Different legislative tracks intersect at several points -- cost, control, consumer needs, care-giver interests and collegiality. Republicans are almost universally skeptical. Democrats are very divided about health care reform between liberals and moderates. How fast the legislation can move through Congress depends on how fast the committees can complete their work. President Obama wants a vote in the Senate by August. The President now active in the debate using the town hall as his forum. So far the American Medical Association is opposed to a public option. And it is fairly apparent that a single payer plan is out of the question.
"The health care industry has a huge stake in reform" opines J.P. Green of the Democratic Strategist: "They will fight the public option, but they know that some form of expanded government health coverage is inevitable." To quote Politico's Carrie Budoff Brown, "The public insurance option remains the single biggest obstacle to a bipartisan bill, snarling the parties – and wings within each party – in a debate over the power of government, the role of the free market and the need to cover the uninsured."
A big part of the division in the Senate is associated with the so-called "public plan." Senators in the cross-hairs of several active advocacy groups include Ben Nelson of Nebraska, Mary Landrieu of Louisiana, and Kent Conrad of North Dakota. Other moderates with whom groups must contend are Evan Bayh of Indiana, John Tester of Montana, Tom Carper of Delaware, along with Blanche Lincoln and Mark Pryor of Arkansas.
Floor strategies in the Senate are not yet settled. The reconciliation process, needing just 51 votes is still on the table. Two senators, Kennedy and Byrd, are absent due to illness, and the Minnesota seat is still empty. Senator Chris Dodd is acting in a leadership role for Senator Ted Kennedy's Health, Education, Labor and Pensions Committee, which has, quoting Politico:
. . . released a 615-page bill, but details on the most contentious issues, such as the public insurance option and the employer mandate, were left out for now . . . The bill calls for insurance market reforms, a prohibition on insurers’ denying coverage to sick people, a mandate on individuals to own coverage and the creation of marketplaces where people can compare and buy coverage.
In the U.S. House of Representatives -- According to Patrick O'Connor and Chris Frates of Politico, House Speaker Nancy Pelosi and Majority Leader Steny Hoyer's top aides have prepared a joint memo indicating the unity of their leadership positions. To quote:
House Speaker Nancy Pelosi and Majority Leader Steny Hoyer are double-teaming powerful chairmen and rank-and-file members to save health care reform from a repeat of the Democratic Party infighting that helped kill it in 1994.
. . . Pelosi and Hoyer urged Education and Labor Committee Chairman George Miller (D-Calif.), Ways and Means Committee Chairman Charles Rangel (D-N.Y.) and Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) to heed the concerns of moderate Democrats.
. . . Waxman, Miller and Rangel — along with their respective aides — are trying to draft legislation in concert with each other so their committees will take up the same bill later this summer.
In the House, moderates include Blue Dog Democrats, constraining any public health plan option, and members of the New Democratic Coalition. Again, the public option provides a variety of sticking points for them including cost, Medicare rules. Rep. John Dingell of Michigan is a respected leader who has "offered a universal health care bill every year since he came ot Congress in 1955," the authors reported. To quote:
Toward the end of Tuesday’s caucus meeting, he rose on his crutches and told the audience that this measure has the promise of becoming a legacy like Social Security — a program his father helped create in the 1930s.
As he closed, he told members they should have the courage to move forward, eliciting a standing ovation from his fellow Democrats. Pelosi announced Tuesday that the bill will bear Dingell’s name.
. . . House Democrats expect to introduce actual legislation next week, Waxman and others said Tuesday. The preliminary goal is to move legislation out of the committees by the Fourth of July and then clear the House by the August recess, setting up a fall showdown with the Senate over a final bill.
Health Care Reform will happen this year, in my opinion. The train has already left the station. In fact change is already happening. The Children's Health Insurance Program (CHIP) is now the law of the land. Health Information Technology reform is being funded by the President's Stimulus monies. And the President will soon sign the bill to mandate tobacco regulation by the FDA. If all of us work hard, a new era can emerge. But it could also easily get derailed. It is going to be an interesting ride.
- "Can Health Overhaul Heal the Economy," by Alex Wayne of Congressional Quarterly (6/3/09).
- "Axelrod Fuels Democratic Message Machine for Health Care Overhaul," by Drew Armstrong of Congressional Quarterly (5/13/09).
[Post date - June 12, 2009]
See also Behind the Links, for further info on this subject.
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