Senate Considers Health Care Legislation Overhauling the nation's health care system has been a topic of debate for years — on the campaign trail, on Capitol Hill and around kitchen tables. A Senate committee took the first formal step Wednesday toward crafting legislation to do so.

Senate Considers Health Care Legislation

Senate Considers Health Care Legislation

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Overhauling the nation's health care system has been a topic of debate for years — on the campaign trail, on Capitol Hill and around kitchen tables. A Senate committee took the first formal step Wednesday toward crafting legislation to do so.


The opening gavel fell this morning for the Senate Health, Education, Labor and Pensions Committee. It signified day one in the formal legislative process of overhauling health care. Democratic Senator Chris Dodd kicked off the proceedings.

Senator CHRIS DODD (Democrat, Connecticut): This bill affects everybody. A hundred percent of our fellow citizens will be affected by what we do in the area of health care - every consumer, every business, every provider, as well. And so, this is truly historic - the journey that we're beginning this morning in this committee to deal with this issue.

NORRIS: Now, this Senate committee is just one of five committees working on health care proposals. And joining me to talk about the legislative landscape is NPR's senior political correspondent Mara Liasson. Hello, Mara.

MARA LIASSON: Hello, Michele.

NORRIS: Of all the thorny issues Congress and the administration is trying to tackle on health care, none is more challenging than how to pay for it. Where does that debate now stand?

LIASSON: Well, with that debate now is at the nitty-gritty detail stage. We're at the painful tradeoff part of this drama of health care. Up until now we've talked about the need to get health care costs down and to make the plan deficit neutral and it's easy to agree on those abstract principles. But now that these plans are being vetted by the most - single most important player in health care on Capitol Hill - and that is the Congressional Budget Office, the CBO, we are finding out that they are more expensive and cover less of the uninsured than the drafters of these plans had hoped.

So, you now are getting these CBO report cards. And at least on the bill in the Health and Education Committee that you heard Senator Dodd talk about, it came in with a $1 trillion price tag - very high. It still hasn't explained how it's going to pay for it. But that is why you saw Republicans on that committee today, like John McCain and Judd Gregg attacking the plan as a big-spending, unwieldy government-run mess.

Meanwhile, another important Senate committee, the Finance Committee, where you have Max Baucus and Chuck Grassley as the chairman and ranking Republican, they have had to go back to the drawing board because their plan, which does provide financing for health care, came in at $1.6 trillion. And they've postponed their markup. They might have to roll this plan out more slowly, maybe have smaller subsidies. These are very, very difficult issues, and we're really getting down to brass tacks on them.

NORRIS: Now, there are a lot of people in Washington who think they have the best prescription for reworking health care. Today, three former Senate majority leaders, two Republicans and a Democrat rolled out an alternative bill. What are these men proposing?

LIASSON: This is a pretty interesting exercise. Bob Dole and Howard Baker were both former Senate Republican leaders, Tom Daschle was a former Senate Democratic leader and almost the White House health czar. They have basically written a draft deal saying, if you want a bipartisan play in Congress, we have worked one out for you. And it includes pain for everyone - the Republicans would have to agree to a kind of pay or play provision for employers. In other words, employers would have to either cover people or pay into a fund -employers above a certain size.

The Democrats would have to swallow something they don't want in this plan, which is to tax employer-provided health benefits. And they've also provided a solution to the public option controversy, which is that instead of having the federal government providing a public alternative to private health insurance, it would be states that - the individual states that would provide this. So, they've come out with this plan, as Tom Daschle said today, if anybody said to you that health care was going to be painless, don't believe them. And they've rolled out a plan that does have a lot of pain in it, but it gets the job done.

NORRIS: Now, speaking of pain, these former leaders had some pretty tough words for their respective political parties. Tell me a little bit more about that.

LIASSON: They did. Bob Dole said don't be the party of no to Republicans, in essence, you know. Don't be the party that just votes against these things. People want health care. He also did say to Democrats, you know, have a bipartisan bill, don't try to ram this through with 51 votes, you'll want someone sharing the blame for this if there are unintended consequences. And Daschle also told Democrats that they're going to have to swallow some things that they don't want, like taxing health benefits.

NORRIS: Thank you, Mara.

LIASSON: Thank you, Michele.

NORRIS: That's Mara Liasson, NPR's senior political correspondent.

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