WASHINGTON – Democrats at both ends of the Capitol yesterday accelerated their drive to enact sweeping healthcare legislation, outlining proposals to extend coverage to uninsured millions but omitting most details on plans for raising more than $1 trillion needed to cover costs.
A first-ever tax on employer-provided health benefits also figures prominently among options under consideration, but President Obama campaigned against that last year and its inclusion in the bill would require him to reverse course.
Given the uncertainty as well as the political sensitivity over raising taxes or cutting Medicare, Senate Republicans prodded Democrats to fill in the blanks before the scheduled beginning of committee work next week.
At their core, a partial draft bill released by Democrats on the Senate Health, Education, Labor, and Pensions Committee and an outline circulated by senior House Democrats were largely identical.
Individuals would be able to purchase insurance through a new federally regulated "national exchange," and private companies would be barred from denying coverage or charging higher premiums because of preexisting conditions.
Both bills would require individuals to purchase insurance if they could afford it. Subsidies to families with incomes as high as about $88,000 a year would help them pay for insurance, and waivers would be available in hardship cases. The Senate measure provides for an unspecified penalty for anyone refusing to obey the mandate, and House Democrats are considering a similar approach, which would be similar to the 2006 Massachusetts healthcare law.
On another contentious point, the emerging House plan would give individuals the option of buying insurance provided by the federal government.
Democrats on the Senate committee embraced a similar provision last week, but omitted it from the draft released yesterday in what Senator Christopher Dodd, a Connecticut Democrat who is taking the lead while Senator Edward M. Kennedy undergoes treatment for brain cancer, said was a gesture to Republicans who oppose it.
But Senator Mike Enzi of Wyoming, the top Republican on the health committee, said Democrats did so "because they know we’re not going to like what they’ve written and they don’t want us to have any time to comment."
His remarks were not the only evidence of partisan maneuvering during the day, suggesting that the White House’s goal of a bipartisan bill was growing more distant.
But after months of preliminary effort, Democrats made clear they intend to move ahead on their own timetable, one that calls for passage of legislation in the House and Senate by early August. A final compromise would wait for September or later in the fall, according to a schedule the party’s leadership established weeks ago.
"This is the year we have to do it," said Representative Henry Waxman of California, chairman of the House Energy and Commerce Committee and one of several senior Democrats who outlined legislation to the party’s rank and file during the day.
Numerous senior Democrats have worked their entire careers on healthcare, but no one is more identified with the issue than Kennedy, the Massachusetts Democrat first elected to the Senate in 1964. But in a poignant announcement during the day, Dodd said Kennedy will be unable to attend the working sessions of the health committee beginning next week.
Obama has made an overhaul of the healthcare system a top priority of his first year in office, both to assure coverage for the uninsured and also to slow the rate of growth in healthcare nationally. Outside groups representing hospitals, doctors, drug companies, and others have pledged to work with the White House on that objective, but it is not clear how much money their efforts would yield in savings to the government.
Obama met with a group of House Democrats at the White House during the day, and White House budget director Peter Orszag said the discussion centered on the administration’s recent announcement that it is willing to try to find as much as $600 billion in Medicare savings, double what the president requested in his budget last winter, to help pay for the legislation.
