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Senate Will Not Vote on Health Bill Until September

By Bart Jansen and Alex Wayne, CQ Staff

July 23, 2009 -- Senate Majority Leader Harry Reid said Thursday the Senate will wait until September to take up a health care overhaul, but the Finance Committee will vote before the August recess.

Reid said he would oversee blending the Finance version with the bill approved July 15 by the Health, Education, Labor, and Pensions (HELP) Committee on a party-line vote.

Finance Chairman Max Baucus, D-Mont., said Thursday he hopes to mark up a health care overhaul the week of Aug. 3; the Senate leaves for its summer recess Aug. 7.

Reid said ongoing talks with ranking Finance Committee Republican Charles E. Grassley of Iowa and two other panel Republicans, Olympia J. Snowe of Maine and Michael B. Enzi of Wyoming, were productive and would lead toward Senate approval of the combined legislation with at least the 60 votes needed to overcome procedural challenges.

"It's a complex, difficult issue," Reid said. "I think it's better to have a product that is one based on quality and thoughtfulness rather than pushing something through."

Although President Obama had pressed Democratic leaders to pass a health bill through both chambers before the recess, he backed off that demand this week. And on Thursday, Health, and Human Services Secretary Kathleen Sebelius, after meeting with the Senate Democratic Policy Committee, said, "This is not about playing beat the clock."

Other Democrats professed no concern about the delay.

"I think it's probably a good thing," said Sen. Claire McCaskill, D-Mo., a centrist. "I think it's important I read the whole bill, go home and talk to my constituents about it, and then come back prepared to vote."

She said she wasn't worried that opponents of the bill might use the recess to their advantage. "I think there's a huge amount of support for change. But there's also fear about change. So I think time can alleviate that fear."

Sen. Shelden Whitehouse, D-R.I., said an August filled with ad campaigns and lobbying by opponents was to be expected regardless.

"That would've been the case either way," he said. "August was always out there for the naysayers to drum up opposition."

Controlling Costs

One of the contentious proposals the Finance Committee negotiators are considering would strengthen the Medicare Payment Advisory Commission, which recommends changes in government reimbursements to health care providers participating in the huge insurance program for the elderly and disabled.

The White House is backing a proposal to have Congress vote on the commission's recommendations up or down, without amendments, as it does on the recommendations of an independent military base closing commission.

Currently, MedPAC's recommendations are often ignored or watered down as affected provider groups furiously lobby lawmakers to preserve their funding.

"There will be some sort of version of it," Reid said.

Reid said he would work to combine the HELP and Finance bills, using as a vehicle an unrelated revenue measure from the House.

"This is not something I'm going to do in a dictatorial fashion," Reid said. "I'll work with the White House. I'll work with the entire Democratic Caucus. We'll work with Republicans. It will be something that gets 60 votes."

Reid said the ultimate goal is to clear health legislation before the end of the year.

"All of this should not come as a surprise to people," Reid said. "What we're going to do is come back in the fall.''

Finance Talks

Baucus made it clear to Democrats in the bipartisan group of panel members who have been working on a draft bill that any proposal they come up with "is just that, just a proposal," and not a final product.

He told reporters he had promised to vet whatever the small negotiating team produces with the committee's Democrats and then take any changes back to the group before a formal markup.

Meanwhile, nine freshman Democrats urged Baucus to keep working to produce a bipartisan overhaul that will contain costs over the long term.

In a letter to Baucus, the senators—crucial to the Democrats' ability to advance any health overhaul—said, "We all believe that increasing coverage, improving quality of care, and reining in annual health care cost increases are vital goals. In the face of exploding debt and deficits, however, we are concerned that too little focus has been given to the need for cost containment.

"The fact is that the current situation is unsustainable in the long term. With 17 percent of our GDP currently being used to pay for health care services, we must get health care costs under control so we can compete and lead in the global marketplace. We believe that any final bill must include innovation, hard decisions, and incentives to bend the cost curve."

The letter was signed by the seven Democrats first elected in 2008 and by two others appointed this year—Roland W. Burris of Illinois and Michael F. Bennet of Colorado. The only new Democratic senator missing from the list was Kirsten Gillibrand of New York.

The group promised to "help you and the Senate Finance Committee to craft a bill that bends the health care cost curve, provides affordable coverage, and rewards value-added services."

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