WASHINGTON — A White House-backed overhaul of the nation’s health care system weathered repeated challenges from Republican critics over taxes, abortion and more on Wednesday, and the bill’s architect claimed enough votes to push it through the Senate Finance Committee as early as week’s end.
“We’re coming to closure,” said Sen. Max Baucus, D-Mont., the committee chairman, as President Barack Obama lobbied at least one wavering Democrat by phone to swing behind the measure.
Baucus said, “It’s clear to me we’re going to get it passed,” although he sidestepped a question about possible Republican support. Olympia Snowe of Maine is the only GOP senator whose vote is in doubt, and she has yet to tip her hand. While she has voted with Democrats on some key tests — to allow the government to dictate the types of coverage that must be included in insurance policies, for example — she has also sided with fellow Republicans on other contentious issues.
House Democratic leaders struggled to reduce their legislation to the $900 billion, 10-year cost that Obama has specified. Officials said numerous alternatives were under review to reduce subsidies that are designed to defray the cost of insurance for millions.
Passage in the Finance Committee would clear the way for debate on the Senate floor in mid-October on the bill, designed to accomplish Obama’s aims of expanding access to insurance as well as slowing the rate of growth in health care spending overall. The bill includes numerous consumer protections, such as limits on co-payments and deductibles, and relies on federal subsidies to help lower-income families purchase coverage. Its cost is estimated at $900 billion over a decade.
While the legislation would not allow the government to sell insurance in competition with private companies, as Obama and numerous Democrats would like, the White House was working to make sure that some version cleared committee. Sen. Jay Rockefeller of West Virginia, a Democrat who has been outspoken in his criticism of features of the bill, said Obama called him to seek support.
“I was noncommittal,” the senator said.
The committee met as Senate Majority Leader Harry Reid of Nevada announced the full Senate would begin debate on health care legislation the week of the Columbus Day holiday, which is Oct. 12. Initial action is expected to be slow, consumed largely with parliamentary maneuvers in which Democrats try to set the stage for passage and Republicans erect a 60-vote hurdle as a test vote.
The precise details of the bill brought to the Senate floor will be determined by Reid, in consultation from the White House and Democratic leaders of the Finance Committee and the Health, Education, Labor and Pensions Committee.
Democrats on the Finance Committee worked behind the scenes on possible last-minute changes to make insurance more affordable and accessible for millions who now lack it.
Sen. Maria Cantwell, D-Wash., floated a proposal modeled after a system in her home state. It would allow creation of a state-run insurance program for lower-income Americans that supporters said would produce lower-cost coverage as the state used its purchasing power to negotiate fees with doctors and other providers.
Inside the committee, the only significant change approved Wednesday was a proposal by Sen. Bill Nelson, D-Fla., to shield seniors from the impact of a tax increase in the bill for individuals and families seeking to exclude certain medical expenses from their income. Under current law, taxpayers who itemize their deductions are permitted to escape taxes on health costs that exceed 7.5 percent of their adjusted gross income.
Baucus’ legislation would raise the threshold to 10 percent, but on a vote of 14-9, Nelson succeeded in returning it to 7.5 percent for taxpayers age 65 and over.
It was one in a string of futile Republican attempts to reshape the legislation by inserting stronger anti-abortion provisions. Attempts to kill fees on health industry providers also failed, along party lines, after Baucus said the result would be to wipe out a key source of funds for the expansion of insurance.
Republicans also were unsuccessful in their attempts to require low-income applicants for federal health programs to furnish photo identification as proof of eligibility, an issue that dealt with illegal immigrants.
Sen. Charles Grassley, R-Iowa, said the goal was to prevent fraud, but Bob Menendez, D-N.J., objected that the proposals went beyond a required birth certificate as proof of citizenship.
