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Health Battles Turn Into War

Democrats Say Finance Health Deal Is Not Gospel

Fearing a budding Finance Committee health care compromise will leave their priorities in the dust, many Senate Democrats are now looking to the next legislative steps to ensure their coveted policy reforms survive.

Those Democrats are hoping that, regardless of what emerges from the Finance panel, they can push their will when that committee’s measure is merged with a competing — and wholly Democratic — Health, Education, Labor and Pensions Committee bill. Additionally, they are hoping to exert their influence when the House and Senate meld their health care bills into one package later this year.

Finance liberals — although troubled by key provisions of the developing deal — are anxious for progress and inclined to hold their fire pending the merger with HELP and the House-Senate conference committee. HELP approved its health care reform bill, which includes Democratic priorities such as a public plan insurance option, earlier this month on a party-line vote.

“There are many steps to this process. Finance is a critical one, but it’s not the only one. And so there will be negotiation in merging the two bills before it goes to the floor. There will be negotiation on the floor; there will be negotiation with the House,— Sen. Debbie Stabenow (D-Mich.) said. “So, we need to start from the position that we can start from that is the best that we can get from the Finance Committee.—

Tuesday’s Democrats-only Finance meeting was described as collegial, with Senators saying afterward that they have an agreement on 80 percent or more of the overall package. A bipartisan group of six Finance members, led by Chairman Max Baucus (D-Mont.), has been huddling for weeks trying to craft a bipartisan bill. The group is continuing to work through the details, with a goal of producing a compromise measure and getting it through the full committee before the August recess.

While a consensus appears to be building in the Finance Committee over how to pay for health care reform, differences remain over whether to implement a government-run public insurance option versus a nonprofit medical cooperative to compete with private insurers. There also is a disagreement over an employer mandate to provide health benefits to workers — generally prized by Democrats but opposed by Republicans.

The gang of six Finance negotiators appears to have decided against an employer mandate and settled on a cooperative. The HELP bill includes both the robust public plan option and a requirement that businesses offer health insurance to employees. Majority Leader Harry Reid (D-Nev.) emphasized Tuesday that the Finance legislation isn’t the only game in town.

Reid said meetings with Democratic Senators would begin next week to address the looming merger of the Finance and HELP bills and to make sure the Conference is on the same page heading into the monthlong August recess. The Majority Leader reiterated that he expects Finance to mark up a bill by the time the summer break begins on Aug. 7.

“The HELP Committee has reported out their bill. The Finance Committee is getting close to reporting out a bill. We’re not going to be working under either one of those bills. We have to put them together,— Reid told reporters.

The six Finance negotiators include Baucus and Democratic Sens. Jeff Bingaman (N.M.) and Kent Conrad (N.D.), as well as GOP Sens. Mike Enzi (Wyo.), Olympia Snowe (Maine) and ranking member Chuck Grassley (Iowa). The group, which was meeting behind closed doors again Tuesday evening, has long since missed Baucus’ original late-June date to begin marking up a bill. Reid originally had hoped to have the full Senate vote on a health care plan before the August recess, a deadline that earlier this month he acknowledged wouldn’t be met.

To garner the support of the three Republicans on the bipartisan negotiating team, Baucus was forced to drop the public plan option and employer mandate. However, there are several policies included in the burgeoning deal that Finance Democrats like. The new affinity for some aspects of the plan comes just a week after many Democrats were grousing at Baucus’ handling of the talks.

The Democrat-favored policies emerging as part of the deal include measures to lower insurance costs for middle-class families, improve access to coverage, implement tax credits for small businesses, ban insurance companies from refusing coverage based on pre-existing conditions, and increase prescription drug coverage under Medicare for seniors.

“I think today some good work was accomplished,— Sen. Ron Wyden (D-Ore.) said Tuesday, after the meeting of Finance Democrats broke up. “I think there’s a lot of appreciation for the fact that those six are putting in killer hours. It’s very clear that they’re going to spend their political capital pushing for a bipartisan approach.—

However, a significant number of Democratic Senators remain skeptical and are worried that their treasured reform priorities could be junked in order to win the support of Republicans and some centrist Democrats.

While those same Democrats understand Baucus is trying to draft a bill that can garner 60 votes, they are hoping the merger with HELP, the amendment process on the floor, and the conference committee will allow them to resurrect their health care priorities.

Sen. Tom Harkin (D-Iowa), a member of HELP and strong proponent of a public insurance option, said flatly Tuesday that “whatever the Finance Committee comes up with is not doctrine.—

Sen. Benjamin Cardin (D-Md.), who doesn’t sit on HELP or Finance, expressed a similar sentiment. “We’re going to push for what we believe in. There are going to be amendment opportunities to deal with that,— he said.

Jessica Brady contributed to this report.