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Baucus Calm in Storm

Senate Finance Chairman Max Baucus (D-Mont.) appeared unflappable Wednesday as he absorbed unrelenting criticism of his health care reform bill from the left and right, and the debate in the Senate took on a new, more urgent tone.

The reaction from Senators and interest groups was almost instantaneous — and overwhelmingly negative or noncommittal — when Baucus dropped his $856 billion bill aimed at reforming the insurance industry, lowering health care costs, creating competitors to private insurance in the form of nonprofit health insurance cooperatives and expanding access to Medicaid.

None of the three Republicans whom Baucus has been courting for months signed onto the measure, and two of them — Finance ranking member Chuck Grassley (Iowa) and Sen. Mike Enzi (Wyo.) — began laying down their exit strategy by issuing statements complaining about the accelerated pace of action. The third, Sen. Olympia Snowe (Maine), said the bill “moves in the right direction— but that “a number of issues still need to be addressed.—

But Baucus struck an optimistic tone when asked why so many were distancing themselves from a product that he has worked on for months within the bipartisan gang of six.

“Part of it could be they want to see what it is, really, because it was just introduced,— Baucus said. “It’s going to take getting a sense, you know, of where things are. But I think that we’re going to get very significant support for this by the time we get to the end of this process, and each step along the way, support for the bill’s not going to deteriorate, it’s going to build.—

However, even Majority Leader Harry Reid (D-Nev.) — who could have a tough re-election fight next year — told Nevada media that he was unhappy with aspects of the Baucus bill.

“While this draft bill is a good starting point, it needs improvement before it will work for Nevada,— Reid said in a statement, according to the Las Vegas Sun. “During this time of economic crisis, our state cannot afford to shoulder the second-highest increase in Medicaid funding.—

Though Reid said he had received assurances from Baucus that the formula for state Medicaid matching funds would be altered, he stated, “Let me be very clear: I will not bring a health insurance reform bill to the Senate floor that is not good for Nevada.—

But Reid is the least of Baucus’ problems. Without Republican support to help Baucus neutralize friendly fire from fellow Democrats, Democratic aides said an internal bloodletting was coming as tensions within the party are more fully exposed.

“People need to vent their frustrations, they need to offer their amendments and this bill will be strengthened in committee,— one senior Senate Democratic aide said.

[IMGCAP(1)]Another senior Democratic aide said Democrats’ discomfort with the bill could have a silver lining, given Reid — in consultation with the White House — will merge Baucus’ bill with a measure passed out of the Senate Health, Education, Labor and Pensions Committee.

“Some Democrats see this as an opportunity — as the HELP bill and Finance bill are merged — to reunite the party,— the aide said. “But there is that important hurdle of getting something — anything — passed by Finance.—

Even Baucus acknowledged that changes to his bill were inevitable as he looks to mark it up next week, possibly beginning Tuesday.

Finance Subcommittee on Health Care Chairman Jay Rockefeller (D-W.Va.) announced Tuesday that he could not support the bill for a variety of reasons, including a tax on expensive insurance plans and the lack of a public insurance option. On Wednesday, Rockefeller said he believes he will not be the only Democrat to register opposition to the measure.

“I think it provided some leverage for others,— he said. “A lot of the members of the Finance Committee have thanked me for doing that because it’s something they might want to do. And I’m just old enough I don’t care what people say.—

Sen. Maria Cantwell (D-Wash.), a Finance member, echoed several of her Democratic colleagues on the committee in voicing concern about the direction of Baucus’ bill. Democratic Sens. John Kerry (Mass.) and Ron Wyden (Ore.) are just a few of those who have taken issue with the bill.

Cantwell conceded that the opposition coming from many Democrats could be a matter of them staking out negotiating leverage to help shape the final bill.

But Cantwell’s disagreements run deeper than some minor tweaks. The HELP legislation includes a public insurance option, and Cantwell said she prefers that bill to the co-op model included in Baucus’ bill.

“It needs some improvements,— Cantwell said of the Finance bill. “There’s certainly more cost-cutting reforms that I’d like to see in there. I would have preferred it to have a public option.—

“No Member is going to give away his negotiating room right now by saying that they’re totally supportive, because we all want things,— Cantwell continued. “I think that’s part of what’s happening right now.—

Besides getting the necessary votes to pass the measure out of committee — which is far from certain at this point — Baucus also has a tough audience with the rest of the Democratic caucus, particularly liberals.

“My goals for health care reform include a strong public option, long-term care reform and reform of the Medicare reimbursement system that has disadvantaged Wisconsin for far too long,— Sen. Russ Feingold (D-Wis.) said. “I am disappointed that the Finance Committee bill, as written, comes up short on all three fronts. I hope my colleagues on the Finance Committee will change the bill to ensure it is not just health care reform in name only.—

Baucus will have two chances today to begin turning the tide in his favor. He is expected to meet this morning with the entire Finance panel to walk members through the bill. Later, he will be front and center at a special caucus of Democrats to discuss the measure.

The legislation, which closely reflects agreements made during the months of bipartisan talks, would use industry fees, taxes on expensive health care plans and mandates on businesses and individuals to keep the price tag from adding to the deficit over the first 10 years. The bill also would expand access to Medicaid as a means to extend health care to the uninsured poor and require individuals to buy health insurance.

Baucus said the bill would strengthen Medicare and lower prescription drug costs for seniors. Additionally, the legislation would implement popular insurance reforms for all Americans, including a popular proposal to outlaw private insurers from denying coverage based on pre-existing medical conditions.

“This is our chance to reform health care in America. We cannot let this opportunity pass,— Baucus told reporters Wednesday during a news conference to introduce the bill.

Neither Baucus nor the three Republicans in the gang of six have been willing to officially end their negotiations. However, Baucus said he does not see a time between now and the beginning of the markup next week for the group to meet.

But continued negotiations with Grassley and Enzi appeared unlikely to bear fruit.

Saying he could not support the Baucus bill in its current form, Enzi told reporters Wednesday, “I’m disappointed that deadlines have brought [negotiations] to a rapid end.—

Despite giving strong indications that he will not support the bill, Grassley said Wednesday that he was still open to talks.

“As we broke up the meeting [Tuesday] there was still collaboration going on and a willingness to talk,— Grassley said. “Whenever Baucus calls us, I’ll be there.—

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