WASHINGTON — Senate Finance Committee members of both parties signaled an aggressive effort to reshape health-care legislation proposed by Chairman Max Baucus, drafting 564 amendments for consideration when the panel meets later this week.
Members want to make a host of changes to legislation designed to lower health-care costs and expand coverage to the uninsured, which Baucus introduced after months of bipartisan talks. Possible revisions include expanding tax subsidies to lower-income Americans to pay for coverage, eliminating a proposed $215 billion tax on high-value health plans, and establishing a government-run insurance program to provide competition with private industry.
Baucus said after introducing his measure last week that he expects some changes to be approved, including areas related to Medicare cost savings and insurance subsidies. He made clear he will try to keep the general framework of his plan intact.
"It's a readjustment andredialing of whatever is in the package," Baucus, a Montana Democrat, told reporters.
Three House panels and the Senate health committee have approved rival measures along party lines.
Baucus' legislation would require almost all Americans to have insurance or pay a penalty, expand Medicaid and provide subsidies to help millions of low-income people get coverage through an online exchange.
In a bid for Republican backing, he offered a plan that the nonpartisan Congressional Budget Office says would lower the budget deficit over 10 years, uses nonprofit cooperatives rather than a Democrat-supported government program to compete against Aetna Inc. and other insurers, and drops a mandate that all employers provide health care to workers.
To pay for his plan, Baucus seeks savings in programs such as Medicare, the federal insurance plan for the elderly and new taxes. He's proposing a levy on costly "Cadillac" health plans and about $13 billion in fees on insurers, medical-device manufacturers, drug makers and clinical laboratories.
Among changes Democratic lawmakers want, Sen. Jay Rockefeller, a West Virginia Democrat, is proposing to replace the nonprofit cooperatives with a government-run so-called public option. Democratic Sens. Charles Schumer of New York and Maria Cantwell of Washington favor setting up a public program, with rules that require the Medicare-like system to compete on a morelevel playing field with private industry.
Like several other lawmakers, he wants to increase the number of uninsured who would qualify for Medicaid coverage. Baucus supports boosting the threshold for coverage to 133 percent ofthe poverty level; Rockefeller wants to lift that to 150 percent.
Democratic Sen. Ron Wyden of Oregon is seeking tax subsidies for insurance purchases available to those earning as much as 400 percent of the federal poverty level, rather than 300 percent as Baucus put forth. Poverty guidelines for 2009 are $10,830 for an individual and $22,050 for a family of four, according to the Department of Health and Human Services.
Sen. Robert Menendez, a New Jersey Democrat, is banding with three other Democrats on a proposal to ensure that anyone below the 400 percent threshold who is utilizing either a subsidy or tax credit will pay no more than 10 percent of their income before getting the aid. Baucus has a maximum of 13 percent of income for some consumers at the top end of a sliding scale.
On the Republican side, a number of lawmakers are taking aim at tax increases and industry fees in the Baucus measure. Sen. Charles Grassley of Iowa, the top Republican on the committee, wants to eliminate $13 billion in new fees thatwould be imposed on the insurance, pharmaceutical, clinical laboratory and medical-device sectors. He would partly offset that by tapping funds approved as part of this year's economic stimulus measure that haven't yet been spent.
Sen. Mike Enzi of Wyoming, who like Grassley was a Republican negotiator on Baucus' bill, wants to block any expansion of Medicaid that results in cost increases for states. Sen. Orrin Hatch, a Utah Republican and critic of the bill's price tag, wants to cut the Medicaid expansion altogether, as well as the cooperatives - which under Baucus' proposal get $6 billion in federal startup funds.
Sen. Jon Kyl of Arizona, the No. 2 Senate Republican leader, is offering a host of changes,including a requirement that legal immigrants show proof they have lived in the U.S. for at least five years before getting government help to buy insurance.
Meanwhile, a GOP congressman grateful for quick detection of her breast cancer said Democratic health overhaul plans could mean life-threatening delays in treatment.
Rep. Sue Myrick of North Carolina said in her party's weekly radio and Internet address that her diagnosis "took six doctors, three mammograms and one ultrasound before they finally found my cancer. This process took only a few weeks."Information for this article was contributed by The Associated Press.
Front Section, Pages 7 on 09/20/2009