After months of anticipation and blown deadlines, Senate Finance Committee chairman Max Baucus on Wednesday finally unveiled his bill to overhaul the nation's health-care system. The Montana Democrat did his best to sell the controversial proposal, stressing that it was largely in line with the principles laid out last week by President Barack Obama: it has a 10-year price tag of less than $900 billion, doesn't add to the deficit and includes a mechanism to ensure that those with pre-existing conditions can't be denied coverage. But Baucus' relentlessly positive spin couldn't change the fact that for all the wrangling and delays, not a single Republican signed on to his much touted bipartisan bill. Even more troubling for anyone hoping there might be some resolution anytime soon, many of Baucus' fellow Democrats had lots of negative things to say about the controversial proposal, treating it as nothing more than a first offer to be bargained over.
"Everyone should understand that it is just the beginning," said Senate majority leader Harry Reid. "There'll be some changes before the markup starts, and then there'll be some changes during the markup."
"There's much more work to be done," said Russ Feingold, a Wisconsin Democrat.
Asked if she could vote for the bill right now, Senator Blanche Lincoln, an Arkansas Democrat, smiled coyly. "There's always room for improvement," she said. "I've got an opportunity to make improvements, so we all look forward to that."
"I'm going to do my best to fix the legislation," declared Oregon Senator Ron Wyden.
"It's a work in progress," hedged Louisiana Senator Mary Landrieu.
Still, Senators shouldn't hold their breath that they will be radically changing the bill, at least in the formal markup expected in committee next week. It's unlikely that any amendments that change the basic framework will be accepted, Baucus told reporters before unveiling his bill. The Montana Democrat has not even given up on the hope of some Republican support. But despite his apparent confidence, Baucus may still need to work to win over enough wavering Democrats to get the bill through the Finance Committee. Here are their five biggest issues with the legislation and what Baucus can — or in some cases cannot — do to assuage these fears.
1. The Public Option
All four other versions of health-care-reform legislation that have emerged from the House and Senate include a government-insurance option that would compete with private plans to help keep costs down. Republicans across the board have denounced the proposal, with many calling it the first step to socialized medicine. In a nod to the concerns of his GOP colleagues and some moderate Democrats, Baucus introduced an alternative to the public plan: nonprofit state or regional cooperatives that, except for some seed money from Washington, would be exclusively financed by members' premiums. The hazy concept of co-ops has been pushed by North Dakota Democrat Kent Conrad, who was part of the bipartisan so-called Gang of Six that worked to draft the Baucus bill, but many health-policy experts view it as a poor substitute for a public plan; in fact, the Congressional Budget Office, in its scoring of the deficit impact of the bill, stated that it didn't believe the co-ops as proposed by Baucus would attract many members. Liberals see the plan as letting insurers off the hook. "Senator Baucus' health-care bill released today is like a dream come true for the insurance industry," screamed a statement by Justin Ruben, executive director of the progressive group MoveOn.org.