Wyden Takes Middle Course on Coverage
Sen. Ron Wyden (D-Ore.) has plunged into the issue of universal health care, a topic that usually is destined for the legislative burial ground. But he aims to avoid a similar fate by lining up a bipartisan coalition to overcome profound differences over how to overhaul the health care system.
Wyden and co-sponsor Sen. Bob Bennett (R-Utah) seek to ensure health coverage for all Americans by allowing employees to take the money they contribute to employer-sponsored health care plans and use it to purchase their own coverage.
[IMGCAP(1)] The bill (S. 334) is a mix of Democratic and Republican ideas, with its focus on ensuring universal coverage while preserving a role for the private sector, Wyden told Roll Call. Individuals would be able to choose from either their employers plan or a list of state-
Democrats, he said, are right that you cant fix this unless you cover everybody. But Republicans, he added, have a valid point about markets and the public sector and how important it is not to freeze innovation.
The bill has 14 Senate co-sponsors, split between Republicans and Democrats, as well as a House companion (H.R. 3163), sponsored by Rep. Brian Baird (D-Wash.). The bills prospects are looking up, at least in the next Congress, driven in part by a favorable score by the Congressional Budget Office and the Joint Committee on Taxation. They determined earlier this month that the legislation would be roughly budget-neutral in 2014 and would create surpluses after that.
That assessment tosses decades of conventional wisdom [about universal health care] in the trash can, Wyden said. The traditional thinking is that it would require an enormous tax increase and more government spending, but the CBO score suggests otherwise, he said.
The timing is in the bills favor as well, Bennett added. Enough time has passed since the bitter fight over the Clinton administrations health care plan for Congress to be willing to look at the issue.
Wydens interest in health care issues began with his founding of the Oregon chapter of the Gray Panthers, an advocacy group for the elderly. That role showed the Senator that health care was the most immediate, personal and important concern for everyone, Wyden said.
Wyden also credits his work at the Gray Panthers for shaping his approach to lawmaking. Colleagues in both parties credit him with putting together bipartisan coalitions. Unlike many lawmakers, Bennett said, Wyden is driven to solve problems, not get sidetracked on politics. You can talk to him without running into the ideological wall, Bennett said.
Wyden said he is careful to listen to the other side. When youre dealing with important and complicated matters [such as health care] youve got to be a bridge builder. Youve got to find a way to secure some common ground, he said.
Some question whether Wydens strategy of building outward from the middle is the most effective way to go. The big question is whether a sustainable coalition can be built this way especially given that there are few moderates in Congress said a senior staffer with the Alliance for Health Reform, a nonpartisan health care think tank. Other Members are striving for a party-line vote with just enough crossover votes to pass legislation through Congress and get it signed by a Democratic president.
Sen. Orrin Hatch (R-Utah) said there is not enough support on either side of the aisle for Wydens bill to become law. Democrats and their union supporters will not back it because the bill cuts from areas they support, such as employer-provided benefits. Republicans will oppose the legislation because they believe it will create more bureaucracy and lead to a one-size-fits-all government-mandated health care system that they oppose on philosophical grounds, he added.
Also, many lawmakers and lobbyists have serious concerns with the bills specifics. First, moving away from employer-based health care coverage threatens the security of coverage on which millions rely, a senior Senate aide said. There are also concerns that basing coverage subsidies on the lowest-cost bid in a particular state could lead to a lower standard of care for vulnerable poor populations.
The legislation creates a radical change in our existing system within a two-year period, the aide said, certainly far beyond what is really required to achieve universal coverage. The concern is that making such a sweeping change over such a short time would reduce coverage to beneficiaries, including many near retirement. For example, a worker who has made employment decisions based on health coverage might see his or her coverage substantially reduced or eliminated, the aide said, and that may be viewed as shredding the social contract.
Critics also question the legislations proposal to use the lowest-cost bids in each state to set subsidy levels. While this approach allowed the legislation to receive a favorable CBO score and could lead to universal coverage, the quality of the coverage could suffer, various aides and lobbyists said.
Wyden rejected these arguments. He said a partisan approach is doomed, just as it was in the 1990s for the Clintons. The key, he said, is to begin with Members who are looking beyond a political fight and who are in the pragmatic center.
As for the policy concerns, he emphasized that the bill includes state checkpoints to ensure the highest enrollment possible. Individuals tax forms would be used to place them into the health care system. The bill would also require employers with 10 or more workers to walk their employees through the health care choices.
The legislation would also ensure quality by requiring that the public receive coverage at least as comprehensive as coverage for Members of Congress, Wyden said. Everybody is going to get under this proposal, as a matter of law, a lifetime guarantee to a high-quality health care package.
Bennett agreed, calling opponents the inertia caucus. Some Democrats want to wait until the system is bad enough that the public will accept a single-payer, government-run system. While some Republicans are unwilling to compromise on anything that deviates from a pure consumer-driven, private system. What both sides must realize is that they lack the votes to push their plans through, and he said the Wyden approach is a fair compromise.