From TIME’s Kate Pickert:
The Senate Finance Committee’s health reform bill has provoked a wide range of reactions from special interest groups and lawmakers. Here is what the major players have to say in the wake of the bill’s unveiling:
Senator Olympia Snowe
(Republican member of the Senate Finance Committee’s “Gang of Six”)
“This is a first step in the process and those of us as members of the bipartisan Group of 6 fully intend to keep meeting, moving forward and continuing to work with the Chairman during the committee process toward crafting a bill that I, and hopefully other Republican members of the Finance Committee, can support. I believe the Chairman’s legislation moves in the right direction away from a government-run system contained in bills that have passed other Congressional committees, but a number of issues still need to be addressed — including cost assumptions and ultimate affordability to both consumers and the government as well as ensuring appropriate competition in the health insurance exchange.
“Moreover, I have repeatedly insisted that Committee Members are given sufficient time to read the legislation – and for the Congressional Budget Office to provide its cost projections – given the monumental complexity of this issue. As one of three Republicans in the Group of 6, I have appreciated the Chairman’s leadership of the only bipartisan effort in any committee in either the House or Senate, which has laid real and substantial groundwork for bipartisan cooperation during this ongoing process – and I will continue to work toward that goal as the committee continues its deliberations.”
Senator Chuck Grassley
(Republican member of the Senate Finance Committee’s “Gang of Six”)
“Over the last several months the bipartisan group of six senators has worked diligently to develop a bipartisan bill for the Finance Committee to consider.
“I applaud the efforts Chairman Baucus has made to provide a venue for us to work together toward bipartisan legislation that we all can support, and we’ll continue to work with him and Senators Conrad and Bingaman — and any other members interested in real bipartisan reforms — as the process moves forward.
“Unfortunately, we’re operating under an artificial deadline set by the Democratic leadership and the White House. 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. In addition to concerns about costs to taxpayers and affordability for individuals, there are still some serious outstanding issues that have yet to be resolved like preventing taxpayer funding of abortion services and the enforcement against subsidies for illegal aliens. I have also pressed for alternatives to the individual mandate and ways to lower the overall cost of the bill, as well as tougher medical liability reform measures.
“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. An overriding issue for some time has been the fact that members of the Democratic leadership haven’t made a commitment to back a broad bipartisan bill through the entire process.
“We’ve been clear from the start that we’re willing to stay at the table. There’s no reason not to keep working until we get it right. In the end, legislation that impacts every American should have strong bipartisan support.”
Senator Mike Enzi
(Republican member of the Senate Finance Committee’s “Gang of Six”)
“I am disappointed that deadlines took precedence over agreement of the bipartisan group of Finance Committee members, as we worked on a final health care bill. All of the Senators in this group have been working tirelessly and in good faith, and we have made significant progress on many issues. I especially want to highlight the good work of Chairman Max Baucus and Ranking Member Chuck Grassley, who have resisted the calls for partisanship in trying to develop a health care proposal that would provide health care coverage for all Americans.
“Unfortunately, there are fundamental issues that we were not able to resolve by the deadline that was set for us. I am deeply disappointed that we could not take the time to find ways to resolve these issues. The proposal released today still spends too much, and it does too little to cut health care costs for those with health insurance. At a time when our nation faces a $9 trillion deficit, we should target assistance to those in the greatest need without creating unsustainable new entitlement programs.
“President Obama said that health reform must improve competition in the insurance marketplace and lower health care costs for those who currently have insurance. I agree, but this bill does not go far enough toward achieving those goals. I also believe that health care reform should not be built on expanding the unsustainable Medicaid program, which 40 percent of doctors will not accept. Coverage is worthless if you can’t see a doctor. If you have Medicare Advantage this bill could reduce your coverage.
“I have other concerns. This is the most complicated bill any of us have ever worked on. It affects about 16 percent of the economy and 100 percent of the people. Those of us who have spent months working on the hundreds of different areas can appreciate the multiple moving parts and the effect getting it wrong would have. Although there is a sense of urgency, getting it done fast is not as important as getting it done correctly.
“While I cannot support the current proposal, I remain committed to working on health care reform proposals that will have broad bipartisan support. The best way to reform our health care system is to do it step by step. That is how you gain the trust of the American people. Let’s start by focusing on the issues where we already have broad, bipartisan agreement.”
Senator Kent Conrad
(Democratic member of the Senate Finance Committee’s “Gang of Six”)
“We all know that the skyrocketing cost of health care in this country has put us on an unsustainable course. Doing nothing is simply not an option. Knowing that, the mark put forward by Chairman Baucus today is a very good start as we work to deliver the health care reform our nation so clearly needs.
“This proposal is fully paid for. It expands coverage to 94 percent of Americans and, most importantly, it begins to bend the health care cost curve in the right way. It also includes a co-op proposal I put forth as an option to expand choice while providing much needed competition to private insurers without putting the government in charge of health care.
“Working with our Republican colleagues, this proposal would prevent those here illegally from benefitting from this expansion in coverage. It also reforms the tax code, begins to address medical malpractice and prevents tax payer dollars from being used to pay for abortions.
“But we all know that, while this is a very good start, it is not a finished product. That’s why it’s so important that we have an active amendment process both in committee and on the floor of the Senate. Colleagues from both sides of the aisle will have ample opportunity to further improve this already quality proposal.”
Senator Jeff Bingaman
(Democratic member of the Senate Finance Committee’s “Gang of Six”)
“I am glad that we are taking another big step forward toward ensuring health care for all Americans. While this is not a bipartisan proposal at this point, I think this bill meets many of the goals on which there is general agreement.
“For example, it allows people to keep the coverage they have, but with more stability and security in part because insurance companies would no longer be allowed to deny coverage to Americans for pre-existing medical conditions. It expands coverage to those who do not have it, and it reduces the costs of health insurance for families and businesses. And not only doesn’t this bill add to the deficit, it also cuts health care costs in the long run, reducing the suffocating burden of health care costs on our economy projected for the future.
“That is not to say this bill is perfect. For example, I believe it should have a public option, and I will support its inclusion when we vote on this bill in committee. I also believe that we should make coverage even more affordable for working families. On balance, though, the proposal moves the process ahead significantly, and I congratulate the chairman for his hard work and for his proposal.”
Senator Harry Reid
(Senate Majority Leader)
“I appreciate Chairman Baucus’ hard work over the past several months. His proposal is another important piece to the puzzle and brings us a step closer to having a comprehensive health insurance reform bill on the Senate floor. There will be a healthy and vigorous debate in the Finance Committee as Senators work to strengthen this proposal. I look forward to working with Chairman Baucus and Senator Dodd as well as the White House in the coming weeks to forge a final Senate bill that lowers costs, improves quality, preserves choice and creates competition.”
Senator Mitch McConnell
(Senate Minority Leader)
“This partisan proposal cuts Medicare by nearly a half-trillion dollars, and puts massive new tax burdens on families and small businesses, to create yet another thousand-page, trillion-dollar government program. Only in Washington would anyone think that makes sense, especially in this economy.”
Senator Tom Harkin
(Chairman of the Health, Education, Labor and Pensions Committee)
“In just the last week, the health reform debate has been reinvigorated. The President’s address to the Joint Session of Congress explained to the American public in clear and concise terms why the status quo is not an option. It is now up to Congress to respond.
“Today, Chairman Baucus has unveiled a proposal that will be marked up in Committee next week. I applaud Chairman Baucus for his steadfast work to get to this point. The proposal outlined today will help to move forward this debate that is so important to the American people.
“Obviously, the bill that Senator Baucus proposes is just that – a proposal. The Finance Committee will have its markup next week, and I know a number of members will have amendments they will want to offer, and changes they will want to make. The measures by which I judge any bill will remain the same: will it provide robust, comprehensive and affordable coverage to all Americans and will it place primary emphasis on prevention and wellness.
“This is a positive development. The HELP Committee completed its health reform markup in July, and we have been eager to get to the Senate floor. Once the Finance Committee reports out a bill, our two committees can begin the process of merging those two measures, and we can finally begin floor consideration. Each day we wait to enact health reform, 14,000 Americans lose their health insurance – over 70 per day in my home state of Iowa alone.
“I remain optimistic that we will pass a strong, comprehensive health reform bill. And we will do so before Congress adjourns for the year.”
“The Chairman’s proposal is yet another step in this ongoing, deliberative process. I will have the opportunity to offer amendments as the Chairman’s Mark moves to the full Committee for consideration next week. Above all, my goal has been to keep what works and make it better, and I will continue to push for common-sense reforms that stabilize health care costs and offer access to quality health care choices for all Arkansans and all Americans.”
Senator Blanche Lincoln
(moderate Arkansas Democrat)
“The Chairman’s Mark is a culmination of the past 20 months of debate and discussion among Senate Finance Committee members,” Lincoln said. “I am pleased that many of my priorities for health insurance reform have been included, namely a deficit neutral bill that would curb health care costs down the road and that preserves the current employer-provided health insurance system. Chairman Baucus’ proposal would allow small businesses, the self-employed, and other individuals to shop for affordable, quality options just like federal employees. In fact, the Chairman’s Mark incorporates provisions of my Small Business Health Options Program (SHOP) Act as its model for opening access and increasing affordability to these individuals. The Chairman’s bill also would change the way insurance companies do business by requiring coverage of pre-existing conditions, barring discrimination based on health status, and allowing individuals to have coverage after a job loss.
Representative Nancy Pelosi
(Speaker of the House)
“Assuring the affordability of health care for all Americans and requiring accountability for insurance companies are two of our central principles in this reform.
“We look forward to studying the impact of the Senate Finance Committee Chairman’s mark on America’s families and businesses, and on the cost of health care. The fifth and final Congressional committee is now putting forward a product that will move this historic debate forward.
“We are pleased that Senator Baucus’ plan mirrors some key provisions in the House proposal, including sweeping insurance reforms and consumer protections. The House bill clearly does more to make coverage affordable for more Americans and provides more competition to drive insurance companies to charge lower premiums and improve coverage. The House bill also does more to help seniors afford prescription coverage, closing the donut hole completely, while the Baucus proposal simply reduces the cost of brand name drugs in the donut hole.
“As this proposal evolves, we hope to see modifications that result in the Senate bill better reflecting the work of the House to make health care more affordable for all Americans and promote competition that is key to keeping costs lower. I believe the public option is the best way to achieve that goal.”
Representative John Boehner
(House Minority Leader)
“This partisan bill is the wrong prescription during these tough economic times. It cuts Medicare for seniors, imposes new taxes on struggling middle-class families and small businesses, and has a trillion-dollar price tag. This issue is too important to get wrong. That’s why Democrats should scrap their expensive plans and work with Republicans on a fiscally-responsible proposal that lowers health care costs and expands access for the American people.”
AARP
(advocacy group that represents seniors)
“Today’s legislation moves the process forward and we hope the Chairman and his colleagues on both sides of the aisle can continue to have a rational, informed debate about its provisions as the committee’s markup process begins.
“AARP is pleased that the bill focuses on keeping people healthy by eliminating out-of-pocket spending for important screenings and preventive services in Medicare, and by covering annual wellness visits for Medicare beneficiaries and their doctors to focus on prevention. Under the legislation, doctors would be rewarded for providing quality care instead of for the number of tests ordered—a critical step in ensuring patients receive the highest quality care.
“The bill also includes incentives to improve quality of care by providing bonuses to Medicare Advantage plans while reducing subsidies to MA plans, saving taxpayers billions in waste. It introduces a pilot program on follow-up care, an important component in reducing costly and preventable hospital readmissions. Finally, the bill eliminates yearly and lifetime limits on what insurance companies will pay and substantially fills the dreaded Medicare doughnut hole—a costly gap in prescription drug coverage.
“However, we continue to have concerns about provisions that would allow for large differences in premiums based on age that could leave millions of older Americans still unable to afford the coverage they need. We also are troubled by the lack of any provisions to improve benefits for people with limited incomes so they can afford Medicare premiums and cost-sharing, and by the inclusion of an added premium tax that would raise prescription drug premiums on many middle-income working people in Medicare Part D.
“We look forward to working with Chairman Baucus, Ranking Member Grassley and their colleagues in the coming weeks to pass a health care reform package that protects benefits for people in Medicare and works for every American.”
Douglas Johnson, National Right to Life Committee legislative director:
The “America’s Healthy Future Act,” proposed today by Senator Max Baucus (D-Mt.), contains an array of pro-abortion mandates and federal subsidies for elective abortion. National Right to Life strongly opposes the legislation in its current form. We will work in support of amendments to eliminate the abortion mandates and federal abortion subsidies. The bill contains provisions that would send massive federal subsidies directly to both private insurance plans and government-chartered cooperatives that pay for elective abortion. This would be a drastic break from longstanding federal policy, under which federal funds do not pay for elective abortions or subsidize health plans that cover elective abortions.
Health Care for America Now
(liberal pro-reform group)
“The Baucus bill is a gift to the insurance industry that fails to meet the most basic promise of health care reform: a guarantee that Americans will have good health care that they can afford. The Baucus bill would give a government-subsidized monopoly to the private insurance industry to sell their most profitable plans – high-deductible insurance – without having to face competition from a public health insurer.
Under the Baucus bill, employers would have no responsibility to help pay for their workers’ coverage and would be given incentives to have workers pay more for barebones insurance. Americans who don’t get health benefits through work would still not be able to get good, affordable coverage.
We urge Senators on the Finance Committee to replace the Baucus plan with legislation that will do what the Senate HELP Committee and three House committees have done: guarantee that Americans have good health insurance that they can afford with the choice of a strong national public health insurance option.”
Justin Ruben, Executive Director of MoveOn.org
(liberal advocacy group)
“Senator Baucus’s health care bill released today is like a dream come true for the insurance industry. Wendell Potter, former Cigna executive, says the Baucus bill delivers more to Big Insurance than they could have hoped for. The Baucus bill is by far the weakest of all five bills that have come from both chambers of Congress, and the only one not to include the public health insurance option, which is key to lowering costs, expanding coverage, and injecting competition into the market. The Baucus bill will not solve the health care crisis that plagues millions of Americans, and fails to meet the basic tenets on successful reform laid out by President Obama.
“The Baucus bill not only lacks the public health insurance option which most Americans believe is the key to affordable coverage, but will also hit working American families in their pocketbooks – requiring individuals and families to buy insurance while doing nothing to make sure it’s affordable.
“The insurance companies have found their champion in Senator Baucus. The only good news is that the Senator stands nearly alone in supporting his bill. So with this bill behind us, we can now move forward with the real business of solving the health care crisis in this country.”
American Federation of State County and Municipal Employees (AFSCME) President Gerald McEntee
“The Senate Finance Committee health care bill is deeply flawed. It does not come close to meeting the needs of America’s working families. Nor does it meet the standards President Obama laid out in his address last week to Congress. There is no employer mandate, no public option, no help for retirees. The bill weakens state insurance regulations and taxes health plans that provide benefits for many middle class families. This bill fails to provide good, affordable coverage and does not protect families from medical bankruptcy. It is unacceptable. We call upon members of the Finance Committee to fix this bill.”
AFl-CIO President John Sweeney
(The nation’s largest umbrella union organization)
Despite months of painful negotiations, the Senate Finance Committee proposal released today absolutely fails to meet the most basic health care needs of working families and it fails to meet the expectations we have set for our nation.
It fails to put pressure on private insurers to control health care costs. There is no history or logic behind the claim that health care co-ops would provide real competition for the giant private insurers that have a stranglehold on health coverage today.
If you’re an individual who does not purchase private health coverage, it sticks you with a hefty tax penalty even though it fails to provide sufficient subsidies to make plans affordable for low and moderate income families. But if you’re an irresponsible employer who does not provide coverage, you get off scot free.
Outrageously, the plan imposes a 35 percent tax on high-cost health care plans without prohibiting insurers from passing on the tax to consumers who happen to be in groups that are older or sicker than average or live in high cost areas.
The Senate Finance proposal, sadly, is little more than a throwback to the failed policies of the last three decades that advantaged corporations over taxpayers and bestowed special breaks on the wealthy while ignoring the middle class.
The proposal does include the important insurance reform and health care delivery system improvements adopted by earlier congressional committees, and it builds on these by reforming the way we pay for health services to focus on the quality of services instead of the quantity. But the proposal’s strong points are nowhere near sufficient to outweigh its problems. However well intentioned the attempts at bipartisanship, the final product reflects the bankrupt policies of the past more than the forward-looking policies needed to drive meaningful health care reform.
We are counting on finance committee Democrats to fix the bill and side with working families, not insurance companies.
America’s Health Insurance Plans
(lobbying group that represents private health insurance companies)
“Senator Max Baucus has led an unprecedented and rigorous bipartisan process to enact health care reform this year and challenged all stakeholders to contribute to this process. The introduction of legislation in the Finance Committee is a very important step in the health care reform process.
“Health plans have stepped up and proposed robust insurance market reforms to ensure nobody falls through the cracks and a complete overhaul of administrative processes that will improve efficiency, reduce paperwork, and free up time for doctors to focus on patient care. We also advocated and support a new reinsurance mechanism to assist in the transition to new market rules.
“We are committed to working with policymakers and stakeholders to find savings in the Medicare program, including Medicare Advantage, but it is important to ensure seniors’ health care choices are protected.
“New health insurance reforms and consumer protections will guarantee access for all Americans without the need for a new untested government-created co-op that could disrupt the quality coverage on which millions of Americans rely today. We believe there is an opportunity for additional system-wide cost containment to ensure coverage is more affordable and to put our health care system on a sustainable and fiscally responsible path. New taxes on health care coverage will have the opposite effect by making coverage less affordable for families and employers across the country.
“As the process progresses, health plans will continue working with members of Congress to enact bipartisan legislation this year that will cover all Americans, make coverage more affordable, and improve quality.”
PhRMA
(lobbying group for drug manufacturers)
“We are currently reviewing the Senate Finance Committee health care reform proposal but we continue to believe that all Americans should have access to high-quality, affordable healthcare coverage and services. If done in a smart way, health care reform will benefit patients, the economy and the future of America.
What’s critical now is that we remain focused on the important goal of helping pass a comprehensive health care reform bill that can get to the President’s desk this year. We will continue to be a constructive partner to help meet this goal.”
Heritage Foundation
(conservative think tank)
“Senate Finance Committee Chairman Max Baucus (D-MT) has been engaged in a good-faith effort to build potentially broad bipartisan support for health care reform. If carried out on a far wider scale with members of both parties, in both houses, and with the good-faith involvement of the President, such a process could lead to the kind of bipartisan health reforms Americans would believe in. To do that, the President needs to hit the “reset” button and bring together a wide set of members with a fresh roadmap – and the Baucus bill is not that roadmap. Many of its key provisions are badly flawed. Some examples are:
While it drops explicit endorsement of a public option, the legislation creates a CO-OP which is literally an acronym for a new federal program – not the empowerment of existing co-ops – and it is in reality a thinly disguised public option.
It applies a 35 percent excise tax on higher-cost plans, together with a new sales tax on pharmaceutical, health insurers, clinical laboratories and medical device manufacturers. These taxes will be passed through to patients. While self-insured health plans, typically offered by employers and including most union-negotiated plans, will not face the insurer tax, they will still be subject to the higher-cost plan tax.
Federal taxpayers will have to pick up almost all of the cost of an expansion of Medicaid, although states will also face additional costs and yet not be granted the necessary flexibility to reform Medicaid.
A “pay-or-play” mandate on most employers will hit the incomes and jobs of low-income workers. And a mandate on individuals to purchase insurance, combined with the taxes and new rules, will push up the cost of coverage. Despite limited new subsidies for individuals, many low-income and middle-income Americans will have to pay more for coverage or break the law. This would break the President’s pledge to reduce insurance costs for families.
This is not the way to achieve bipartisan reform. The president needs instead to lead by meeting with key leaders of both parties and seek bipartisan reform around two key themes. Congress must remove legislative obstacles to states so that they can make reforms to health insurance rules and Medicaid to increase coverage. And it must reform the tax treatment of health care in order to provide tax assistance for Americans who have no tax relief for the coverage they want.”
American Benefits Council
(lobbying group that represents companies that offer employee health insurance benefits)
“With so much at stake, and so many stakeholders, reform of the American health care system must be undertaken thoughtfully and cooperatively. We congratulate Senate Finance Committee Chairman Max Baucus for his tireless work the past several months and on today’s release of The America’s Healthy Future Act, which is not a perfect bill but represents a critical step toward a comprehensive solution to the nation’s health care problems,” said American Benefits Council President James A. Klein.
“Importantly, the Senate Finance Committee proposal avoids many of the destabilizing provisions included in other legislative proposals, such as the employer ‘pay’ or ‘play’ mandate, unlimited state law remedies for employers obtaining coverage within the insurance exchanges, federal waivers to states that enact single-payer systems and the public health insurance option,” Klein said.
“The Council continues to have concerns with certain key aspects of this measure, such as the complicated and costly excise tax, other fees on health insurers and other stakeholders and the tax on valuable prescription drug coverage for retirees. These costs are all likely to eventually be paid by employers and employees and would therefore make health care less affordable,” Klein said.
“The most successful and enduring public initiatives are those that are developed and approved with broad bipartisan support. The House of Representatives tri-committee bill and the Senate Health, Education, Labor and Pensions (HELP) Committee bill do not meet this standard, but the Senate Finance Committee proposal offers reason for optimism that broad agreement on health care reform may be possible this year,” Klein said. “We will continue to work with the Senate Finance Committee and other lawmakers to make that possibility a reality and we applaud Chairman Baucus for his continued efforts.”