The Senate Finance Committee Writes a Health Care Bill

It starts–finally–in just a few hours. With the bang of a gavel in the high-tech cavern that is the conference room of the Senate Hart Office Building, the Senate Finance Committee will sit down around a table and confront the question of whether it can actually produce a health reform bill.

One of the worst kept secrets on Capitol Hill is that “mark-ups”–the formal public sessions in which legislation is ostensibly drafted–are not where any real work gets done. Where the real deals get cut, and where the favors get traded back and forth, is in private. The mark-up itself is little more than theater, a chance for everyone to give speeches and then march toward a pre-ordained conclusion.

There will be plenty of dealing on the sidelines here as well. But the Senate Finance Committee’s markup of health reform legislation is likely to be more revealing than most. On public display will be all of the ideological and philosophical fault lines that have for decades stymied every President and every Congress that have tried to do something about this issue.

And there will be additional pressure. The mark-up comes as the culmination of months in which Chairman Max Baucus made a thus-far fruitless effort to woo a handful of GOP members, shutting out some of his fellow Democrats in the process. As a result, the bill that Baucus produced has been the target of intense criticism from both sides. It faces hundreds of amendments, promising a tug of war between the left and the right that will be the best test yet of whether this legislation has any chance of ever reaching the President’s desk.

Baucus and his staff are predicting that the committee will actually reach its final vote by the end of the week. That looks pretty optimistic to me, though Baucus has been moving with uncharacteristic speed to resolve as much as he can in advance. Already, he has modified his original bill to meet some of the broader concerns of his members. He has made the subsidies more generous, so that the uninsured will be able to better afford the coverage that they would be required to purchase under the legislation. And he has trimmed back his initial plan to slap a hefty excise tax on the most expensive health insurance policies.

But there are a raft of other issues that can only be settled the old-fashioned way, by an up-or-down vote. Among them: Will there be a new government-run “public option”? Should employers be required to offer coverage? Should individuals be forced to buy it? And what should be the consequences if they don’t?

There are other bills out there. Three committees in the House and one in the Senate passed theirs this summer. But this is the one that matters the most, if only because the degree of difficulty is so much greater. If Baucus manages to get his legislation through his committee intact, it will become the template–first on the Senate floor, and then in the conference committee. If he doesn’t, Democratic leaders will have to recalculate their entire strategy amid new questions as to whether health reform, Barack Obama’s most ambitious domestic priority, is doable at all.

Kate Pickert, Jay Newton-Small and I will be following the progress of the mark-up here in Swampland, so check back with us often in the coming days.

Related Topics: Senate Finance Committee, Congress, Health Care
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  • trifecta55

    Do Wyeth, Merck, Amgen and AstraZeneca get their own seats at the table, or have they given Baucus proxy shares?

  • gysgt213

    I heard Baucus will attempt to reduce the penalty people will have to pay for insurance they can’t afford. What a deal!

  • http://www.historyisaweapon.com historyisaweapon

    Baucus delivers unfunded mandates, no republican votes, and does nothing to bring down the skyrocketing cost of health insurance. His proposal isn’t a starter; we can start by tossing it in the trash. The health insurance companies have failed the country. While the best solution is clearly single payer, no robust public option on day one means reform has fundamentally failed. Baucus might not be running again soon, but other dems might look to 94 when they failed to reform then. Baucus is leading them into the fire.

  • plukasiak

    But this is the one that matters the most, if only because the degree of difficulty is so much greater.
    _
    Bullsh*t. The reason why this bill might have a hard time getting out of committee is because it flies in the face of common sense, and therefore lacks the support of the Democrats on the committee.
    _
    YOU decided months ago that Baucus’s “gang of six” efforts were the most important thing there was. Those efforts failed, and Max Baucus decided to personally hijack the process and submit his own bill, and you treat it as perfectly normal.
    _
    ITS NOT. This is evidence of the complete corruption of the process, but because it suits your professional agenda, you treat it as normal. Max Baucus FAILED, and now has hijacked the process because YOU refuse to report on how completely he failed, and how ridiculous it is for the Finance committee to IGNORE is own subcommittee structure and let Baucus define the terms of the debate.

  • http://swampland.blogs.time.com/2009/09/22/my-first-markup/ Max Baucus’s Senate Finance Committee Markup on Health Care Reform – Swampland – TIME.com

    [...] a few days this week to help Jay Newton-Small and Karen Tumulty cover the Senate Finance Committee markup of Chairman Max Baucus's health reform bill. Here in the Hart Senate Office Building, the hearing [...]

  • rustyreturns

    Fifty-six percent (56%) of voters nationwide now oppose the health care reform proposed by President Obama and congressional Democrats.

    .
    plukasiak says:

    “Max Baucus FAILED, and now has hijacked the process because YOU refuse to report on how completely he failed, and how ridiculous it is for the Finance committee to IGNORE is own subcommittee structure and let Baucus define the terms of the debate.

    .
    You are blaming Karen for the failure? Are you NUTS?
    .
    The failure of this bill, the entire Healthcare Reform Plan is simply due to the fact that the majority of Americans do NOT like this bill and have expressed such to their individual Senators and Representatives.
    .
    It is simply a bad plan. It will cost way too much, increase the deficit beyond anything we currently are experiencing, and most ALL Americans who have healthcare nearly 85% are very satisfied with what they have.
    .
    Karen has presented the FACTS. Which I must admit on occassion she and the other TIME journos inject way too much of their opinions into their articles. But, in complete defense of Karen, so far as her reporting on healcare, she has simply reported on what Congress, in specific Baccus has been stating for the past several months. IF Karen or any of the other Journos can be faulted for not asking the right questions, the only question they consistently fail to ask Congressional Reps and Senators is how they plan to cut the actual cost of Healthcare. How they plan to control costs of drugs, DME’s, wages and salaries of Nurses and Doctors, and Hospital bed charges. That is the only way to make Healthcare affordable for ALL Americans.
    .
    If you want to get mad, call up your Senator or Representatives office and complain.

  • plukasiak

    I didn’t blame KT for the failure — I blame her for allowing Baucus to hijack the entire process after the whole gang of six thing failed.
    _
    And the reason the bill is so bad is that it was written by the health care parasites after negotiations with the White House, Republicans, and Blue Dog Democrats. Its welfare for insurance companies, drug companies, and for-profit health care.
    _
    KT never bothered to question the handouts she was given by the White House and Baucus — it wasn’t until Sunday that she pointed to an article that expressed skepticism of the claims that the Mayo Clinic model was achievable/advisable.
    _
    KT, of course, is not alone in her utter failure to provide adequate coverage of the issues (as opposed to ‘horserace’ coverage) in the health care reform debate — she merely personifies the problems with the press coverage of the issue.

  • kathy

    Karen – I don’t understand all the passion and effort that went into the other bills – particularly the Kennedy/Dodd bill that Ted Kennedy was reportedly so pleased was finished before he died – if the inevitable result was that they would get ignored and it was only the Finance comittee bill that matterred. And isn’t this part of the reason it’s nuts? After all, one presumes that health care is not, um, the specialty of the finance committee, and maybe it is the specialty of the prinicpal committee that deals with health. If it was obvious that this all focused on Baucus, and I’ve read that for months, why was the health committee bothering?

  • http://blog.kaiserhealthnews.org/index.php/2009/09/22/markup-preview-what-would-harry-do/ Markup Preview: What Would Harry Do? – Blog Watch

    [...] Time’s Karen Tumulty thinks the committee’s markup is “likely to be more revealing then most.”  According to Tumulty, “On public display will be all of the ideological and philosophical fault lines that have for decades stymied every President and every Congress that have tried to do something about this issue.”  And perhaps a glimpse of the internal debates plauging the “gang of six.” In a later post, she notes “Chairman Max Baucus just warned the committee that he is prepared to work all night.” She promises that she and her Swampland colleagues will be closely following the action. [...]

  • rdquinn

    This markup already has over 500 amendments to it. If read closely it should be called the Medicare Modification and Expansion Act. All of the pending “reforms” have serious consequences, usually for people with health insurance and for employers who provide it. I have made a quick assessment for anyone interested and posted it on my blog Quinnscommentary.com at

    http://quinnscommentary.com/category/healthcarehealthcare-reform/

  • http://bewellbuddy.com/2009/09/the-senate-finance-committee-writes-a-health-care-bill-and-related-posts-3/ “The Senate Finance Committee Writes a Health Care Bill” and related posts – BeWell Buddy

    [...] “The Senate Finance Committee Writes a Health Care Bill” and related posts Read The Full Article…“The Senate Finance Committee Writes a Health Care Bill” and… [...]

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