The Baucus Proposal and the Process Moving Forward
As we all know, Senator Baucus released the Senate Finance Committee (SFC) mark on Wednesday. There are many important provisions in the bill that we think will significantly improve health care for millions of people – expanding Medicaid, preventing insurers from excluding coverage for pre-existing conditions, banning annual or lifetime caps, as well as improving community benefits and prescription drug policies.
We acknowledge there are also many problems with the bill, including how it treats immigrants, the “free-rider” provision, a lack of public option, and more. We are most concerned about the weakness of affordability protections, particularly in the context of a plan that includes an individual mandate.
The good news is that right now affordability is definitely a central issue that everyone – on and off committee, on both sides of the aisle, and in the Administration – is discussing. This is, in large part, due to the great work you have done over the past few months sounding the drum beat on affordability issues in your meetings on the Hill, through your grassroots activities, and in the many calls you and your colleagues have made across the country. This has helped the issue gain traction and momentum. Congratulations!
Community Catalyst’s current strategic thinking
We regard the Baucus proposal as the “floor” and believe we have an opportunity to improve the legislation, particularly at three critical junctures:
- During the SFC mark-up process
- As SFC and HELP are merged
- During the conference committee
On the Senate floor (and in the House) our main goal is to positively build on current proposals and prevent them from getting worse. If the current schedule holds, the first two opportunities will occur over the next week or two.
We understand that different national and state groups will reach different conclusions on how hard to come down on the Baucus proposal. The important thing is that we continue to work collaboratively to keep the process moving forward and push for improvements. We also strongly encourage folks not to draw lines in the sand or have a single-issue litmus test – it is still (believe it or not) too early in the process for that. We need to assess the package as it moves along and very carefully weigh the decision to oppose it against the cost of failure and continuation on the current path.
We believe the process has to move forward. To continue our forward momentum and not polarize Members to the extent that it causes the process to break down, we need to play a critical yet constructive role. Without a bill from the SFC, we will be at a standstill in the Senate, and the House has told the Blue Dogs they will wait to see what the SFC is doing before moving forward. Reform efforts of any kind cannot continue without this bill.
What does this mean for our outreach right now? A couple of things:
First, at each of the three critical junctures, we need to push for revenue and savings the SFC has not included while keeping moderate Democrats from jumping off the bill. We also need to encourage our progressive allies to keep “pay-fors” in the bill. Every time we lose an offset, the improvements in the affordability provisions become less likely. The silver lining of the Baucus proposal is that CBO scores it well under the $900 billion figure the President said he expects reform to cost; there is room under that ceiling to make the bill better. However, we can not afford to lose revenue from the current mark.
Second, we are confident there will be amendments to improve the affordability provisions. The deadline for filing amendments was 5 pm today. We will have information on these amendments, as well as a summary of the Mark, early next week before the mark-up begins on Tuesday.
Third, we recognize that everyone has other issues with the bill, but we strongly believe we need to be strategic about what we can fix and when we can fix it. It is helpful to push now on all the issues we care about so that we continue to send a message and set up positions for future negotiations. However it is most important that the bill moves forward and progress continues.
In order to help you in your efforts, we wanted to share some new materials with you:
- Getting Affordability Right
- A Comparison of the Subsidies in the Three Congressional Health Reform Proposals
- Why American Families Need Health Reform
- Community Catalyst's comments to Chairman Baucus on the SFC mark
We must remember that we have gotten farther in our efforts to reform the system than we ever have before, and we still have a great deal of work and opportunity ahead. Let’s continue to work to ensure that at the end of the year there is a bill on President Obama’s desk that helps to accomplish our collective goal of making our nation’s health care system more fair and more affordable for everyone.
Thank you for your dedication and continued advocacy.
Community Catalyst National Health Reform Team