Senate Finance Committee Chairman Max Baucus (D-Mont.) worked for months to find common ground with Republicans on health care reform — but when he released his long-anticipated proposal Wednesday, the real problem quickly came into focus.
He set the stage for a titanic struggle within his own party.
Reaction from congressional Democratic leaders was lukewarm to worse, progressives were downright hostile and Republicans were scornful of what they described as brazen government grab.
But Baucus may have provided lawmakers with the only viable blueprint for winning support across Congress, because he sought to find elements that pleased all sides.
“There are honest and principled differences on all of us working for reform, and this package may not represent all of our first choices,” Baucus said. “But at the end of the day, we all share a common purpose: that is to make the lives of Americans better tomorrow than they are today and to get health care reform done, which means the time for action is now.”
The next challenge for Baucus and the Senate leadership is to get the bill out of the Finance Committee — but after that, Senate Majority Leader Harry Reid (D-Nev.) will need to merge the Finance bill with one approved in July by the Senate Health, Education, Labor and Pensions Committee.
Even Reid, who has generally supported Baucus’s efforts, sounded less than pleased, saying he needs to be convinced the bill is right for Nevada on a proposed Medicaid expansion. House Speaker Nancy Pelosi (D-Calif.) dug in on the element dear to her liberal caucus — the public insurance option — and whacked the Baucus bill for shunning it. Baucus has made the challenge clear for Democrats, who now must choose between competing visions of health reform: an employer mandate versus fees on employers, a public insurance option versus nonprofit insurance cooperatives, and taxes on millionaires versus industry and people with expensive health care plans.
The proposal capped months of closed-door discussions that, in the end, produced no immediate Republican support — and critical comments from negotiators Chuck Grassley of Iowa and Mike Enzi of Wyoming, both of whom complained about “artificial deadlines” from the White House and Democratic leaders to push through a bill, as Grassley said.
Baucus put the cost of his bill at $856 billion. It would require nearly all Americans to carry insurance and employers to help cover the costs of providing government subsidies, while prohibiting insurance companies from dropping or denying coverage for people with pre-existing conditions.
The Congressional Budget Office estimated the bill would cost $774 billion over 10 years and cover 94 percent of Americans. It would leave 25 million people uninsured in 2019 — a third of whom are illegal immigrants — compared with 17 million in the House bill.
The analysis came in $82 billion lower than Baucus had thought it would, suggesting there could be room for senators to make adjustments. However, any expenses added to the bill must be offset with new revenue, making the task politically difficult.
Another looming battle between Baucus and fellow Democrats is over how to pay for the bill — especially since the Finance bill came in at least $100 billion cheaper than the House bill. The House would pay for health reform in part by taxing high earners, families who make at least $1 million, but Baucus proposed an excise tax on insurers for their top-of-the-line plans. And Republicans think both plans cost too much.
On Wednesday the U.S. Senate released its version of the U.S. healthcare overhaul that has recently been advocated by  Barack Obama.

The  released an 18-page summary of the 223-page bill that will, according to Senate Finance Committee Chairman , cost 856 billion over 10 years.  The  estimates that the bill will cost US$774 billion over 10 years and will cover 94% of Americans.  The Senate version was orchestrated by Senator Baucus, a  from .  The bill was released without any  support from the committee.  However, today, the bill received support from a bi-partisan group of Senators including the Republican Senator from ,  and  .  If the bill's passage is determined along party lines, Democrats will need at least one Republican Senator to avoid a possible  in the Senate.

The proposal mandates nation-wide individual insurance by 2013 and omits a government-run insurance clause as is included in the U.S. House version; instead, the plan calls for non-profit healthcare cooperatives.  The healthcare cooperatives would be provided with US$6 billion in initial funding to cover start-up fees and costs. Individuals refusing to obtain coverage can be charged up to US$950 annually with families fined up to US$3,800 per year.  Small businesses will not be mandated to provide healthcare to their employees but those who do will receive tax credits. Also, insurances companies that have more expensive individual plans will be taxed for 35% of the amount that that the plan exceeds the federal individual threshold of US$8,000 or the family threshold of US$21,000. The bill includes clauses for protection against coverage suspensions due to illnesses and protections for individuals with pre-existing conditions. It will not pre-empt state laws on abortion and does not provide for abortion payments except in cases of rape or incest. The plan also mandates registration with the  as a means to avoid illegal alien use of the program.

The bill will reportedly be paid for by US$850 billion in spending reduction, taxes and fees to include reduction in  benefits.  The Senate Finance Committee is the last approval authority before the Senate or House bills can be considered for floor debate.