Senate Democratic leaders’ hopes of approving health care reform before adjourning for the August recess appear all but dead, with the prospect of meeting President Barack Obama’s demand for a bill on his desk by Oct. 15 looking increasingly difficult.
Logistical hurdles in the Senate, while significant, are only part of the problem. A major political battle looms over the key components of health care reform — particularly over the role of the federal government — that could stall Democrats even after they gained a filibuster-proof majority with the addition of Sen.-elect Al Franken (D-Minn.).
Sen. Chris Dodd (D-Conn.), managing the health care bill in the Health, Education, Labor and Pensions Committee, signaled late last week that Democratic leaders do not expect a bill to clear the Senate in the next five weeks. Rather, Dodd indicated, the goal is to complete the tricky merger of the HELP and Finance Committee bills, with the floor fracas over a final bill put off until after Labor Day.
“One step at a time,— Dodd said Thursday during a conference call with reporters. “This is a long process.—
Senate Democratic leaders’ official timeline still calls for a bill to clear the chamber by Aug. 7, according to a senior Democratic aide.
Dodd has stepped in to run HELP in the absence of Chairman Edward Kennedy (D-Mass.), who is battling brain cancer. HELP began marking up its bill in mid-June, and Dodd hopes to finish by late this week or early next week.
The Finance Committee has yet to put out a mark on its bill, which is still being negotiated. The pending merger of the Finance and HELP bills could be tricky.
Finance Chairman Max Baucus (D-Mont.) is attempting to draft a bill that costs less than $1 trillion, is deficit neutral and can garner significant bipartisan support. The HELP bill has been drafted to satisfy liberal reform goals, including a robust government-run insurance option Republicans will never accept.
HELP announced last week that its legislation would cost approximately $611 billion over 10 years. But that is not a deficit-neutral figure, and the score did not include the cost of expanding Medicare, projected by some to be worth another $400 billion in additional spending.
Meanwhile, political difficulties abound in Obama’s push to overhaul the nation’s $2.3 trillion health care system this year.
Congressional Republicans and other opponents of Obama’s health care agenda are sure to use next month’s recess to sow doubts about the legislation, particularly the cost of reform and the so-called public option for health insurance.
Even Democratic allies such as organized labor might go on the offensive in August, either to push for a more robust government-run insurance option, or to discourage Obama and Congress from taxing health care benefits to help finance reform, a proposal that remains under serious consideration. In fact, both conservative and liberal advocacy groups actively opposed Senate Democrats during the Fourth of July recess.
“The longer something’s laying out there, it’s a target,— said one downtown operative monitoring the health care debate. “It’s a target for all of the vulnerable folks who are going to have to make a tough call on it.—
However, an insurance industry insider speculated that the August recess could allow policy experts to examine the legislation and recommend changes that strengthen the bill in advance of a presumed fall floor debate.
Sen. Sherrod Brown (D-Ohio) dismissed the notion that the push for health care reform might suffer a politically terminal setback during the summer break.
“I think people at home in both parties are going to hear how [their constituents] need help,— Brown told reporters Thursday during the conference call with Dodd. “I don’t think it hurts us at all.—
The senior Democratic Senate aide, predicting a relatively fast markup of the Finance bill and an easier merger with the HELP legislation than most, said a final bill could hit the floor just after the middle of July, allowing for two weeks of debate before the docket is cleared to deal with the confirmation of Supreme Court nominee Sonia Sotomayor.
But Sotomayor’s confirmation process, consisting of Judiciary Committee hearings set to begin July 13 followed by floor debate, could play a leading role in delaying approval of a final Senate bill until after Congress returns from the August recess.
The wealth of parliamentary delaying tactics available to the Republicans could also draw out the process, even with the Democrats set this week to command a 60-seat majority.
“I think Democrats understand they have their work cut out for them to produce something that can withstand public scrutiny,— a senior Republican Senate aide said.