It’s all over but the vote. The Senate Finance Committee–the most closely watched of the five congressional panels that have jurisdiction over health reform, and the final one to weigh in–worked until after 2 a.m. this morning, finishing its markup of health legislation.
Final passage is expected next week. The only suspense there is whether Maine Republican Olympia Snowe will vote for the measure, becoming its only GOP supporter. She has gotten much of what she wants in the bill, but continues to express dissatisfaction with its requirement that people who are not covered by their employers or by government plans go out and buy coverage themselves. However, that provision was weakened significantly by some of the final amendments, which would lighten the penalties for failing to do so and exempt more people from the requirement.
All of this sets the stage for action on the House and Senate floors, which leaders say they hope will begin in mid-October, after Columbus Day. Some contentious issues will return then, among them, the government-run “public option” that was defeated by the Finance Committee. And some will have their first tests. Snowe, for instance, plans to offer an amendment on the Senate floor to put the public option on a “trigger,” establishing it as a fallback if private insurance companies fail to compete vigorously to bring down the price of health coverage.
The spotlight now shifts to Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi, who will have to make some very big decisions on how to meld the total of five versions of the legislation they now have before them. For instance, on the public option: Will Reid present a bill on the floor that includes it (as the Senate Health, Education, Labor and Pensions Committee bill does), inviting an amendment to strike it, or will he present the Finance Committee’s version that does not, in which case public option advocates will try to add one? Will Nancy Pelosi choose the more robust option of the Ways and Means Committee and Education and Labor Committee’s bills, or the Energy and Commerce Committee’s version, which would operate more like a private insurance company?
There is also the crucial issue of affordability. If government is going to require people to buy insurance, how much assistance should it give them to do that? The subsidies are the most expensive element of the bill, and Pelosi in particular is under great pressure to reduce the price tag of her measure, to bring it in line with President Obama’s dictate that it not cost more than $900 billion over the next 10 years. (One reason that the Finance Committee vote is being delayed until next week is to give us a clearer idea of what the numbers are in that measure.)
Nonetheless, the Finance Committee’s markup has been a significant step, and marks the beginning of a new phase in this debate. At 2:23 a.m., the White House issued this statement from President Obama:
“Thanks to the unyielding commitment of Senator Baucus and members of the Senate Finance Committee, we have reached another milestone in our effort to pass health insurance reform. Over the past two weeks, the Committee has engaged in long hours of thoughtful deliberation and vigorous debate. They have considered hundreds of amendments, and incorporated many of the best ideas from both parties. And they have shown a spirit of civility, a seriousness of purpose, and a willingness to compromise that embodies our democratic process at its very best.
“The Finance Committee’s work is the culmination of tireless efforts over the better part of this year by the five committees and many members of Congress involved in health reform – holding numerous hearings and bi-partisan meetings; reaching out to stakeholders across the spectrum; and striving to find common ground. As a result of this work, we are now closer than ever before to finally passing reform that will offer security to those who have coverage and affordable insurance to those who don’t. We have a long way to go, but I am confident that as we move forward, we will continue to engage with each other as productively as the members of the Finance Committee, and will get reform passed this year.”