At a special evening meeting of the Democratic caucus tonight, Senate Majority Leader Harry Reid outlined, in broad strokes, the details of his health care bill, which the CBO has found, in a preliminary analysis, will expand coverage to 94 percent of Americans while reducing the deficit. And earlier in the day, during a separate meeting about floor procedure, Reid let three of his party’s key skeptics know that if they join Republicans at any stage of the process to block the bill, he still retains the option of passing major parts of it through the filibuster proof budget reconciliation process.
In response to a question from TPMDC Nelson told reporters that, at a meeting this afternoon with Sens. Mary Landrieu (D-LA) and Blanche Lincoln (D-AR), Reid “talked about process, procedure, discussion about reconciliation and a whole host of issues of that sort.”
“Nobody’s really jumping up and down to push for reconciliation,” Nelson said, “he’s not threatening that, but anybody can conclude that if you don’t move something on to the floor, that is one of the possibilities.”
Nelson said he has still not committed to vote for even the first procedural vote, but in a sign that he’s leaning toward bringing a bill to the floor, he emphasized his view that the floor debate is a chance to improve the legislation. “I wanted to make it clear that that is, unlike some are suggesting, is not the vote…it’s a motion to enter into the debate and possible amendments and improvements of the legislation” Nelson said. “The vote is the second cloture vote, and that is the cloture on a motion to cease debate, and I wanted that clear, because I’ve already begun to see people out there say, ‘oh no, no, if you vote [to take it up] you’ve voted for health care.”
Senate Minority Leader Mitch McConnell (R-KY) has explicitly stated that the Republican party will treat Democrats who vote for any procedural motion as if they’ve voted for the entire health care bill.So what’s in it exactly? Tonight, Reid described some of the key controversial provisions to the full caucus.
The bill will include a public option with an opt-out clause for states, though the public option itself, and many other key provisions in the bill, including the exchanges and a Medicaid expansion wouldn’t be available until 2014–one year later than previous versions of the legislation, and the House bill call for. It also includes new language prohibiting federal funds from financing abortions–though the exact mechanism remains unclear.
“There is a strict wall between a woman’s private funds and federal funds,” said a supportive Sen. Barbara Boxer (D-CA), one of the Senate’s leading pro-choice members.
Boxer could not elaborate about whether or not the bill would, like the House’s legislation, preclude people who receive federal insurance subsidies from buying health care plans that cover abortion, but Sen. Bob Casey (D-PA), a pro-life Democrat, told TPMDC, “I think that’s certainly the intention.”
According to a number of senators, the language differs from both the Stupak amendment and the less restrictive Capps amendment. But though most details remain unclear, the public option would not be permitted to provide abortions, and insurance companies in every exchange in every state would be required to provide at least one plan that covers abortion, and one that does not. “There will be no public money spent on abortions…there will be a requirement in each state that they offer a plan, one without any abortion and one with so that you cover bases appropriately,” said Sen. John Kerry (D-MA)
As expected, Reid raised the floor on a controversial tax on high-end “Cadillac” health care plans, so that fewer policies with more luxurious coverage will be immediately impacted. At a baseline, insurance companies would pay a 40 percent tax on purchased plans that cost individuals $8,500, and $23,000 for families of four. To account for the lost revenue, Reid increased the Medicare payroll tax for high-income earners.
Under the terms of the bill, Medicaid would be expanded to cover everybody up to 133 percent of the poverty line. And in a move that will disappoint progressives, tax credits to buy health insurance would be limited to those between 133 and 300 percent of poverty line. (People between 300 and 400 percent of poverty would not be provided any direct federal assistance, but insurers would not be able to set their premiums at more than 9.8 percent of their annual income.)
And, to address one of Ben Nelson’s concerns, Reid stripped out a provision that would have overturned the insurance industry’s anti-trust exemptions.
As they trickled out of the meeting, Democrats sounded optimistic. “We’re going to pass this legislation,” Kerry said. “That means we’re going to get it to the floor, we’re going to debate it, we’re going to pass it.”
“We’re not going to allow a procedural hurdle to deter the effort to get to what the American people want us to do, which is their business with respect to health care,” Kerry said. “A procedural hurdle is a minor, minor inconvenience in the process of getting this legislation addressed and on the floor.”
Dick Durbin (D-IL), the second highest ranking Democrat in the Senate, said the caucus had a “very positive response to the legislation.”
Tomorrow, Reid will file for cloture on the motion to proceed, which will set off 30 hours of debate before the cloture vote itself is held, likely on Saturday. That could set off yet another delay before the motion to proceed is actually passed, which could take until Monday. If that happens, the debate on the bill–including a reading of its 2000+ pages, won’t likely begin in earnest until after Thanksgiving. Got that all? Good.