Sens: Time has come for decisions on healthcare

The leaders of an effort to assemble bipartisan healthcare reform in the Senate emerged from a lengthy meeting Wednesday with a message: The clock is ticking.

“We’ve got a lot of work ahead of us,” Baucus said. “Soon we have a mark up, soon we have a bill, and that realization is forcing us to make decisions.”

{mosads}Senate Finance Committee Chairman Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa) addressed the press after the panel met behind closed doors Wednesday to debate different ways of raising tax revenue or cutting healthcare spending to finance a healthcare reform bill that could top out at more than $1 trillion.

Baucus and Grassley both described the meeting as productive but not conclusive.

“Nothing’s pushed off the table. We’re looking at it all,” Baucus said.

“There weren’t any decisions made today,” Grassley said.

Baucus indicated that the he senses “convergence” on issues such as universal coverage, blending private and public insurance, creating a health insurance exchange for shoppers and making reforms to the healthcare delivery system.

This was the third and final committee meeting to “walk through” elements of healthcare, following previous gatherings on the delivery system and on coverage.

The Finance Committee, along with the Health, Education, Labor and Pensions Committee and their House counterparts, plan to mark up healthcare reform legislation next month, get it to the Senate and House floors in July, and have a finished product ready for President Obama’s signature by the end of the year.

“Senators will be asking more questions over the next two or three weeks to start taking some positions here. We all know that. The world’s runs by deadlines and that deadline is [approaching] very quickly,” Baucus said.

“We’ll have – boy! — a lot more meetings,” he said.

While keeping to that timeline, lawmakers must not only decide how to recreate the healthcare system to cover everyone while improving quality and driving down spending, they must also figure out how to pay for it.

“This is going to require investments,” Baucus said. “And like any private business, we develop a good business plan, upfront investment, which will yield dividends.” Unlike a business, however, governments raise capital by levying taxes on their citizens.

“Nobody likes raising revenues,” Baucus said.

The panel is weighing a laundry list of possible tax reforms and increases that would provide revenue for the bill. “Lifestyle” taxes on products such as sugary soft drinks and alcohol have garnered a lot of media attention but the committee’s real target is much bigger: Limiting the current tax-free treatment of workplace health benefits.

“That was discussed quite a bit. It was not, in any respect, dismissed summarily,” Baucus said.

Targeting the revenue that could be raised by taxing healthcare expenses is appealing to many lawmakers in both parties, in large part because Congress estimates the “lost” revenue in this area at $194.2 billion a year.

Baucus has previously indicated that he does not favor eliminating the exclusion but rather capping it based on income, the cost of health insurance premiums or some combination of both.

In addition to new tax measures, the Finance Committee also discussed reducing Medicare spending on home healthcare, durable medical equipment, medical imaging and prescription drugs, as well as finding ways to address why healthcare spending varies widely from region to region with no correlation to the quality of the medical care.