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'Gang of Six' Hopes to Finish Draft

By Drew Armstrong, CQ Staff

September 11, 2009 -- A week after Congress' return from a contentious August recess, a health care overhaul appears to be regaining momentum as the Senate Finance Committee enters the final stages of its efforts to write a bill that can pass the chamber.

On Monday, a group of three Democrats and three Republicans on the panel, led by Chairman Max Baucus, D Mont., will hold what may be its final meeting to put the finishing touches on a draft bill to be released midweek and marked up soon after.

"We're meeting again Monday at 11 o'clock and begin to wrap up," Baucus said. "I'll find out who wants to support the mark and who doesn't. I obviously hope there'll be bipartisan support."

The first sessions with the group started in the middle of June, and for nearly three months the "Gang of Six" has tried to craft a proposal that could win a filibuster-proof 60 votes in the Senate.

The House, meanwhile, appears to be waiting for Baucus to move. And before a bill can get to the House floor, there will be a final day of markup in the Energy and Commerce Committee, where a handful of amendments awaits action. Chairman Henry A. Waxman, D-Calif., has a "gentleman's agreement" with ranking GOP member Joe L. Barton of Texas to finish them.

A spokeswoman for Waxman said Sept. 11 that no date has yet been set for that session. Baucus has said he intends to mark up the Finance Committee draft during the week of Sept. 21.

States' Burden and Illegal Immigrants
As the Gang of Six negotiations have gone on, two of the Republicans—ranking member Charles E. Grassley of Iowa and Michael B. Enzi of Wyoming—have seemed less and less likely to support Baucus' proposal, making comments over the August recess that they might not back the chairman's draft legislation.

"We must begin to reach a resolution, a conclusion, in preparation for a mark to be put out early, middle of next week," Baucus said Sept. 11.

The group has only a few significant issues left to wrap up. They include determining how much states would have to pay as part of a significant expansion of Medicaid and preventing illegal immigrants from getting federal assistance under new programs that will offer insurance coverage to currently uninsured people.

Kent Conrad, D-N.D., said the group would talk with governors to determine how much of the burden states would be expected to carry for the cost of expanding eligibility for Medicaid to 133 percent of the federal poverty level.

"That is still under discussion, and we will be having that conversation with the governors on Monday," he said, "but the federal government will bear the overwhelming share of the cost of those who are newly eligible."

To keep illegal immigrants from getting federal subsidies to buy health insurance or receiving other federal assistance, the government would require a check of Social Security numbers to determine eligibility, Conrad said.

But, he added, people who are in the country legally but might not have Social Security cards could provide visas or other documentation showing their eligibility.

However, nothing would keep illegal immigrants from buying private insurance on their own—a point conservatives have raised in their contentions that illegal immigrants would benefit from a health care overhaul.

"You can't prevent somebody from buying an insurance policy, but it would not be one that is federally assisted," Conrad said.

The senators' Monday meeting will also wrap up details on ensuring that no federal dollars pay for abortions and examining changes in medical malpractice law to reduce the number of lawsuits against health care providers.

Baucus said that when he produces the draft bill that will be the basis for the committee markup, he hopes to have a full scoring of the proposal from the Congressional Budget Office (CBO).

"I want to make sure this is deficit-neutral," he said. "It's very clear, we've got to find a way to bend the cost curve here. I'm very sensitive to the fact that we do need CBO scores."

When the draft bill is released, Baucus will get a true sense of the temperature of his caucus and how much support there actually is for his proposal. He has left out ideas dear to some liberals, such as using a government-run "public option" to compete with private insurers.

But he said he believes he has the backing of President Obama. In a speech to Congress on Sept. 9, Obama gave support to the idea of a public option but made it clear that he cares more about creating more competition for insurers than about the specific method of doing so.

"I think I can speak for most members of Congress—at least Democrats, and also Republicans who are supporting health care reform—that's their goal, too, and they care less about the means," Baucus said.

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