Updated

Bipartisan Senate Health Care Talks Hit Snag

BY CARL CAMERON AND TRISH TURNER

Bipartisan Senate health care negotiations have been going on for months, and it appears that patience on all sides  is wearing thin.   Sources tell Fox that top Finance Committee Republican Charles Grassley, R-IA, has now asked committee chairman Max Baucus, D-MT, to reconsider two critical elements of the compromise proposal:  the individual mandate and the $3,800 maximum penalty for lack of insurance. The source said Grassley considers these as too onerous.

Body language spoke volumes Wednesday, as negotiators grew more terse with reporters.  Sen. Kent Conrad, D-ND, said any reference to deadlines was unhelpful and stated emphatically, “What is critical is that we achieve a result by the end of the year. If we have (full committee consideration) in the next couple of weeks, that will be plenty of time to get this job done.”

Another Republican negotiator voiced concerns to Fox.  Sen. Olympia Snowe, R-ME, said there is still concern about the size of the package which is carrying a near $900 billion price tag. “Maybe we could shrink that to $800 billion or below,” the moderate senator said, citing a skeptical public with bailout fatigue and concern for rising deficits. Snowe said she is certain there will be amendments offered in committee to scale back the scope of the bill.

As for the much-touted idea of a “trigger,” a set time at which if current plans don’t provide affordable, quality care, a government-run plan kicks in, this appears to be more talk in the media than in the negotiating room.  Snowe told Fox that she thinks the White House is talking about it more than senators.  She would not even concede that it will be offered as an amendment, and as the Baucus plan currently stands, there is no mention of a “trigger.” Baucus even told reporters that it was not mentioned in compromise talks.

Yet another Republican negotiator called on the President to support medical malpractice reforms, something that does not appear in the Baucus proposal. Sen. Mike Enzi, R-WY, said in an op-ed published on Foxnews.com, “We must eliminate frivolous malpractice cases, which not only drive up costs through malpractice insurance, settlements and legal fees, but also force doctors to practice defensive medicine, where they order unnecessary tests and treatments to protect themselves from getting sued.”

All of this consternation comes on the very day when the chairman told reporters that he will present a bill next week with or without Republicans.  Baucus bluntly laid it on the line, saying, “I very much hope and do expect Republicans will be on board. I don't know how many, but if there are not any, I am going to move forward in any event,”.

Democrats on the committee who are not directly participating in compromise talks  met privately for an hour with Baucus, and they emerged unhappy, as well.  Many voiced concerns that Baucus was making too many compromises with Republicans.

Sen. Ron Wyden, D-OR, said he had a number of problems with the Baucus plan, particularly with the lack of choices and with affordability.  The senator said he is concerned that middle income Americans will not be able to afford coverage under the plan as it stands. Wyden also said he will offer an amendment called the Free Choice amendment that says, “Over a period of time, all Americans will be able to get access to the good quality, affordable choices available at the marketplace, called ‘the exchange’. What you have now, the only people who get to get into the (exchange) are folks who are unemployed, folks who are uninsured, and folks with small businesses.”

Sen. Jay Rockefeller, D-WV, a staunch proponent of a government-run health care option, eviscerated one component of the Baucus proposal, nonprofit cooperatives.  Rockefeller said emphatically, “They don’t work.”

Sen. Tom Harkin, D-IA, who is not on the Finance Committee but took up the helm of the other Senate committee crucial to health care reform efforts, the Health, Education, Labor, and Pensions Committee (HELP), replacing the late Sen. Ted Kennedy, D-MA, told Fox, “I’m for a public option. I still have not seen a viable co-op plan. I mean, how is it portable? If it’s regional, then why not just have a public plan?”

Baucus said Wednesday that he does not have the votes to get a so-called “public option”, or government-run plan, out of his committee, as Republicans and some moderate Democrats do not support it.  Cooperatives are seen, by some, as an alternative to the public option.  This, alone, has liberal Democrats up in arms.

Senate Majority Leader Harry Reid, D-NV, dodged a question about government-run health care versus co-ops, saying he is “for a public option” but that he did not want to “get into hypotheticals,” as it is unclear what will eventually come out of the Senate.  Reid said Democrats will have an opportunity to offer a public option as an amendment in the Finance Committee. Reid indicated he would not presume to know how a vote would look in the committee, despite what Baucus told reporters.

Reforms to Medicare Advantage also emerged as a point of concern for a number of Democrats.  Sen. Bill Nelson, D-FL, a member of the Finance Committee, told reporters that he is very concerned about cuts, saying that proposals thus far will, indeed, hurt seniors.  Nelson said he has a proposal that will keep that from happening, though he would offer no details.

Some Senate Democratic leadership aides continue to insist that a budgetary gimmick, called “reconciliation,” that allows Democrats to circumvent a filibuster and push through a more liberal plan, is more likely. Still, parliamentary experts say this is a very dicey path, as Republicans can and will throw up many obstacles that could leave a Democrat-only bill looking like legislative Swiss cheese.