WASHINGTON – Fearing a backlash, Democrats smoothed the impact of sweeping health care legislation on working-class families Thursday and steered President Barack Obama’s top domestic priority toward a crucial Senate advance. The most far-reaching overhaul in decades aims to protect millions who have unreliable coverage or none at all.
Republicans on the Senate Finance Committee attacked the bill as riddled with tax increases that violated Obama’s campaign promises, but failed to remove any of them.
After marathon public debate, agreement by the committee is all but certain for the legislation, although no final vote was expected until next week. That formality – Democrats hold a 13-10 majority on the panel – will clear the way for the full Senate to begin work on the measure at midmonth.
The legislation, like a companion bill under construction in the House, would bar insurance companies from denying coverage or charging higher premiums on the basis of pre-existing medical conditions. It also includes federal subsidies to make insurance available to millions who lack it, and it takes steps to slow the skyrocketing growth in health care costs.
After days spent largely turning aside Republican calls for changes in the bill, Senate Democrats coalesced behind two of their own that could alter the legislation in significant ways.
One, backed by Sen. Maria Cantwell, D-Wash., would allow states to negotiate with insurers to arrange coverage for people with incomes slightly higher than the cutoff for Medicaid, the government health care program for the poor.
The second, which passed on a 22-1 vote, would exempt millions of people from a requirement to purchase insurance that is currently in the bill and reduce the penalties on millions more who defy the mandate.
Cantwell’s amendment uses the popular Washington state Basic Health Program as a model for the state-run pools. States would receive 85 percent of the tax-credits the bill gives individuals and families earning between 133 and 200 percent of the federal poverty level, allowing them to pool those people and negotiate with insurance companies for lower rates.
The amendment passed on a near party-line vote, after Republicans and Sen. Blanche Lincoln, D-Ark., voted against it citing worries about reduced health care options.
Washington’s Basic Health program has been in existence for more than 20 years, and negotiates insurance policies with five state insurers. Washington Basic Health Assistant Administrator Preston Cody said it’s been several years since any insurers have not renewed their contracts or opted out of the program.
The program used to cover 107,000 Washingtonians, but the state cut funding so now it can only afford to insure 70,000, Cody said. People gradually leave the plan as they get jobs with health insurance or qualify for other programs. There are about 67,000 people on a waiting list for the plan, he said.
Cantwell said her amendment would get more money to Washington’s program, which she said has proven there’s a demand for this service and also insurers willing to cover the population. It’s a good start toward further conversation about a public option, she said.