Washington: The US Senate Finance Committee begins consideration of its long-delayed healthcare reform bill on Tuesday, with costs and affordability topping the list of concerns for Democrats who control the panel.
Committee members have filed 564 potential amendments to the healthcare plan offered by Democratic chairman Max Baucus as the raging debate over President Barack Obama’s top domestic priority enters a new phase in Congress.
Obama has pushed for a sweeping healthcare overhaul that would rein in costs, create competition for insurers and expand coverage to many of the 46 million uninsured people living in the United States.
The initiative has been besieged by critics and slowed by battles in Congress, where elements of the insurance and healthcare industries have lobbied against parts of it.
The finance panel, the last of five congressional committees to take up a healthcare bill after months of negotiation failed to win Republican support, is expected to spend at least three days working its way through amendments before a final vote.
Many of the amendments were designed to reduce costs and make insurance more affordable. To help ease those concerns, Baucus said on Monday he would adjust his bill to make it easier for people at all income levels to afford insurance under his plan.
In shifts incorporating several Democratic-sponsored amendments, Baucus will consider an expansion of subsidies to help purchase insurance, a reduction in penalties for not buying insurance and an increase in the level where an excise tax on high-cost insurance plans kicks in.
“There is a strong desire to make the plans more affordable,” Democratic senator Kent Conrad told reporters after a meeting of Democratic panel members on Monday.
Baucus would pay for the changes with $28 billion in surplus from the bill. The Congressional budget office estimated last week the proposal would reduce the deficit by $49 billion over 10 years.
Under the plan Baucus unveiled last week, all US citizens and legal residents would be required to obtain health insurance, with subsidies offered on a sliding scale to help people buy it.
The plan would create state-based exchanges where individuals and small businesses could shop for insurance. The proposal also would levy fees on healthcare companies and insurers, tax high-cost insurance plans and expand Medicaid, the healthcare system for the poor.
Many Democrats have questioned whether the subsidies are generous enough, and panel Democrats had offered amendments similar to the changes being considered by Baucus.
Democratic senator John Rockefeller of West Virginia offered an amendment to exempt workers in high-risk professions—such as coal miners in his home state—from the tax because they typically have expensive insurance policies.
“These are workers that require more expensive health coverage due to the nature of their job, and they should not have to foot the bill for healthcare reform,” said Rockefeller, the only panel Democrat to say he will not support the bill in its current form.
Other amendments would require a government-run public insurance option, which is not included in the bill, and would kill the bill’s provision to create nonprofit cooperatives to inject competition into the insurance market.
Republicans offered 292 of the bill’s amendments, including proposals to eliminate the individual insurance requirement, allow purchase of insurance across state lines and eliminate the fees on healthcare industries.
Republican Olympia Snowe, a moderate who was one of the “Gang of Six” negotiators with Baucus, offered an amendment making the government-run public insurance option an emergency option if coverage remained too expensive.
Snowe’s “trigger” option would establish a government-run plan in any state where affordable coverage—as defined by a portion of an individual’s income—was not available to 95% of residents.