The Senate will not likely consider healthcare overhaul legislation next week as planned, according to Senate Majority Leader Reid's office, and moderate Democratic senators might have further delayed efforts to complete the bill.
With the Senate Finance Committee not voting until late this week or even possibly next, Reid is unlikely to be able to take a merged Finance and Health, Education, Labor and Pensions Committee bill to the floor until the week after next at the earliest.
"We likely will not get to it until the week after next on the floor since the Finance Committee will likely not report the bill until later this week," said a Democratic leadership aide.
Finance Chairman Max Baucus expects to get CBO scores soon, possibly today, on his committee's proposal. Timing for a vote in his panel will depend on what those scores reveal about the cost of his measure and whether it remains deficit-neutral after the committee's modifications.
Eight moderate Democrats further complicated the floor effort Tuesday by asking Reid to post on the Internet for 72 hours the full legislative text of a final bill and complete CBO scores "prior to the first vote to proceed on health reform legislation."
The moderates want the text as amended and modified CBO scores available electronically 72 hours before a final vote on the measure. If Reid determines he must acquiesce to the moderates to get the bill passed, such efforts could delay a final vote further by a few weeks at least.
"Whether or not our constituents agree with the direction of the debate, many are frustrated and lacking accurate information on the emerging proposals in Congress," the senators wrote. "Without a doubt, reforming health care in America is one of the most monumental and far-reaching undertakings considered by this body in decades. We believe the American public's participation in this process is critical to our overall success of creating a bill that lowers healthcare costs and offers access to quality and affordable health care for all Americans."
Reid's office did not offer any guarantees. "Senate Democrats have pursued the most transparent process possible in both the [Health, Education, Labor and Pensions] and Finance committees and intend to do the same as the debate moves to the Senate floor," a Reid spokeswoman said. "This was Sen. Reid's position before the letter and remains his position now."
Reid's staff has been working with the White House to merge the Finance and HELP bills. HHS Secretary Sebelius is scheduled to meet today with administration officials to discuss the overhaul.
The letter to Reid was sent by Democratic Sens. Blanche Lincoln and Mark Pryor of Arkansas, Evan Bayh of Indiana, Mary Landrieu of Louisiana, Joseph Lieberman of Connecticut, Claire McCaskill of Missouri, Ben Nelson of Nebraska and Jim Webb of Virginia. The senators also requested legislative text of all amendments be posted prior to a vote on each amendment and that following a Senate and House conference, a formal conference report and complete CBO scores be made available to the public 72 hours before a final vote.
Senators who signed the letter did not say they would oppose the bill if they did not have 72 hours to review it, but Lieberman said having time to review the measure would be a factor. "It would be hard for me to vote for a motion to proceed if there wasn't that time," Lieberman said.
The request is similar to ones made by Republicans in recent weeks. Sen. Jim Bunning, R-Ky., offered an amendment in the Finance Committee that was shot down to require the committee to post full legislative text and final CBO scores on its proposal 72 hours prior to a final vote.
Bunning plans to offer a resolution today that will require the transparency measures before any vote on the floor or in committee.
National Republican Senatorial Committee Chairman John Cornyn of Texas referenced the need for more transparency on the floor Tuesday as well.
"Maybe there's a reason why so many of my colleagues don't want the public to read the actual legislative language," Cornyn said. "And maybe that reason is they have no intention of reading the language themselves."
Cornyn pointed to backroom deals that legislative language, rather than the conceptual language used by the Finance Committee, might have brought to light sooner, including one in the Finance proposal that excluded hospitals from a Medicare cost-cutting commission and another that provided four states -- including Reid's state of Nevada -- a special Medicaid deal.
As the Finance Committee awaits CBO, Baucus might have about $29 billion in additional revenues to play with, according to preliminary scores from the Joint Committee on Taxation. The initial scores issued by JCT for Baucus' mark of three proposed fees -- referred to as taxes by Republicans -- on health insurance providers and manufacturers of pharmaceuticals and medical devices pegged the total amount raised at $92.4 billion.
But those estimates assumed companies would be able to deduct the fees on their tax returns, which is not the case under the Finance bill. In revised scores circulated Tuesday, the three fees or excise taxes are estimated to raise $121.2 billion, even after accounting for the economic impact on business activity.
Although CBO scores of the subsidy provisions are pending, the new estimates could ease some concerns that other offsets will have to be found if senators reduce some of the proposed fees. For example, a proposed levy on medical device-makers would raise $38.6 billion, or $8.7 billion more than original estimates showed. Fees on insurance providers, separate from an excise tax on high-cost plans, would raise $60.4 billion, about $15 billion more than initially expected.
While some budget wiggle room might be helpful for Baucus and the Democrats, Republicans have been consistently arguing that the fees would be passed down to consumers in the form of higher prices and insurance premiums. The $6.7 billion annual insurers' fee, for example, could result in a 2 percent increase in all policyholders' premiums, according to one Senate staff estimate. The higher JCT revenue estimates could give Republicans ammunition to argue that the Democrats' new fees will result in an even higher tax increase than expected.
"A $29 billion change like this is why Republicans on the committee asked to have the tax and budget experts at the table, answering questions, before the committee votes on a healthcare reform bill that costs nearly a trillion dollars and affects every American," Finance ranking member Charles Grassley said.
Republicans on the Finance Committee wrote Baucus Tuesday requesting CBO Director Elmendorf and JCT Chief of Staff Thomas Barthold be available to answer questions about scoring when the committee reconvenes either this week or next to take a final vote on its version of the overhaul bill. A Finance aide said Baucus had already invited CBO and JCT to the final vote.
This article appears in the Oct. 10, 2009, edition of National Journal Daily.
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