Senate Debates Healthcare

December 4, 2009
Jeri G. Kubicki -- Vice President, Human Resources Policy-- NAM

Note: This is a more comprehensive overview of the healthcare debate in the U.S. Senate than the previous posting.

Debate in the Senate began this week on the Patient Protection and Affordable Care Act. With no clear path outlined and many Senators looking to significantly modify and/or delay the bill, it could be a number of weeks before a final vote takes place. On Monday, the Congressional Budget Office (CBO) released a controversial analysis of the bill’s effect on insurance premiums, which noted that employer-sponsored plans would be minimally affected. Analyses by different groups draw different conclusions from the report and indicate that some of the assumptions are questionable.

By late Wednesday, an agreement was reached to begin the amendment process with consideration of the first four amendments, two Democratic amendments related to preventive care and two Republican amendments related to Medicare cuts. Additional amendments from both sides of the aisle are in the queue for consideration, so the process is moving slowly.

Republicans have organized a full public relations plan focusing on Medicare cuts and tax increases. Bolstering their arguments, a study was released this week showing that when faced with the current legislative proposal, most employers will reduce benefits to avoid the excise tax. Furthermore, key Senators such as Blanche Lincoln (D-AR) are looking at state polling, saying that 71 percent of her constituents are against a government-run plan that “encouraged companies to drop private health insurance coverage for their workers.”

The NAM and our partners in the Employers for a Healthy Economy and Start Over! coalitions, who represent 186 leading employer associations and hundreds of thousands of businesses of all sizes from all 50 states and nearly every sector of the economy, recently launched a new television ad telling Congress to “Start Over!” and get health care reform right. The ad, entitled “Crisis,” urges Senators not to pass legislation that will result in higher health care costs while families are struggling and our economy slips deeper into debt. The coalitions are committed to fundamentally changing the health care system by expanding access to coverage for all Americans, lowering costs and improving care without shifting those costs to the private sector.

House

The House has been eerily silent on health care since its vote. Conventional wisdom holds that behind-the-scenes pre-conference negotiations are taking place with the House while the Senate debates its bill. It is still to be determined if the House is willing to accept a Senate bill that will inevitably focus less on progressive ideals. Additionally, if the Senate can develop a health reform package that achieves the critical 60-vote hurdle required for passage, the role of the House bill in the conference process will be highly questionable because the Administration will likely back the Senate package to ensure a bill is delivered to the President in short order.

Administration

The President’s approval rating has dropped below 50 percent, strengthening the Republican resolve to stop the health care bills currently in Congress. President Obama’s proponents, meanwhile, note the similarity to poll numbers under Ronald Reagan when he was facing a similar economic crisis and are not outwardly swayed by the setback. The Administration continues to work behind the scenes with Senate Majority Leader Reid (D-NV) in swaying moderate Senators to support the Senate bill.