WASHINGTON (Nov. 18) -- Setting up a historic year-end health care debate, Senate Majority Leader Harry Reid unveiled long-awaited legislation Wednesday night to extend coverage to all but 6 percent of eligible Americans and bar private industry from denying insurance because of pre-existing medical conditions.
The Democrat's $849 billion measure is designed to remake the nation's health care system, relying on cuts in future Medicare spending to cover costs — as well as on higher payroll taxes for the well-to-do and a new levy on patients undergoing elective cosmetic surgery.
Aides said the mammoth, 2,074-page bill would reduce deficits by $127 billion over a decade and by as much as $650 billion in the 10 years that follow, citing as-yet-unreleased estimates by the Congressional Budget Office.
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"Tonight begins the last leg of this journey," said Nevada Sen. Reid, less than two weeks after the House approved its version of a sweeping remake of the health care system— and nearly 10 months after President Barack Obama's Inauguration Day summons to action.
Obama welcomed Reid's action, saying, "Today, thanks to the Senate's hard work, we're closer than ever to enacting solutions to these problems. I look forward to working with the Senate and House to get a finished bill to my desk as soon as possible." There was no mention of Obama's longtime goal of signing legislation by year's end.
Republicans vowed a protracted struggle to block the legislation and deny the president a victory that would cap a tumultuous first year in office.
"This bill has been behind closed doors for weeks," said Sen. Mitch McConnell of Kentucky, the Republican leader. "Now, it's America's turn, and this will not be a short debate. Higher premiums, tax increases and Medicare cuts to pay for more government. The American people know that is not reform."
An early showdown on the Senate floor is expected by week's end.
Reid's Senate measure would require most Americans to carry health insurance and would provide hundreds of billions of dollars in subsidies to help those at lower incomes afford it. It also would mandate that large companies to provide coverage to their workers.
Beginning in 2014, it would set up new insurance marketplaces — called exchanges — primarily for those who now have a hard time getting or keeping coverage. Consumers would have the choice of purchasing government sold insurance, an attempt to hold down prices charged by private insurers.
After weeks of secretive drafting, Reid outlined the legislation to rank-and-file Democratic senators at a closed-door meeting. "Everyone was positive," said Sen. Amy Klobuchar, D-Minn.
That didn't mean there weren't problems — far from it. At his news conference, Reid pointedly refrained from saying he had the 60 votes necessary to propel the bill over its first hurdle.
Reid met privately earlier in the day with Sens. Ben Nelson of Nebraska, Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, moderate Democrats who have expressed concerns about the measure.
Nelson later issued a statement strongly suggesting he would vote with fellow Democrats on an initial showdown expected within days. Aides have said privately that Reid decided to retain an existing antitrust exemption for the insurance industry as a way of satisfying the Nebraskan's concerns.
Landrieu said, "I'm not going to be for anything that doesn't drive down costs over time."
Lincoln, the only one of the three who faces re-election next year, told reporters, "We'll wait and see."
With the support of two independents, Democrats have 60 seats, the precise number needed to choke off any delaying tactics by the 40 Republicans who appear united in opposition to the bill in its current form.
In general, Reid proposed an outline that is similar to the House-passed bill, but there were important differences.
He called for an increase of a half percentage point in the Medicare payroll tax for individuals with income over $200,000 a year, $250,000 for couples.
He also included a tax on high-value insurance policies, meant to curb the appetite for expensive care.
The House bill contains neither of those two provisions, relying on an income tax surcharge on the wealthy to finance an expansion of coverage.
Reid's measure also calls for hundreds of billions of dollars in cuts in future Medicare spending, an attempt to satisfy Obama's call to curtail the growth of health care spending that is fiercely opposed by Republicans.
On another controversial issue, Sen. John Kerry, D-Mass., told reporters Reid had decided to require the side-by-side sale of insurance policies that cover abortion services and do not, an attempt to satisfy both sides. That is far less restrictive than a House-passed provision that left liberal Democrats angry.
Ahead lie weeks — if not more — of unpredictable maneuvering on the Senate floor, where Reid and his allies will seek to incorporate changes sought by Democrats and repel attempts by Republicans to defeat the legislation and inflict a significant political defeat on the president.
Reid released his legislation more than a week after the House approved its version of the health care bill on a near party-line vote of 220-215.
According to estimates from the Congressional Budget Office, that House bill, with a price tag of about $1.2 trillion, would result in coverage for tens of millions of uninsured, and provide 96 percent of the eligible population with insurance.
Two Senate committees approved different versions earlier in the year, and while Reid has said he would produce a blend of the two proposals, in fact he had a virtual free hand to come up with a plan that could command the 60 votes needed to pass.
Anticipating a major struggle, the White House deputized Interior Secretary Ken Salazar and former Senate Majority Leader Tom Daschle to join Vice President Joe Biden in trying to clear the way for the bill's approval over the next several weeks.
Salazar, a former Colorado senator, is viewed as a bridge to moderate Democrats who are far outnumbered by liberals inside the Democratic caucus.
Daschle was Obama's first choice for secretary of health and human services, a position from which he was to try and oversee the administration's drive to enact health care legislation. He withdrew his nomination when it was disclosed he had not paid more than $120,000 in federal taxes over several years.
Associated Press writers Ricardo Alonso-Zaldivar and Erica Werner contributed to this report.
Mom's take kids to the pediatrician too often. A sore throat or a headache can be treated at home without antibiotics. After all, headaches come and go away. Actually bad headaches in children are rare, and could mean something as bad as meningitis. So those kids should see the doctor. Also, undiagnosed Streptococcus (sore throat) can cause high fevers which can be dangerous for the child.
Outpatient status for labor and delivery. Not good. The one or two days in the hospital involve help and education about breast feeding, photo therapy for high biliruben, needed bed rest for mom, education for parents, and lots of support. I do not agree that this should be removed in maternal care. He also mentioned home-delivery by nurse practioners. Good, but not for everybody.
Putting newborns in a sunny window for hyperbilirubenemia can work for mild cases. Also, does every home have a place in the window that will work for photo therapy? Will mom put baby on the floor for phototherapy?
scary. ann
Let do the first thing 1. demand that we pay our bills, this mean everyone need to have fair and equity tax system either by have consumption tax and do away with the income tax. In E gland no one files taxes except the individuals who get a tax return. Second, lets create job by buying American and enacting feedin tarriffs for green energy. Thirds, free trade does happen. You has Korea only allow us to sell 3,000 cars in there country is joke, China the same way. But unlesss you balance the budget you cant go after our bankers. Free trade mean free trade...we understand that we don't have free trade agreements.
1. Balance the budget and start paying the debt
2. Enact industrialize policy that require us to buy American good when using public funds
3. Enact a free trade policy that state we can produce the same number of items as allowed in the ohter country.
4. top tax credits except for homeownership and enact feed-in tarriffs for solar and wind systems.
Cheers
10:02AM Nov 19 2009
Why is it always, "Tax the rich"?
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Because they are the only ones paying federal income taxes....
Why do you suppose that all of a sudden, the government has changed the long-standing rule of thumb for mamograms? If they paid for one per year from the age of 40, through 60, they would pay for 20 mamograms per woman. Under the NEW plan, beginning at 50 and getting one EVERY OTHER YEAR, they have reduced the number to just 5 mamograms per woman, over the same 20-year span.
The government has proven just how "qualified" they are at handling our healthcare. Just look at how "well" the Medicare and Medicaid programs work!
We are in SERIOUS trouble!
so don't trust this government for health care or anything else.
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Whether or not the government can do healthcare more efficiently or not is a 'red herring'. I dont' believe they can, ******* not the key point. The key point is that you can't lower costs by insuring more people. Its been demonstrated empirically that people with insurance consume more healthcare than people ************* also been proven that, with the exception of vaccines, preventative care costs far more than simply waiting till people get sick and see a doctor. It may be preferable to the individual, but the overall costs are far higher. The plan is going to increase the number of uninsured (see my last post), cost millions their employer sponsored healthcare, and not make a dent in costs (best case) or actually raise them (worst case). All to raise hundreds of billions in tax dollars (from individuals, employers and medical companies) that can then be redistributed to a very small subset of the population that: (1) is too young to be on Medicare, (2) too rich to be on Medicaid, but (3) not rich enough to be able to afford to purchase their own insurance.