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What's At Stake In Senate Panel's Health Care Vote?

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What's At Stake In Senate Panel's Health Care Vote?


What's At Stake In Senate Panel's Health Care Vote?

What's At Stake In Senate Panel's Health Care Vote?

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  • <iframe src="" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript

The Senate Finance Committee is set to vote Tuesday on its health care overhaul bill, and the gloves are coming off. Some major interest groups in the health care debate say they want a bill passed, but they seriously oppose this particular bill.


It's MORNING EDITION from NPR News. Good morning. I'm Steve Inskeep.

Today, senators take a step toward changing health care in this country. It's just one small step in a long process, but it's a step that lawmakers have awaited for months. The Senate Finance Committee votes on its version of a health care bill. And at the last moment, some of the most powerful interest groups in health care have voiced their opposition. Insurance companies say they support some kind of health care change, just not this.

NPR's Julie Rovner has been covering the story from the beginning and before. Julie, Good morning.

JULIE ROVNER: Good morning.

INSKEEP: What bothers the insurance companies so much?

ROVNER: Well, first there are a series of new taxes that would be levied on the insurance industry. That is not in the four other bills that are pushing their way through Congress. So that's something that they particularly don't like, and they've commissioned a study that would say that, you know, insurance rates would rise dramatically under this bill.

INSKEEP: Well, let's talk about that part. Do they have a point when they make this other claim that would affect you - not just insurance companies but me and you, that our premiums would go up?

ROVNER: Well, we certainly saw yesterday the White House and the members of the Finance Committees who support this bill say, no, this is a really bad study that they have commissioned. Now, certainly on the question of these taxes, there's some question about whether they would be passed through, whether premiums would go up, but there is a legitimate point that not just the insurance industry but other economists are making about this bill, and it takes a little bit of explaining.

One of the problems that the Finance Committee had when it was writing this bill is they didn't have enough money to play with to make subsidies for the middle class as high as they wanted, to help them pay for their insurance. Remember, insurance will be required under this bill. Because they weren't going to help the middle class that much, they got a little bit squeamish about imposing penalties on people who would then have to buy insurance.

So what they did at the very last minute is they reduced, and in some cases eliminated at the beginning, penalties for those people. The problem with that is that if there are no penalties, the insurance industry is worried that people will not buy insurance or they will pay this very small penalty. Particularly, they are worried about the young and healthy not buying insurance. And so if there are not enough young and healthy people to subsidize the older, sicker people, premiums really will go up, and economists say that that is indeed going to be a problem.

INSKEEP: So they have this complaint about taxes, which you can argue about whether that's fair or not. And they have this complaint about whether this bill is really going to bring down premiums, which is actually the goal. And I understand hospitals, who are a big part of this debate, are also not happy about that.

ROVNER: That's right. Hospitals are upset also again with this problem about not getting enough people covered. Earlier this year, the hospitals made a deal that said they would give up special payments that they get for treating people who don't have insurance, but it was premised on there being this many more people who have insurance.

INSKEEP: Basically being nobody anymore who had no insurance or almost none.

ROVNER: Practically nobody. And now the Congressional Budget Office says that there are really only going to be 91 percent of people covered at the end of 10 years, if you count people who - illegal immigrants, who will not be covered under this bill, and the hospitals say that violates their deal. So now they're unhappy with the Senate Finance Committee Bill.

INSKEEP: So if you get insurance companies unhappy and hospitals unhappy, is that going to affect the Senate Finance Committee vote on this bill today?

ROVNER: Probably not. The White House and Senate Finance Committee chairman, Max Baucus, say that they are pretty confident they're going to get if not all the Democrats, probably all but one of the Democrats. They may get Republican Olympia Snowe. All the Republicans were going to vote no anyway, and frankly, having the insurance industry come out against this is only probably going to solidify the Democrats saying, you know, oh wow, the insurance industry saying premiums are going to go up. That's probably not the greatest PR for the insurance industry.

INSKEEP: Oh, because the Democrats can say we're defying the insurance industry here and so forth.

ROVNER: Exactly.

INSKEEP: Well, assuming it gets through this committee, of course, it's still nowhere near becoming law. What happens next?

ROVNER: That's right. This bill has to be merged with another bill that came out of another Senate committee earlier this summer before it can go to the Senate floor. The House is still struggling to put together the three bills that came out of the three House committees before it can go to the floor. We're looking at floor debates probably later this month or early November. This has a long way to go before it gets to the president's desk.

INSKEEP: In just a couple of seconds, though, is there a feeling now that things are moving on health care legislation in Congress?

ROVNER: I think so. You know, this is moving much slower than the White House and Congress would have liked, but it certainly is moving forward with this sort of air of inevitability.

INSKEEP: Julie, thanks very much.

ROVNER: You're welcome.

INSKEEP: That's NPR's Julie Rovner in our studios this morning.

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