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Senate Finance Awaits CBO Cost Analyses of Health Care Options

By Alex Wayne, CQ Staff

June 4, 2009 -- The Senate Finance Committee has reached no consensus on major provisions of a health care overhaul, in part because members still lack a clear picture of what different policy choices would cost.

The indecision has raised doubts that the committee can meet the goal of Chairman Max Baucus, D-Mont., to vote on a bill this month.

The Congressional Budget Office (CBO), which estimates what legislation will cost the taxpayers, is scrambling to analyze hundreds of policy options the committee is considering.

"We're all frustrated because this is so complicated, and we've tried to schedule a fairly tight deadline," Baucus said after a meeting Thursday.

Russell W. Sullivan, Baucus' chief of staff, added, "Part of it is we have so many options we've given them [CBO] because members haven't decided what their top priorities are."

Sen. Olympia J. Snowe, R-Maine, said a markup in mid-June seemed "less likely" at this point, though she added that the timing was up to Baucus.

"Next week we'll have the opportunity to start looking at some real proposals, real provisions, more substance on the legislative language," she said. "But obviously it has to work in tandem with CBO so we know what we are dealing with moving forward." Rushing the bill to a markup would decrease the likelihood of winning any Republican support, said Sen. Pat Roberts, R-Kansas. "If we have those kind of marching orders and we go to a markup, it's going to be much more difficult to achieve bipartisan support," he said.

The committee is attempting to draft an overhaul to expand health insurance coverage to millions of Americans who lack it, while also improving health care quality and reducing its costs. CBO must analyze not only individual policy options, such as a proposal to create a government-run insurance plan to compete with private insurance plans, but also the interactions between provisions of the bill. Snowe aide Bill Pewen estimated that there are more than 1,000 such interactions.

"When you add the combinations, that's the problem," he said.

Finance Committee Republicans are not the only GOP members warning Democrats not to rush to a markup.

Sen. Michael B. Enzi of Wyoming, a Finance member and the ranking Republican on the Health, Education, Labor and Pensions Committee, said, "I am disappointed in the focus that some Democrats have placed on meeting arbitrary deadlines over getting the legislation done right."

The HELP Committee, chaired by Edward M. Kennedy, D-Mass., is moving on its own track to mark up a health overhaul, though the two chairmen say they are confident they can produce a single bill for consideration by the full Senate.

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