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).
4. Questions about how exactly should pay. A surtax on millionaire families is one of the ideas being considered in the House. Legislation passed by House Ways and Means last week called for a surtax on families earning $350,000-plus, but House leaders have said that could be rolled back.
The Senate Finance side reportedly has been cool about any type of surtax. The committee had been looking at limiting tax exclusion on higher income individuals but has moved away from that idea.
5. Disallowed savings stall process. In June, the Congressional Budget Office said that only a "subset" of the initiatives proposed by major healthcare groups including the American Medical Association, the American Hospital Association, and America's Health Insurance Plans could result in meaningful savings to be incorporated into CBO health reform cost estimates.
Most of the proposals were for steps that did not require the federal government involvement or "are not specified at a level of detail that would enable the CBO to estimate budgetary saving," CBO Director Doug Elmendorf wrote. This meant, especially for the Senate Finance Committee, going back to the drawing board to find ways to meet the 10-year, $1 trillion-plus price tag of healthcare reform.