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Senators Debate Utility of Health Roundtables

The Senate Finance Committee is touting the public roundtables it has been holding on health care reform as a signal of a new bipartisan, open approach to lawmaking. But some Members, aides and lobbyists question if the sessions are anything more than window dressing before Members retreat behind closed doors to write a bill.

The committee is in the midst of holding three roundtables before marking up health care legislation in June. The panel is scheduled to hold the last of those hearings, with a focus on how to pay for these reforms, on Tuesday.

Senate Finance Chairman Max Baucus (D-Mont.) is the architect of the roundtables, which echo calls throughout the Obama administration for more open government. A Baucus aide said the meetings “satisfy the chairman’s commitment to transparency while allowing for frank discussions among Members and stakeholders.—

However, Senate Finance ranking member Chuck Grassley (R-Iowa) believes that the roundtables, while useful, are only a precursor to closed-door talks where lawmakers and their staffs will cut deals and write the bill.

“I’m not sure [the roundtables are] going to make the decisions any easier because what you’ve got to do is bite the bullet, and it’s going to be tough whether you’re a Republican or a Democrat,— Grassley said.

For example, Grassley said, lawmakers would not openly talk about compromising on some of the most thorny issues, such as whether to mandate coverage for an estimated 46 million uninsured Americans.

Sen. Orrin Hatch (R-Utah), another Finance member, agreed that “sooner or later there’s going to be hard work and that’s where you’ll find the real legislating.—

Hatch said Members will likely only find political compromise on the explosive issue of how to pay for universal health care in closed-door talks. He said some of those meetings are already taking place — even as the roundtables continue.

Some health care lobbyists and lawmakers described the roundtables as useful but only one part of the process that Members will use in writing the bills.

David Sloane, AARP’s senior vice president for government relations, said the sessions will help staff negotiations by informing them about possible roadblocks as they get ready to write the actual legislation.

Sen. Tom Harkin (D-Iowa) has been a vocal backer of the approach, saying Baucus is “opening the doors, he’s doing [reform] in a bipartisan fashion.—

Sen. Olympia Snowe (R-Maine) said the meetings highlight contentious issues early on and allow almost any group with interest in the legislation to make its case publicly.

However, critics, including several lobbyists who asked not be named, say the roundtables amount to more style than substance.

“Pure theater,— one health care lobbyist said. “The first roundtable was nothing more than a primary care love-fest.—

A former GOP Congressional aide said the roundtables are only designed to highlight the Democratic agenda on health care. “Most of the stuff you heard at the roundtable was very interesting, but has been said or published before,— the aide said. “We used to do hearings all the time that bolstered where we wanted to go.—

Critics suggest Senators are given too little time to question the witnesses at the roundtables and say it’s impossible to digest proposals offered by more than 70 witnesses, ranging from union leaders to private health insurance company executives, in such a short period. Following one roundtable meeting, a 52-page list of policy options for improving health care was compiled for lawmakers.

But backers say bringing all interested parties together in a public forum can help avoid charges of partisanship that have stymied previous health reform efforts.

“The apparent lack of inclusiveness was one of the problems that brought down health care reform during the Clinton administration,— said a public health lobbyist. “So this time, they will try to avoid that problem by having public meetings with lots of people and organizations represented.—

A former senior House Democratic aide added, “It is almost never wise to shut people out and not seek their input.—

But even backers acknowledge the realities of the legislative process. “The real work will be done behind the scenes,— the public health lobbyist said, “as it virtually always is with every complicated policy issue.—

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