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Senate Finance Chairman Sets Summer Deadline for Health Care Overhaul

By Drew Armstrong and Alex Wayne, CQ Staff

March 10, 2009 -- A key Senate chairman Tuesday firmed up a deadline for getting a health care overhaul bill to the president, promising to have the measure out of committee by June and to President Obama by the summer's end.

Finance Committee Chairman Max Baucus, D-Mont., doubled down on his own self-imposed timeline, promising earlier action than the president has asked for.

"We should put a health care bill on the president's desk this summer," Baucus said, promising his committee will mark up the bill in June.

Obama has said he wants a health care overhaul completed this year, without being more specific.

Committee ranking Republican Charles E. Grassley of Iowa called the timeline an "ambitious but achievable schedule." Baucus plans to begin a series of informal "walkthroughs" previewing the legislation to interest and advocacy groups in late April, a sort of dress rehearsal before the bill's actual introduction.

The Finance leaders' comments came at a hearing on Obama's budget health care proposals, with Office of Management and Budget Director Peter R. Orszag as the only witness.

The administration continues to shy away from providing detail about how many of the country's 46 million uninsured a health overhaul might cover, or how to structure a minimum benefit to insure them.

"You should not expect and you will not be receiving from me any information on the benefits or coverage side," Orszag told the panel at the beginning of the session.

Orszag also told senators that the biggest savings they could hope to achieve might come not from health information technology or cutting payments to private Medicare plans known as Medicare Advantage, but from equalizing the widely varying costs reported by doctors and hospitals in different parts of the country.

Orszag said finding ways to bring down the costs in areas that spend the most for care could save as much as $700 billion a year.

"There's nothing else that comes close," Orszag told lawmakers.

A health overhaul was the subject of hearings on the other side of the Capitol as well. The House Energy and Commerce Subcommittee on Health quizzed Congressional Budget Office (CBO) Director Douglas Elmendorf and Medicare Payment Advisory Commission Chairman Glenn Hackbarth about proposals to reduce costs in the health care system.

Energy and Commerce Chairman Henry A. Waxman said he was "not wedded" to any specific overhaul plan and said that "the best approach" will be "one that we can pass."

The committee's senior Republican, Joe L. Barton of Texas, sounded a conciliatory note, saying that he thought there was a better chance at reaching compromise on a health care overhaul than on climate change legislation. Another Energy and Commerce subcommittee was holding a hearing on that subject at the same time as the health care hearing.

"This is not like the hearing upstairs on climate change, where there is a clear ideological difference," he said.

Elmendorf and Hackbarth each warned lawmakers that wringing costs from the health care system will be tough, because many people and companies benefit from those costs and because payment systems lack incentives to encourage doctors and hospitals to save money.

"The available evidence suggests that a substantial share of spending on health care contributes little if anything to the overall health of the nation, but finding ways to reduce such spending without also affecting services that improve health will be difficult," Elmendorf said in prepared testimony.

He also said in response to a question by Del. Donna Christensen, D-V.I., that CBO cannot precisely estimate the potential long-range savings from health overhaul proposals. Many lawmakers have complained that legislation to overhaul the health care system might be constrained or even hamstrung because CBO only calculates the costs of legislative proposals over 10 years.

"Unfortunately, we don't have the evidence or modeling capacity to play out a whole set of reforms and how they're to matter 10, 20 or 30 years down the road," he said. He told Christensen that CBO would "try to offer qualified judgment" on the long-term effects of overhaul proposals.

A hearing at the House Education and Labor subcommittee on Health, Employment, Labor and Pensions, meanwhile, focused on issues in the employer-sponsored health insurance system. The subcommittee's chairman, Rep. Robert Andrews, D-N.J., said the cost of employer-sponsored insurance could be lower if Congress passes an overhaul that expands coverage to all Americans.

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