Baucus Open to Changes in Health-Care Bill

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Allison Shelley / The Washington Times / Landov

As his much awaited sweeping health-reform legislation comes under heavy fire from both the left and the right, Senate Finance Committee chairman Max Baucus is doing his best to keep his game face on. In an interview with TIME.com, he said the reaction he has gotten "feels like it's about right, because this is something that can pass ... It's a sense of inevitability that [the bill] is pretty close to the mark here." But after a stormy closed-door session with his fellow Finance Committee Democrats, Baucus is sounding open to making some changes, even before he bangs the gavel for his first formal drafting session on Sept. 22.

Baucus acknowledges the criticism he is getting from within his own party. "My assumption is, the other person's view probably has more than a grain of truth," he says. The chairman told TIME.com that he hopes to iron out some of those differences in the coming days. Specifically, Baucus is talking to Democratic members of his committee about addressing one of their chief complaints about the bill — that it won't do enough to make insurance affordable for the middle class. That's a crucial question, because the legislation would, for the first time, impose a requirement that virtually everyone have some kind of coverage or face a fine. Under Baucus' bill, the government would provide subsidies to help those earning up to three times the poverty level (in other words, a family of four making as much as $66,000 a year) buy insurance as well as set caps on their out-of-pocket expenses.

But many of his fellow Democrats say that help doesn't go far enough — especially in comparison with the version that the House is working on, which would provide assistance to those earning up to 400% of the poverty level (or a family of four making up to $88,000). "We're working to address that concern," Baucus said, adding that one idea "very much on the table" is to increase the refundable tax credits for those purchasing insurance. That, however, would most likely increase the overall price tag for the measure, which in its current form would cost $774 billion over the next decade, according to estimates by the Congressional Budget Office.

Baucus expressed some flexibility with regard to his proposal to impose a 35% excise tax on insurers who sell "gold-plated" insurance policies — a levy insurance companies say they would be forced to pass on to their customers. Under the bill as it is currently written, that tax would kick in on plans that cost more than $8,000 for individuals and $21,000 for families. Health-policy experts say an excise tax could help curb health spending overall by discouraging the purchase of lavish plans that lead to overuse of the health-care system. The levy would also raise $215 billion over the next decade — or about one-quarter of the cost of the bill.

The bill's critics, however, say the taxes would probably be borne by many middle-income people, especially municipal employees and unionized workers in states where insurance costs are high. What's more, if health-insurance costs continue to rise as they have, the tax would catch more and more insurance plans. In the interview on Thursday evening, Sept. 17, Baucus sounded sympathetic to those kinds of concerns and hinted that the threshold for taxation is likely to be raised. "Union plans are very expensive, and we have to be respectful of that," Baucus said.

But one place where Baucus does not appear to be so flexible is on the question of adding a government-run public option to the measure as an alternative for providing coverage to the uninsured. While some liberals in the Senate have gone so far as to say they will not vote for a bill that does not include a public option, Baucus said it would not pass on the Senate floor. He said, however, that one "live possibility" is the idea of adding a so-called trigger that would create a public plan if private insurance companies fail to do enough to bring down costs and make coverage available to enough Americans. That is an idea that has been proposed by, among others, Maine Republican Olympia Snowe, who is the only Finance Committee Republican considered likely to vote for the bill. The current version of the bill provides only for nonprofit, member-owned cooperatives as an alternative to private insurance companies.

Holding his party together has become all the more important as the prospects for winning Republican support have become fainter and fainter. Baucus noted that even Charles Grassley, his good friend and the ranking Republican on his committee, is "under intense pressure from his side of the aisle to withdraw from the process" after months of bipartisan talks. Nonetheless, Baucus says, "I still think there'll be some Republican support at the end of the day." Say this for Max Baucus: he's not one to give up easily.