Senate Democrats made a big step toward comprehensive health care reform Wednesday night as Sen. Majority Leader Harry Reid (D-Nev.) unveiled a bill that merges the two plans that passed the health and finance committees.
With the House having already passed its own bill, Congress is now closer to achieving health care reform than it has ever been in the six decades that Democrats have pursued it.
"We're now down to the week we've been waiting for for a long time," said Sen. John Kerry (D-Mass.) after emerging from a meeting of Senate Democrats.
Democratic leadership expressed confidence that the votes would be there by Saturday for a motion to proceed to a floor debate on the bill. Three Democratic senators -- Ben Nelson of Nebraska, Mary Landrieu of Louisiana, and Blanche Lincoln of Arkansas -- have yet to commit to vote for the motion to proceed.
During the meeting, the fence-sitting members spoke to the caucus, but didn't commit one way or another on the motion to proceed, said one Democratic senator who spoke not for attribution.
The bill presented by Reid is stronger than pundits ever thought possible in the summer months, when centrist and conservative Democrats worked to kill a public health insurance option. A loud round of applause could be heard toward the end of the meeting -- unusual for Senate gatherings.
Reid's bill includes a national, government-run insurance plan that would be available to consumers within the health insurance exchanges that the reform effort establishes. States could opt out of the plan.
The bill is being posted online Wednesday night, Senate Majority Whip Dick Durbin (D-Ill.) said. "I would hope [Republicans] would take this opportunity to post their health care bill online," Durbin teased. The GOP has no health care bill.
The Senate bill does not go as far as the House bill does in restricting access to abortion. The House bill would block a woman's ability to purchase health insurance that covers abortion even with her own money in many instances. The Senate package, several senators said, makes crystal clear that no federal funds could be used to pay for abortion. But at least one plan within the exchange would have to offer abortion coverage -- and one plan would not.
An aide who saw the specific language said the bill authorizes the secretary of Health and Human Services to audit plans to make certain no federal funds are being used to pay for abortion services.
House conservatives have threatened to block the reform bill if their more restrictive provision isn't included. Kerry acknowledged that there could still be negotiations, "but that's where the Senate is starting."
Instead of taxing the rich to pay for a significant piece of the bill, as the House does, the Senate plan would tax "Cadillac" health plans. But the value of plans that would be taxed is higher than in previous versions: $8,500 for an individual and $23,000 for a family of four. Even higher values are allowed in high-cost states and workers in high-risk jobs -- such as coal miners -- are given an exemption.
Reid's bill also alters the formula by which businesses would be assessed a fee for not insuring their workers. But the new formula was unclear. Kerry called it "convoluted" and Durbin dubbed it "complex."
Reid on Wednesday also presented to his colleagues a preliminary Congressional Budget Office analysis, which finds that the bill will cost $849 billion over the next decade. It would cover 94 percent of eligible Americans, including 31 million currently uninsured Americans. The bill would also lower the federal budget deficit by $127 billion over the next decade and by $650 billion during the decade after that. Kerry cautioned that the numbers were still being finalized and could change slightly.
By keeping the total cost of the bill under $900 billion, Reid met one of the conditions set by the Obama White House. The bill is also expected to drastically bend the cost curve in the health care system -- another major Obama objective -- by achieving "almost a trillion dollars in cost savings" within the health care system.
Reid will file a cloture motion Thursday, which will be followed by an intervening day, by Senate rules, leaving Saturday for the vote.