As hundreds of thousands of citizens gathered in Washington, DC to protest government expansion and rising deficits, President Barack Obama and his Democratic allies on Capitol Hill shifted their goals on a national health care overhaul from a so-called “public option” plan to other ideas.
Following the president’s September 9 address to a joint session of Congress in which he laid out his requirements for health care legislation, Senate Finance Committee Chairman Max Baucus (D-MT) released his version of a health care overhaul, dropping the public option in favor of state health care co-ops and an individual mandate.
According to John Calfee, a resident scholar at the American Enterprise Institute in Washington, DC, the Baucus legislation still contains several measures closely following Obama’s outline.
“These ‘consensus’ measures include much of what the president laid out in his speech to Congress: guaranteed issue of insurance, guaranteed renewal, limits on lifetime expenses, cross-border exchanges, high-risk pools, some token cost-saving addressing of waste, fraud, and abuse in Medicare, and, of course, an individual mandate,” Calfee said. “It’s got pretty much everything but a full public option.”
Although it’s consistent with the president’s remarks, Baucus’s plan met with immediate negative responses from some of his fellow Senate Democrats. Sen. Jay Rockefeller (D-WV) blasted the Baucus plan in remarks to reporters, saying it amounts to a massive tax on middle-income Americans and specifically for coal miners in his state.
“There is no way in its present form that I vote for it,” Rockefeller said, “unless it changes in the amendment process by vast amounts.”
Rockefeller, who serves on the Finance Committee, has a constituency that includes many union members, many of whom have so-called “gold-plated” health care plans, subject to higher taxes under the Baucus measure.
“Virtually every single coal miner is going to have a big, big tax put on them because the tax will be put on the company and the company will immediately pass it down and lower benefits,” Rockefeller said. “So that’s not really a smart idea. In fact, it’s a very dangerous idea, and I’m not even sure the coal miners in West Virginia are aware this is what is waiting if this bill passes.”
Taxing Health Insurance
During the 2008 presidential campaign, Obama repeatedly promised not to raise taxes on middle-income families, and he criticized his opponent, Sen. John McCain (R-AZ), for considering an individual mandate, described in television ads at the time as a tax on health insurance. But as the White House and Senate have shifted from a public option to an individual mandate—which would fine citizens who do not purchase the required amount of health insurance—the president has come under fire for breaking his promises.
In a September 20 interview with Obama on ABC News’ This Week, George Stephanopoulos asked: “Under this mandate, the government is forcing people to spend money, fining you if you don’t. How is that not a tax?”
“No. That’s not true, George,” Obama said. “For us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase; … you can’t just make up that language and decide that that’s called a tax increase.”
“I don’t think I’m making it up,” Stephanopoulos said, invoking the Merriam Webster’s Dictionary definition of “tax” as “a charge, usually of money, imposed by authority on persons or property for public purposes.”
“George, the fact that you looked up Merriam’s dictionary, the definition of tax increase, indicates to me that you’re stretching a little bit right now,” Obama said. “Otherwise, you wouldn’t have gone to the dictionary to check on the definition.”
Regardless of whether voters view the individual mandate as a tax, and despite continued protests against the plans, health policy experts believe some form of reform legislation will pass the Senate by the end of November, with the aim of ironing out any differences with the more-liberal House legislation in conference.
“We will end up with something,” Calfee said. “What that something is, we’ll have to wait and see.”
Benjamin Domenech ([email protected]) is managing editor of Health Care News.
For more information …
“Call to Action: Health Reform 2009,” by U.S. Sen. Max Baucus (D-MT), November 12, 2008: http://finance.senate.gov/healthreform2009/home.html