Republicans Push To Delay Health Bill Debate

"I think all of us would agree that the current system needs work," said Sen. Christopher Dodd, D-Mass., who inherited responsibility for the Senate HELP health bill effort from the late Sen. Edward Kennedy, D-Mass.

Dodd said Democrats engaged in significant efforts to try to work with Republicans to develop a consensus bill.

Republicans agreed that the U.S. health finance system is flawed, but they argued that H.R. 3590 is too long, too complicated and too expensive, and relies too heavily on accounting gimmicks.

"The bill fails to drive down the cost of health insurance premiums," said Sen. Charles Grassley, R-Iowa, the highest ranking Republican on the Senate Finance Committee.

The bill also calls for $500 billion in unspecified Medicare cuts over 10 years, including close to $8 billion in cuts in hospice reimbursement funding, said Sen. John McCain, R-Ariz.

"Of all things," McCain sputtered. "Hospice!"

That cut and others, such as more than $100 billion in proposed Medicare hospital reimbursement costs, "are not attainable cuts without eventually rationing health care in America," McCain said.

A genuine bipartisan effort would put more emphasis on reforming the medical malpractice system and controlling health care cost inflation, McCain said.

McCain and other Republicans argued that the bill would be a better bill if Senate Democratic leaders would slow down and send the bill back to committee for a thorough rewrite.

With permission from Reid and other Democratic Senate leaders, the Senate is considering a motion offered by McCain that would send the bill back to the Senate Finance Committee, with instructions for the committee to take out many of the Medicare spending cuts now included in the bill.

Shortly before the official PPACA debate began, Sen. Jon Kyl, R-Ariz., went further. "I don't think this bill can be fixed," Kyl said. Instead, he said, Congress needs to start over from scratch.

In the Senate Finance Committee, for example, only one of more than 100 amendments proposed by Republicans was adopted, and the Republicans now feel as if, rather than "having a seat at the table," Republicans have had what amounts to a seat at the kids' table, Kyl said.

If Reid wants to show that he is open to Republican contributions, he could start by working with Republicans to eliminate some of the proposed cuts in Medicare and Medicare Advantage program funding, Kyl said.

"Seniors know that you can't make these kinds of cuts in Medicare spending without jeopardizing the quality of the care that they receive," Kyl said.

Sen. Mitch McConnell, R-Ky., questioned the idea that the Senate should focus on health care at this time.

"There are a number of things that actually must be done this week, this month," McConnell said. "We have a debt ceiling expiring or needing to be expanded, according to the administration. We've not passed appropriations bills. There are tax extenders that expire at the end of the year. There are Patriot Act provisions that expire at the end of the year…. There are many things we must do this month, and yet, we're going to spend an enormous amount of time working on a bill that the American people wish we would not pass this month."

Senate floor debate is set to continue at 10 a.m. Tuesday.

Senate floor debate began as the Congressional Budget Office released a report suggesting that H.R. 3590 could increase the cost of coverage for some U.S. residents who buy individual health coverage without help from subsidies.

Analysts at the CBO and the Joint Committee on Taxation "estimate that the average premium per person covered . . . for new nongroup policies would be about 10% to 13% higher in 2016 than the average premium for nongroup coverage in that same year under current law," CBO Director Douglas Elmendorf writes in a letter summarizing the analysts' findings. "About half of those enrollees would receive government subsidies that would reduce their costs well below the premiums that would be charged for such policies under current law."

For people receiving subsidies, the average nongroup premium would decrease 56% to 59%, Elmendorf writes.

For group health plans, the average cost of coverage per covered life would be about the same under the PPACA rules and the current rules, Elmendorf writes.

For small groups, proposed PPACA subsidies could make the per-life cost about 8% to 11% lower than it would if the current rules prevail, Elmendorf writes.