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Senior and Post-Acute Healthcare News and Topics

Senate Health Reform Bill Loses Public Option

The Senate Finance Committee voted yesterday to eliminate the public option from its reform bill (aka the Baucus Bill) by a margin of 15 to 8. All Republicans and a hand-full of Democrats voted against inclusion. Of note, the Bill’s author, Senator Baucus voted for the removal of the public option stating that in his opinion, inclusion would sentence the Bill to its death in a floor vote. The legislation requires 60 votes to pass the Senate.

The Committee continues to take up other amendments and issues such as public funding for abortion, a sticking point for Republicans and Moderate/Conseravative Democrats. As of now, current law forbids federal funding of abortions except in the case of rape or incest. Another key amendment that has found no traction is a provision that would require the entirety of the Bill, including mark-ups and amendments to be published on-line at least 72 hours prior to a floor vote. Democrats defeated this amendment.

While the Senate version at least for now, contains no Public Option, this is not the end of the line for inclusion of a Public Option by any means. Democrats insist that they will bring the Public Option back during floor discussions commensurate with a final vote. The House version of reform presently contains a Public Option and Democrats in favor of such an option, have enough votes in the House for the provision to remain intact. Should a House bill get passed containing the Public Option and a Senate bill absent the provision get passed, it will remain the duty of a Conference Committee to iron out whether a Public Option remains in the final version that returns to both houses for a vote.

The next few days should be interesting as the Senate works through hundreds of amendments and Democrats explore procedural options to speed passage. One such option is called Reconciliation – a process by which a “shell” version of a bill is brought directlty to the floor and crafted in “session”. The advantage for Democrats to this strategy is that such a procedure requires only 51 votes for passage of a bill. The disadvantage is that provisions not related to spending control such as a requirement for insurance companies to eliminate pre-existing condition requirements can be excluded as “not germane”. This potential gambit by Democrats could produce a wholesale meltdown within their Blue Dog ranks and certainly, will galavanize moderate Republicans against any form of legislation being passed. In essence, this strategy, the dreaded Nuclear Option, could very easily backfire. Stay tuned.

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September 30, 2009 - Posted by | Policy and Politics - Federal | , , ,

1 Comment »

  1. it ain’t over til the fat lady sings! I’ve just posted on the alternatives…with respect to federalism. …a different angle, huh? If you want to have a look, here is the link. I would argue that the consideration of health-care insurance reform alternatives ought to include an assessment of how consistent each is with federalism, for if we focus narrowly on the issue of the day without pausing to consider the impact on our system of governance, we will be unintentionally passing on a less perfect Union to our descendents. If you are interested in my attempt, pls see http://euandus3.wordpress.com/2009/10/27/health-care-insurance-reform-a-spectrum-of-alternatives-with-respect-to-federalism/

    You might also be interested in this NYT article:
    http://www.nytimes.com/2009/10/27/health/policy/27health.html?_r=1&hp

    Comment by euandus | October 27, 2009 | Reply


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