Finance Committee Will Tackle Public Plan Option Tuesday, Baucus Says

Jane Norman, CQ HealthBeat, May 4, 2009

The day before the Senate Finance Committee convenes its second roundtable of experts dissecting a proposed health care overhaul, Chairman Max Baucus, D-MT, said Monday that debate now will kick off on what he called an "800-pound gorilla" - a government-backed health plan.

Baucus, on a conference call organized by the liberal-leaning Center for American Progress Fund, told reporters he expects a public option as part of the overhaul will come up Tuesday during the roundtable focusing on health coverage, and then during a closed-door walkthrough among members of the committee to debate possible legislation. Two or three public-plan alternatives will be examined by the committee and Baucus said he will encourage "second- and-third-level questions" about the details.

The first committee roundtable focused on options for delivery, while the third and last will probe costs and financing.

Baucus repeated his desire for a bipartisan plan and a far-ranging discussion among lawmakers that does not presume a government choice for consumers will be included or excluded. Many Republicans and some business groups are resistant to the idea, saying it would drive workers away from employer-sponsored group plans and eventually lead the nation into a single-payer health system. House Democrats, however, appear headed toward a version of a health overhaul that would include a public plan, saying they can't see a way to expand coverage otherwise to the uninsured.

Baucus acknowledged the difficult political terrain ahead. "I've told everybody that everything is on the table. We're all in this together, we Americans," he said. "And it's providers, it's insurance companies, it's device manufacturers, it's pharmaceuticals, it's everybody. We're all together here.

"And I'm not going to take anything off the table because once it's off the table, initially anyway, then other groups will have justification why their measures should be taken off the table," he said.

The Tuesday roundtable will focus on coverage - who is covered, what is the benefit package and what assistance is needed for the uninsured, said Baucus, likely looking at the Massachusetts state plan that requires coverage for all. Additionally senators will discuss how to expand Medicaid and the State Children's Health Insurance Program.

John Podesta, president of the Center for America Progress Fund, said the group supports a public plan but agrees with the approach Baucus has taken. "If you begin with a series of non-negotiable demands, it's very hard to get the conversation started," said Podesta. "That's what these dialogues in the Finance Committee are all about and I'm confident we can find resolution on this."

Vivek Murthy, president and co-founder of Doctors for America and another participant in the call, said his grassroots group has some 11,000 physician members in all 50 states whose goals are expanded access, the provision of high-quality care, affordable coverage and practice environments that allow doctors to focus on care. Murthy said the group does not specifically back a public plan, though it wouldn't rule it out.

"Our current system is failing patients and it's not allowing us to provide the kind of care patients deserve," said Murthy, a physician at Brigham and Women's Hospital in Boston. It's important for Congress to hear about the experiences of physicians, he said. Murthy said the group is self-funded and does not receive money from other organizations.

Advocacy groups say the need for action is urgent. Podesta pointed to a report issued by his group today saying the numbers of uninsured are growing. The report says census data found 46 million Americans were without insurance in 2007 but new statistics gathered by the North Carolina Institute of Medicine peg the numbers at 52 million.

That would be a 13 percent increase in just two years, the report said, reflecting workers who have lost insurance in the midst of the economic crisis either through job loss or employers ending benefits. "We need to get on with the task of comprehensive reform," said Podesta.

AARP will be among the groups testifying before the Finance Committee and officials said in a statement their focus will be on six themes. AARP also plans to run an ad campaign on television and in print, hold events in states and organize town hall meetings around the subject of health care.

"The next few weeks will be an all-out blitz for health reform," said Nancy LeaMond, executive vice president of the group, in a statement. "As leaders on Capitol Hill hammer out the details of their legislation, we want to make sure they include the priorities that we're hearing from our members. Any final package must include these critical issues."

They are: access for Americans age 50 to 64, who are too young for Medicare but often go without coverage; closing the Medicare Part D prescription drug plan "doughnut hole" that leaves beneficiaries without coverage; creation of a Medicare transition benefit for those moving from hospital to home; increased money and eligibility for home-based services through Medicaid; a way to approve generic versions of biologics to reduce costs; and improvement of subsidies of prescription drugs for low-income Americans and the Medicare Savings Programs, which help with premium payments.

Also, the conservative Heritage Foundation's health expert, Stuart M. Butler, will testify in favor of health insurance exchanges similar to the Federal Employees Health Benefits Program; more favorable tax treatment for individual plans; and automatic enrollment of working families in a private plan that would have to be actively declined.

Witnesses scheduled for the Finance roundtable are: Butler, vice president, domestic and economic policy studies, the Heritage Foundation; John Castellani, president, the Business Roundtable; Gary Claxton, vice president and director of the Health Care Marketplace Project, the Henry J. Kaiser Family Foundation; Donald A. Danner, President and CEO, National Federation of Independent Business; Jennie Chin Hansen, president, AARP; Karen Ignagni, President and CEO, America's Health Insurance Plans; R. Bruce Josten, executive vice president, government affairs, US Chamber of Commerce; Len Nichols, director, Health Policy Program, New America Foundation; Ron Pollack, executive director, Families USA; Sandy Praeger, chairwoman of the Health Insurance and Managed Care Committee, National Association of Insurance Commissioners; Sara Rosenbaum, chairwoman of the department of health policy, George Washington School of Public Health and Health Services; Diane Rowland, executive vice president, Henry J. Kaiser Family Foundation; Raymond C. Scheppach, executive director, National Governors Association; Scott Serota, president and CEO, Blue Cross and Blue Shield Association; Andy Stern, president, Service Employees International Union.

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