the Senate has completed six, but it is expected to finish the seventh -- the $636.3 billion FY10 Defense Appropriations bill -- Tuesday, under an agreement reached by Senate leaders last week.
The Senate will start debate on the Commerce-Justice-Science bill today, but no votes will be taken.
That bill includes $64.9 billion in discretionary funding for FY10, which is $7.27 billion above the FY09 level, excluding funding provided in the $787 billion economic stimulus package enacted in February. For the Justice Department, the C-J-S measure would provide $27.38 billion, $1.29 billion above the amount provided last year; the Commerce Department would receive $14.04 billion, $4.77 billion above FY09; and the National Science Foundation would receive $6.9 billion, a $426 million increase over FY09.
The Senate might take up the conference report on the $33.5 billion Energy and Water Appropriations bill, which the House passed Thursday.
The House this week is poised to consider the conference report for the FY10 Agriculture bill, which provided a $23.3 billion in discretionary spending, $2.7 billion more than the 2009 bill.
The House might also take up conference reports for the FY10 Homeland Security and Interior-Environment spending bills.
A conference meeting for the Homeland Security bill was scheduled for last week, but was postponed. Senate Democrats said the meeting was postponed because the Thursday meeting time conflicted with votes on the Senate floor. The House Appropriations Committee said the delay was needed because the bill is being finalized.
Republicans said the meeting was delayed to try to block GOP plans to offer a motion to recommit.
House Republicans say they intend this week to push to a vote a privileged resolution introduced by Republican Conference Secretary John Carter of Texas to force Ways and Means Chairman Charles Rangel to step down as chairman, unless he voluntarily steps aside before then.
Carter and other Republicans -- including Minority Leader Boehner -- have argued it is improper for Rangel to continue as chairman while he is the focus of a House Ethics Committee investigation into his business dealings. Rangel has said it is unfair to call for his ouster as chairman before the Ethics Committee completes its inquiry.
Carter offered a similar resolution to remove Rangel in February, but Democrats voted to block consideration of the bill.
• The Senate meets today at 2 p.m. for morning business, then begins consideration of the Commerce-Justice-Science Appropriations bill.
• The House is not in session today. On Tuesday, the House meets at 12:30 p.m. for morning hour and 2 p.m. for legislative business, with votes postponed until 6:30.
After it considers several amendments still pending on the $636.3 billion, FY10 Defense Appropriations bill, the Senate plans to wrap up work on the spending measure Tuesday.
Among the amendments pending was one from Senate Minority Whip Kyl that would restore a $900 million cut from the Obama administration's $7.5 billion request for the Afghanistan Security Forces Fund.
The White House has taken issue with the cut, arguing that the full request reflects plans for the Afghan forces to assume a greater share of responsibility for security as quickly as possible.
Senate Appropriations Chairman Daniel Inouye said the administration indicated it would not be able to spend $1.8 billion of the amount requested for Afghan security forces until FY11.
The money, he argued, would be better spent on buying more all-terrain Mine-Resistant Ambush-Protected vehicles for Afghanistan.
"It's a situation of, 'Yes, we need the money, but we can't spend it,'" Inouye said Thursday. "That's a hell of a way to run the government."
Other issues that could be debated before the final vote on the bill include the politically charged competition to build the Air Force's next fleet of aerial refueling tankers, a looming strike-fighter shortfall in the Air National Guard, and the administration's decision to make dramatic changes to its plans for missile defense in Eastern Europe.
Meanwhile, the House and Senate Armed Services committees are expected to hold a formal conference this week on the FY10 defense authorization bill.
The top Republicans and Democrats on the two panels met privately several times last week to negotiate remaining differences in the two chambers' versions of the bills. At week's end, only a few issues remained unresolved, boosting hopes that Congress could send the final bill to the White House this week.
The House Financial Services Committee will hold a final series of hearings this week on proposals to revamp the nation's financial regulatory system before it heads into markups.
The panel will hold a Tuesday hearing on a discussion draft that would place new registration requirements on hedge funds and other private pools of capital, put additional fiduciary duties upon broker/dealers and provide enhanced consumer protection for securities products. The draft also would create an Office of Insurance Information within the Treasury Department.
On Wednesday, the panel will hold a hearing on a measure to revamp the derivatives market in the wake of the collapse of American International Group, Inc., which suffered catastrophic losses while trading credit default swaps -- insurance-like contracts used by companies to mitigate risk as well as by speculators who play the market for big profits.
On other issues, the panel's Housing Subcommittee will hold a Thursday hearing on legislation that would give the FTC the power to regulate interchange fees that banks charge merchants for using a debit or credit card. The subcommittee also will consider another bill to advance the implementation date of new credit card regulations to Dec. 1 from effective dates of February and August of next year.
House Financial Services Chairman Barney Frank is using the hearing to show his displeasure at the banking industry for its opposition to a proposed Consumer Financial Protection Agency.
The Housing Subcommittee will hold a hearing the same day on the Federal Housing Administration's capital reserve fund, which recently dipped below its 2 percent level established by Congress. The agency, which provides government-backed mortgage insurance, has seen its business rapidly grow as a result of housing industry woes as well as losses, which have totaled $15 billion over the past year.
The Senate Banking Securities, Insurance and Investment Subcommittee will hold a Wednesday hearing to explore ways to better securitize assets in the wake of the downfall of the housing market where shoddy mortgage-backed securities were blamed as a prime contributor. The full committee will hold a Thursday hearing on the future of the mortgage enterprises Fannie Mae and Freddie Mac, which are both under conservatorship by the federal government.
Census Bureau Director Robert Groves Wednesday will make his first appearance since taking office in July before the Senate Homeland Security and Governmental Affairs subcommittee that oversees the 2010 count.
Testifying before a House panel in September, Groves said the bureau underestimated the cost of the first wave of census operations, the "address canvassing" effort to confirm addresses nationwide before the official count begins in March.
The Census Bureau recently announced that it will revise its plans to send letters this winter to notify households that census forms will soon be arriving in the mail and direct recipients to the census Web site. The previously planned notification would have been English-language only; the new letter will also include directions in Spanish, Chinese, Korean, Vietnamese and Russian.
The Senate Judiciary Committee plans to resume its markup Thursday of legislation that would extend and modify provisions of the USA PATRIOT Act. The panel last week began considering the bill, which was introduced by Judiciary Chairman Patrick Leahy and Sen. Dianne Feinstein, D-Calif.
Sen. Russell Feingold, D-Wis., said he plans to introduce amendments that would add more control and congressional oversight of the government's authority under the PATRIOT Act.
The committee approved one Feingold amendment on a party-line vote last week that would reduce from 30 to seven days the time period in which authorities must notify targets they were under surveillance in certain investigations.
After the panel finishes its markup, one question will be whether the Senate Intelligence Committee gets a crack at it. A GOP aide said Republicans hope to be able to review proposed changes to the law in a classified setting to better understand how they might affect investigations.
The expiring provisions include a "roving wiretap" statute that allows government bugs on any phone used by the person being tapped; language broadening law enforcement access to the records of library and bookstore patrons; and a related "lone-wolf" provision that covers a noncitizen engaging in or preparing for international terrorism.
Faced with bleak September unemployment figures, Reid and Baucus are working on a bill to extend unemployment benefits for at least four weeks in all states, but objections from both parties may prevent the quick action Reid wants.
The Reid-Baucus bill would give all states a four-week extension while providing an additional 13 weeks to 27 states where unemployment rates exceed 8.5 percent, based on the average of the last three months, aides said.
That approach is opposed by senators from the 23 states with lower unemployment rates that would receive only the four-week extension. Sen. Jeanne Shaheen, D-N.H., and 17 Democratic colleagues from those states last week blocked an effort by Reid to move an unemployment extension bill by unanimous consent. Shaheen said Friday she will offer an amendment to the bill that would use money from the Troubled Asset Relief Fund to cover the added cost of extending benefits in all 50 states for the full 17 weeks.
A Reid aide said Republican senators also want to amend the bill. That leaves the fate of the measure uncertain, because Democrats hope to move it by unanimous consent this week, before moving a healthcare bill to the floor after Columbus Day. That timeline may leave insufficient floor time to pass an extension without agreement.
FCC Chairman Julius Genachowski, Sen. Al Franken, D-Minn., and Rep. Mike Doyle, D-Pa., will join officials from the Copyright Office and the Justice Department as well as high-tech and entertainment industry executives at the Future of Music Coalition's annual two-day policy summit, beginning today at Georgetown University. Panelists will discuss the challenges and opportunities facing creators and fans in the rapidly evolving music business.
The Senate Commerce Communications, Technology, and the Internet Subcommittee Wednesday will wade into the debate over how to reauthorize sections of the Satellite Home Viewer Act slated to expire Dec. 31. The House and Senate Judiciary committees passed their versions of the legislation last month and the House Energy and Commerce Communications Subcommittee approved its bill in June. The Judiciary and Commerce committees share jurisdiction over the statute, which permits satellite systems to retransmit local and distant television signals.
Internet policy continues to dominate the communications agenda as the FCC ramps up its efforts to craft a sweeping national broadband plan to be presented to Congress in February.
On Monday and Tuesday, Democratic Commissioners Mignon Clyburn, a South Carolina native, and Michael Copps, a former aide to now-retired Sen. Fritz Hollings, D-S.C., hold a consumer forum and field hearing on the topic in two South Carolina cities -- Ravenel and Charleston, respectively.
On Thursday, the Media Access Project holds a forum on "Smart Grid, Green Tech and Communications," with a keynote by Nick Sinai, energy and environment director at the FCC. The agency may incorporate the use of smart-grid technology into its blueprint for broadband in the 21st century.
After a busy travel period that took him to New York, Pittsburgh and Copenhagen, Denmark, Obama will stay close to home this week, with no travel outside of Washington planned.
Obama will meet today with physicians on health insurance reform. On Tuesday, he will go to the National Counterterrorism Center in northern Virginia. On Wednesday and Friday, he will have meetings on Afghanistan and Pakistan.
This article appears in the October 10, 2009, edition of NJ Daily.