Before the Senate adjourned earlier this week, Majority Leader Harry Reid (D-NV) announced plans that he would bring Senate's version of healthcare reform legislation to the floor next week.
Time will be short as the Senate attempts to unveil the bill and aim for passage and eventually reconciliation with the House bill (HR 3962) within a few weeks. "Our goal is to make sure we get it out of the Senate this year," Sen. Dick Durbin (D-IL), the number two Senate Democrat, said earlier this week.
But any fast actions on the bill may likely run into legislative amendments introduced from the floor that may slow the process as they are debated.
Here's a look at three of the amendments:
Public insurance option. Not surprisingly, the public option will be front and center of the debate. Under the current Senate proposal, the option where states can opt-out of the process appears to be the top version under consideration. And the House bill has a different version requiring the Health and Human Services secretary to negotiate rates with healthcare providers as private insurers.
In this debate, attention has focused on senators, such as Joseph Lieberman (I-CT), who usually votes with the Democrats and has said he won't support any public option, or others such as Sen. Blanche Lincoln (D-AR), a Finance Committee member who has remained quiet on the issue. Their support is needed to reach the magic number (60) needed to pass legislation in the Senate. But attention also needs to be paid to moderates, such as Sen. Jay Rockefeller (D-WV) or Sen. Sherrod Brown (D-OH), who say they would not vote for a bill without the option.
Again, the "trigger plan" suggested earlier by Sen. Olympia Snowe (R ME)—which would feature nonprofit agencies offering health insurance in instances in which private insurers could not cover 95% of the people in their regions—could make an appearance. But it may be hard to appease that core of senators who are demanding an actual option.
"Pay or play." In July, the Senate Health, Education, Labor and Pensions Committee passed a package that included a "play or pay amendment," in which employers would pay an annual fee for individuals not covered by a health insurance plan.
In September, Sen. John Kerry (D-MA) introduced an amendment that would impose a similar fee on employers not offering healthcare coverage to the legislation pending in the Finance Committee; however, he withdrew it. He planned to reintroduce this amendment on the floor.
Under his proposal, employers with at least 26 employees would have to pay an annual fee of $750 for each full time employee and $375 for each part time employee not covered by a health insurance plan. At the time, he said many employers could terminate healthcare coverage without an employer mandate and that the amendment would help to keep employers in the healthcare financing system.
Individual responsibility. In the current House bill, individuals will be responsible for obtaining and maintaining health insurance coverage. Those who decide not to obtain coverage would pay a penalty capped at 2.5% of modified adjusted gross income above a specified level.
This issue, though, has triggered responses in both chambers about penalizing those who may have difficulty affording insurance in the first place—and that debate is likely to emerge again in the Senate.