Today in Washington D. C. - Oct 5, 2009 - Dems Still Divided On Health Reform Issues

The Senate began consideration of the fiscal year 2010 Commerce-Justice-Science appropriations bill, H.R. 2847. No votes are scheduled today. Tomorrow, the Senate resumes consideration of the $636 billion fiscal 2010 Defense appropriations bill, H.R. 3326, with 13 amendments to work through. This week the Senate Finance Committee is expected to vote on passing chairman Max Baucus’ (D-MT) health care bill once a preliminary CBO score is released.

As the health care debate enters its fifth month and Senate Democrats are finally preparing to vote on a health care reform bill in the Finance Committee (something that was initially supposed to happen in June), it appears that they’re still divided over key issues.

The Washington Post reports today, “At least two Democrats on the Senate Finance Committee have refused to pledge support for the health-care reform bill scheduled for a vote this week, underscoring the hard work ahead for President Obama as he tries to enact the most ambitious domestic policy legislation in more than a generation. Although Chairman Max Baucus (D-MT) said he has the votes to pass the 10-year, $900 billion bill out of the committee, Sens. Ron Wyden (D-OR) and John D. Rockefeller IV (D-WV) remained undecided Sunday.” Rockefeller reportedly is still agitating for the creation of a government-run insurance company (the so-called “public option”), despite a defeat of two different versions of that idea in the Finance Committee last week. Beyond that, Sen. John Kerry (D-MA) wants an employer mandate in the bill while Sen. Blanche Lincoln (D-AR) seems concerned about new taxes and fees being passed along to middle class families.

The elephant in the room is the massive and expensive Medicaid expansion and it is seriously troubling governors. According to The Washington Post, “The nation’s governors are emerging as a formidable lobbying force as health-care reform moves through Congress and states overburdened by the recession brace for the daunting prospect of providing coverage to millions of low-income residents. The legislation the Senate Finance Committee is expected to approve this week calls for the biggest expansion of Medicaid since its creation in 1965.” Democrat Tennessee Governor Phil Bredesen told The Post, “I can’t think of a worse time for this bill to be coming … I’d love to see it happen. But nobody’s going to put their state into bankruptcy or their education system in the tank for it.” The Post article continues, “Bredesen said Tennessee could face $1 billion in extra Medicaid costs for the first five years of the expansion. ‘I have no idea how we’re going to afford it,’ he said.”

The Medicaid issue isn’t lost on Democrat senators, either. The Washington Post writes, “[C]ongressional Democrats are sufficiently alarmed about the potential impact that they already are seeking special protections for their states. Even Senate Majority Leader Harry M. Reid cut a deal with Senate Finance Committee Chairman Max Baucus (MT) to ensure that the federal government would pay the full cost of expanding Medicaid in Reid’s state, Nevada.” Indeed, “health-care negotiators are prepared for a flood of pleadings like the one Reid made that could add up to many billions, forcing reductions to other portions of the bill. California Gov. Arnold Schwarzenegger (R), for one, estimated that the Medicaid expansion could cost his state $8 billion a year. Sen. Dianne Feinstein (D-CA) underscored those concerns with her own pledge: ‘I could not support a bill that pushes additional costs on California state government or its counties.’”

So will Democrats again fight with each other over a government insurance option? Will they side with the White House or Max Baucus over the pleas of their states not to increase their financial obligations? And there are even more fundamental questions, as Senate Republican Leader Mitch McConnell pointed out on Friday, “Are [Democrats’] own members comfortable enough with a proposal that takes $500 billion out of Medicare over the next 10 years and raises billions of dollars in taxes on both individuals and corporations? Are they comfortable with that?”

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