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November 21, 2009 at 07:00 PM
Members of the Senate have started debating whether they ought to debate the Patient Protection and Affordable Care Act bill, and Sens. Blanche Lincoln and Mary Landrieu now say they favor letting the bill come up for discussion.
The Senate plans to hold a cloture vote around 8 p.m. today. PPACA bill supporters need 60 votes to move ahead with debate.
Landrieu, D-La., one of a handful of known health bill swing voters, buoyed supporters shortly after 1 p.m. when she announced that she would vote for starting debate on the bill. But she added that “much more work needs to be done” on the bill before she would consider voting for it.
One step lawmakers ought to take is to improve small business tax credits, especially for businesses with fewer than 25 employers, and to provide tax equity for self-employed individuals who buy their own health coverage, Landrieu said.
Lawmakers also should keep health rates rising excessively between today and the time any proposed changes take effect, and they should limit the amount of exposure taxpayers have to any proposed public option health plan, Landrieu said.
Around 2:30 p.m., Lincon, D-Neb., said she still opposes the idea of a creating a government-run “public option” plan, and may oppose to block further consideration of the bill in the future. “Who pays if [the public option] fails to live up to expectations” and needs a taxpayer bailout, Lincoln asked.
But she said it is important for lawmakers to begin to debate on the bill rather than simply walking away.
“That’s not what the people sent us here to do,” Lincoln said.
Lincoln noted that groups on the left and the right have spent heavily on ads intended to influence her vote, and she reported that individuals from out of state have e-mailed her “unbelievable” threats in connection with the vote.
Sen. Ben Nelson, D-Neb., a third health bill swing voter, announced Friday that he would vote to move ahead with debate on the PPACA bill and try to amend the bill to make it more to his liking.
Senate Majority Leader Harry Reid, D-Nev., unveiled the text of PPACA late Wednesday. The Congressional Budget Office has estimated programs proposed in the bill would cost about $848 billion from 2010 to 2019 but raise enough additional revenue and cut enough spending to save the federal government about $130 billion over that period. The CBO estimates the bill would cut the number of uninsured people to about 24 million, from 54 million if current laws prevail.
FLOOR DEBATE HIGHLIGHTS
Sen. Mark Udall, D-Utah, acknowledged during floor debate on the decision about whether to proceed with debate that PPACA opponents are complaining about the inclusion of a public option provision.
But today, “fewer and fewer people can get insurance,” Udall said. “
Where are these people ending up? Medicaid, if they’re poor enough. Or in the emergency room getting uncompensated care.”
Insured Americans already pay for most of that uncompensated care, either through tax-supported government programs or by paying more for their own private health insurance and the care they pay for out of their own pockets, Udall said.
The CBO also declined to include estimates of the effects of many PPACA health cost control provisions, such as efforts to improve wellness efforts and provider payment strategies, and that means that effects of the bill could turn out to be better than the Congressional Budget Office has predicted, Udall said.
Sen. Judd Gregg, R-N.H., said Senate Democrats held down the CBO’s estimate of the gross cost of the bill from 2010 to 2019 by implementing tax increases, Medicare cuts, and other revenue raisers and spending cuts immediately, then holding off on spending on new programs.
