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Five Reasons Why Healthcare Reform Is Being Delayed

Janice Simmons, for HealthLeaders Media, July 24, 2009

Senate Democrats announced Thursday that they will not meet their self-imposed August 7 deadline to vote on a marked-up healthcare reform package on the Senate floor. No announcement has been made yet on whether the House will vote by July 31—its selected deadline.

However, the lack of hearings since Monday by the House Energy and Commerce Committee on the Tri-Committee's reform bill (H.R. 3200) may imply that momentum has slowed down on the House side as well to get a bill voted on by Congress' summer recess.

President Obama, hosting a town hall meeting outside of Cleveland on Thursday, said of the delay: "That's OK, I just want people to keep on working." However, Obama emphasized that he wants the legislation to be "done by the fall."

So what has slowed down the process? Here are five reasons:

1. These bills are immense. One thing that can't be disputed by either Democrats or Republicans is that all reform legislation introduced has been lengthy and detailed. The initial House bill, issued July 14, for instance, is more than 1,000 pages long—or one ream of paper printed on both sides.

In between meetings on Wednesday with the Senate Finance Committee—which has yet to introduce its legislation—Sen. Kent Conrad (D-ND) seemed nonplussed that the committee has not produced a bill yet. He talked about the immensity of the reform legislation and the "levels of complexity" that are "just beyond typical legislation."

2. "Blue Dogs" make themselves known. Currently, there are 52 self-proclaimed fiscally conservative Democrats in the House that call themselves "Blue Dogs." In a House controlled 256 178 by Democrats, the Blue Dogs—if they stick together—could be a formidable voting block for (or against) the legislation. They have become more vocal in asking House leadership and the President to listen to their ideas about ways to hold down health costs and finding innovative ways to deliver healthcare.

3. Debate about public insurance plan. From the beginning, this has been a hot button item. The option is included in the House and Senate Health, Education, Labor and Pensions Committee bills. While some senators have said they would not vote for a bill without the option, a number of "centrist" Democratic lawmakers have voiced their reservations about the idea, including Sen. Ben Nelson D-NE), Sen. Mark Pryor (D-AR), Sen. Blanche Lincoln (D-AR), and Sen. Mary Landrieu (D-LA) Louisiana, as well as former Democratic Sen. Joseph Lieberman (I-CT).

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