Health care bill intact with challenges ahead

[September 24, 2009]  WASHINGTON (AP) -- Health care legislation along the lines sought by President Barack Obama is moving methodically if slowly through the Senate Finance Committee, where Republicans are so far unable to force any significant changes and Democrats have yet to try.

But additional, difficult challenges are certain as Sen. Max Baucus, D-Mont., tries to shepherd the measure through the panel he chairs and toward a vote this fall in the full Senate.

Sen. Bill Nelson, D-Fla., told reporters Wednesday night he hopes to sweeten Medicare prescription drug benefits and lay the costs off on the pharmaceutical industry, a change that threatens to undermine an agreement that the White House and Baucus struck months ago with drug companies.

Other committee members want to ease cuts in future payments to hospice, home health care and other service providers under Medicare, a key source of funding for the legislation.

And Sen. Kent Conrad, D-N.D., said additional work needs to be done to make insurance more affordable for lower-income families.

Republicans sought unsuccessfully to wipe out or reduce the estimated $500 billion in Medicare savings in the legislation on a day consumed largely with politically-charged sparring over the giant health care program for seniors.

Sen. Pat Roberts, R-Kan., said the bill is "paid for by cutting, maybe a better word is slashing, Medicare by $500 billion."

Sen. Jon Kyl, R-Ariz., said it was "disingenuous to say Congress can cut this much ... without having an adverse affect on seniors' access to care."

With polls showing seniors are skeptical about Obama's call for legislation, Democrats said the bill included numerous provisions to enhance benefits under Medicare, and Baucus said it would improve the solvency of the financially strained Medicare trust fund.

The Finance Committee is the last of five congressional panels to debate health care legislation that is atop Obama's domestic agenda. While the bill omits several provisions backed by liberals, Baucus hopes to hold support from all Democrats on the panel, and perhaps pick up support from Republican Sen. Olympia Snowe of Maine as well.

Snowe has yet to disclose her intentions, and while she sometimes sided with fellow Republicans during the day, she also voted with Democrats at other points.

At its core, the bill is designed to expand health insurance coverage to millions of people who lack it, employing a new system of federal subsidies for lower-income individuals and families and establishing an insurance exchange in which coverage would have federally guaranteed benefits. Insurance companies would be prohibited from refusing to sell insurance based on an individual's health history, and limits would be imposed on higher premiums based on age.

At the same time, Baucus -- in keeping with Obama's wishes -- drafted legislation that would reduce the skyrocketing rate of medical spending overall. The bill's price tag is less than $900 billion over a decade.

Legislation already has cleared three committees in the House, and the leadership is slowly piecing together changes that could lead to a vote next month.

Senate Majority Leader Harry Reid, D-Nev., has said he intends to bring legislation to the Senate floor as soon as possible.

Whatever measure emerges from the Finance Committee must be blended with a bill that cleared the Senate Health, Education, Labor and Pensions Committee several weeks ago.

[Associated Press; By DAVID ESPO]

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