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Baucus' Reform Bill Likely To Face Challenges Next Week

Janice Simmons, for HealthLeaders Media, September 16, 2009

Senate Finance Committee Chairman Max Baucus (D-MT) released on Wednesday the panel's healthcare reform bill, called America's Healthy Future Act, that was hammered out with an eye toward bipartisan support. But if its release is any indication, this Chairman's Mark will be facing an uphill battle when hearings begin next week.

Already, two of the three GOP senators who had worked with Baucus on the bill--part of his bipartisan "gang of six" senators--in recent weeks are choosing not to support it.

Sen. Charles Grassley (R-IA), who is also the ranking minority members on the Finance Committee, said in a statement that he's disappointed because "it looks like we're being pushed aside by the Democratic leadership so the Senate can move forward on a bill that, up to this point, does not meet the shared goals for affordable, accessible health coverage that we set forth when this process began."

Grassley was particularly concerned about "some serious outstanding issues that have yet to be resolved like preventing taxpayer funding of abortion services and the enforcement against subsidies for illegal aliens."

Sen. Mike Enzi (D-WY) said "fundamental issues" existed that were not able to be resolved "by the deadline that was set for us." He said that the measure that was released "still spends too much, but it does too little to cut healthcare costs for those with health insurance."

The Congressional Budget Office estimates the Chairman’s Mark would cost $856 billion over 10 years. This amount would be paid for mostly through "increased focus on quality, efficiency, prevention, and adjustments in federal health program payments, without adding to the federal deficit," according to Baucus in a statement.

When hearings begin next week, it's likely that the process is going to turn into "the wild West," said Julian Hobson, a senior policy advisor at international law firm Bryan Cave LLP, in Washington, DC.

"Usually when Chairman's Mark comes out, it's all set: Everybody's negotiated what they wanted in [the bill], and that's sort of it. The deal is [to] defeat all amendments," he said. This will likely be different with Republicans and Democrats both expected to offer a significant number of amendments.

One area where amendments are expected to be introduced is over the area of a public insurance option, which is excluded from Baucus' bill. While several senators—including Sen. Jay Rockefeller (D-WV) and Sen. Charles Schumer (D-NY)—have voiced strong support for the public option, it is likely that the votes won't be there to include that option in the Senate Finance bill.(It is currently included in the bill approved by the Senate Health, Education, Labor and Pensions Committee in July.)

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