May 28, 2018
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Health Bill Questions

As Senate Democratic leaders struggle to muster the necessary 60 votes to bring their health care reform bill to the floor, three members of Maine’s congressional delegation raised critical questions that could bear on details of the bill and on an eventual final vote. They should not, however, stand in the way of overdue reform.

Both Sens. Susan Collins and Olympia Snowe have said they would not vote for the bill as it now stands. They were among the few Republicans who once seemed possibilities to break ranks and vote for it. Among their objections is their opposition to a “public option” or government-run insurance company.

Democratic Rep. Mike Michaud said Monday that he remained concerned about cuts in Medicare and Medicaid but voted to move the process forward: “The work is too important to fail, and I could not in good conscience let the perfect be the enemy of the possible.” That is the difficult balance lawmakers must find — what is possible, if the perfect is unattainable.

The bill approved in the House over the weekend “moves us much closer to a time when no one can be denied health care coverage because of a pre-existing condition, no one can be told you can’t have health care coverage, no one will have to go into personal bankruptcy,” said Rep. Chellie Pingree.

Sen. Collins said she could not support the Senate bill because it would increase insurance costs for many middle-income families and small businesses.

“We should rewrite the whole bill,” she said. “There is considerable unease on both sides of the aisle about the impact of this bill, and as more analysis is done, I believe those concerns will grow.”

She objected that the bill included “billions of dollars in new taxes and fees that will drive up the cost of health insurance premiums,” many of which would take effect before the government started providing insurance subsides to low- and middle-income people.

Some members of both parties complain that neither bill does much to curb the steady 15 percent-a-year rise in total American health cost.

While Maine’s delegation, like many other lawmakers, have been carefully appraising details and changes in the health care reform legislation, the details may not prove decisive from a political point of view. Both Democrats and Republicans know that many Americans want major improvement in the health care system, while others oppose any change, and that either outcome could affect lawmakers’ chances of re-election.

And leaders of both parties know that a failure to deliver could damage President Barack Obama’s prospects for a second term. Republican leaders seem determined to block any Democratic bill regardless of the details.

The Democratic leaders could use a legislative device called budgetary reconciliation, which would require only 51 votes for passage in the Senate instead of the 60 votes needed to overcome a filibuster. Republicans used the same device to push through the Bush tax cuts.

That would end any chance of bipartisanship, but it is a better option than allowing the reform work to languish.

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