Fixing The Baucus Bill

Last week after months of negotiating, Max Baucus released his version of the health care reform bill. It was one a bill that had a rare bipartisan agreement – both Democrats and Republicans hated it. Among the concerns that Democrats had about the bill:

It proposed a tax on so-called high- value health care plans, those costing >$21,000 for families and >$8000 for individuals.

No public option, only state co-ops and these state co-ops would not be able to join together.

The “free rider” provision, which penalizes employers for hiring low income workers who need subsidies to help pay for insurance.

The rather stingy subsidies for families that have difficulty buying insurance, which meant families could pay up to 13% of their income for insurance coverage.

Republicans hated it because it is a health insurance reform plan.

Consideration of the amendments begin today. In all there were 564 proposed amendments. (You can examine all the amendments at this link.) A lot of the amendments offered by Democrats seek to fix the holes identified above. Perhaps the one amendment everyone will be watching is Rockefeller C7 #187 which adds a public option, similar to the one proposed in HR3200, to the bill. Other important Democratic amendments:

* 185, Rockefeller, “Strike state exchanges, multiple competing exchanges, and regional exchanges, and create one national exchange”
* 191, Rockefeller, “Strike health care cooperatives”
* 196, Rockefeller, “Increase Medicaid eligibility to 150% of poverty”
* 201, Rockefeller/Hatch, “Remove the Children’s Health Insurance Program (CHIP) from the exchange”
* 206, Rockefeller, “Allow early retirees between ages 55 and 64 to buy into Medicare”
* 226, Kerry/Schumer, “Replace the Free Rider provision with an employer mandate”
* 248, Wyden, “To ensure affordable access to health insurance exchange plans for all Americans”
* 261, Schumer/Cantwell, “Public option as passed by HELP Committee”
* 274, Stabenow/Wyden/Kerry, “To ensure parity for mental health services within the exchange”
* 275, Stabenow, “Give states the option of including family planning as part of their Medicaid programs”
* 312, Menendez, “Providing a reduction in the out-of-pocket maximum for those between 300%-400% of poverty”

Most of the Republican amendments look to kill or gut the bill. Perhaps the most intriguing amendments are the ones offered by Olympia Snowe. Snowe’s amendments look to be answering concerns from the left and can give Democrats some cover on the public option. After all, a public option is being added to the bill by a Republican on a Democratic bill that doesn’t have one. Ezra Klein is happy with Snowe’s amendments:

After reading every one, I have to say: they’re almost all worthy changes to the bill. Snowe vastly strengthens the exchanges, which is a huge deal. She expands subsidies to more people, sets limits on high deductible plans, and weakens the penalty in the individual mandate. If I’d read this list of amendments without an attached author, I would indeed have thought they came from a moderate, though not particularly conservative, Democrat.

The Snowe amendment that everyone will be watching will be the public option “trigger” which most Democrats hate. I think you could design a good trigger but I do agree that the whole logic behind a trigger is lame.

So, the next few weeks will be another roller coaster but we’re closer than ever to the finish line.