Kitsap Congressmen Unsure Health Care Reform Can Reach the Finish Line

By:  Steven Gardner
Source: The Kitsap Sun

Kitsap Sun; Steven Gardner

It took 60 votes to get the Senate to open debate on health care bills this weekend, and it'll take 60 more later on to close debate before the chamber can vote on a final bill.

So, will the Senate's Democratic leaders be able to round up 60 votes twice in the coming weeks?

U.S. Rep. Jay Inslee, D-Bainbridge Island, said he's optimistic they will. But, he added, "I wouldn't bet the farm on it."

U.S. Rep. Norm Dicks, D-Belfair, has a less-sunny opinion of the Senate's likelihood of generating a filibuster-proof majority twice. "It will be a miracle," he said.

Washington's two Democratic senators, Maria Cantwell and Patty Murray, voted in favor of opening debate on the Senate health care bill, their representatives said.

Inslee said the Senate bill is structurally similar to one passed by the House, but takes different approaches on some issues.

Critical to Inslee and Dicks are provisions that would address what they call inequities in how Washington is treated in terms of Medicare reimbursement.

"We're at a disadvantage for doing the right thing," said John Diamond, a Cantwell spokesman. That "right thing" is Washington medical providers delivering more efficient service, but getting paid less by Medicare.

Inslee and Dicks worked in the House to insert language that would remove some of the Medicare payment disparities and establish rules that reward quality of care rather than the traditional model paying for every service provided.

A Cantwell provision in the Senate would establish what she calls a "value-based index," rewarding providers for efficient, quality care.

Another Cantwell measure would let states put their uninsured into one pool to negotiate insurance rates, similar to what Washington offers with its Basic Health Plan.

There are also minor differences in how the two bills handle abortion, illegal aliens, the public option and ways to shrink what's known as the "Medicare Doughnut Hole" for prescription coverage.

Alex Glass, Murray spokeswoman, said the Senate bill could still change a lot before a final version is approved by the chamber.

Glass said Murray's office has received a lot of feedback on health-care reform from Washington residents. "But the majority of people who have written her are people who already have insurance," Glass said.

Diamond said the debate about health insurance has been less about people who are uninsured and become more about people who are in danger of losing insurance because it has become so expensive. "Really the out-of-control cost issue has eclipsed the uninsured issue," he said.

If the Senate votes this weekend to open debate on its health care bill, the give and take would begin Nov. 30.

No one would predict whether it will get the votes it needs to close debate.

Inslee acknowledged people have been frustrated with how long it has taken, but suggested that is appropriate for legislation this monumental. "This is heavy lifting."

Inslee also said he's glad the tenor of the conversation has become more rational.

"There's still wide disagreement in the country about this bill, but people have a better grasp of what is and what is not in it," he said.