Key Democratic Provisions Fading Fast

Liberal senators' best laid plans may be sacrificed in committee

Bipartisan negotiations on the Senate Finance Committee are moving closer to eliminating two health care provisions favored by many Democrats – a mandate on employers to provide insurance or pay a penalty, and a government insurance option, a senator and health care insiders said Monday.

That could bring even greater pressure on Finance Chairman Max Baucus (D-Mont.), who has been challenged by more liberal senators who say he is sacrificing key Democratic priorities on health care reform to win the votes of a few Republicans.

Sen. Olympia Snowe (R-Maine) confirmed that the three Republicans and three Democrats negotiating the Senate Finance bill are moving away from a broad-based mandate that would force employers to offer insurance. The senators instead are leaning toward a “free rider” provision that requires employers to pay for employees who receive coverage through Medicaid or who receive new government subsidies to purchase insurance through an exchange.

Snowe stressed the committee hasn’t reached a final agreement on any of the key provisions but said, “There is not a broad-based employer mandate. … There are approximately 170 million Americans that receive coverage through employers. That is a significant percentage of the population. We don’t want to undermine that or create a perverse incentive where employers drop the coverage because their employees could potentially get subsidies through the exchange.”

On the nonprofit insurance cooperative, Snowe also said no final decisions have been reached, but “it is safe to say it is probably one that will remain in the final document.”

Both the “free rider” proposal and the co-op plan were included in an outline of the Finance Committee bill that leaked out last month.

“If it is to be a bipartisan package, it’s going to be co-ops, not public plan and some middle ground on employer mandates,” said a health care insider, noting that many of the details still need to be sorted out.

Baucus, who continued his almost daily calls Monday with President Barack Obama, declined to say where the committee was headed.

“We are working towards a way to get a bill that lowers health care costs, which provides affordable, high-quality health care to people and in a way that passes the Senate,” Baucus said. “I can’t tell you exactly what that is yet, but I can tell you we are getting very close to it.”

Democrats on the Finance Committee meet Tuesday morning, but already talk of a deal along these lines drew fire from one prominent Democrat – former national party chairman Howard Dean. If the co-op plan and free rider provision make it into the bipartisan compromise, "I fear for the future of health care reform because that is not health care reform," Dean said Monday on MSNBC's Rachel Maddow Show.
Instead, he called it “health insurance reform.”
As for the co-op plan, Dean said, "That is what I call the fake public option. And that is a shame."

"This compromise does nothing except reform insurance. It is not worthless because it makes it fair, but it is not health care reform," Dean said.

Chris Frates contributed to this story.

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