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Senate negotiators race deadline to craft health care deal

September 14, 2009

WASHINGTON (AP) -- Senate health care negotiators said Monday they've cut the cost of their 10-year coverage plan to under $880 billion, but they're not ready to shake hands yet on a bipartisan deal.

Finance Committee Chairman Max Baucus, D-Mont., said he'll have a formal proposal by midweek -- maybe as early as Tuesday -- to meet a deadline for moving ahead on President Barack Obama's top domestic priority with or without Republican support.

At the same time, Baucus said the bipartisan talks could continue even as his Finance panel begins its formal bill-drafting session next week. Talks continued during the day Monday, and more meetings were expected Tuesday.

"It's not just tomorrow or the next day," said Baucus. "We're going to keep working."

His small group of three Democrats and three Republicans has been laboring for weeks in hopes of finding a bipartisan path toward guaranteeing coverage for all and trying to control the rise in health care spending. Staff aides on both sides said Monday the negotiators are close, but it's unclear if they'll get agreement.

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The three Republicans -- Mike Enzi of Wyoming, Chuck Grassley of Iowa, and Olympia Snowe of Maine -- are under intense pressure from leaders of their own party, some of whom have publicly dismissed Baucus' framework as a Democrat's plan. Baucus may not be able to get any of the them to agree. But he seems to have a chance of persuading at least Snowe.

Monday, the negotiators said they discussed illegal immigration, benefits for the poor, medical malpractice and restrictions on abortion coverage.

Sen. Kent Conrad, D-N.D., said they're close on a verification system to prevent illegal immigrants from getting government subsidies to buy health coverage.

"We're very close to conclusion on how to prevent people who are here illegally from benefiting," Conrad said.

Negotiators also said they've found ways to reduce the cost of a planned expansion of Medicaid to cover more people near the federal poverty line. The issue is critical to winning support from governors, since the states share in the cost of the program. Baucus said his staff is trying to schedule a conference call with governors for Tuesday.

On medical malpractice, Conrad said the negotiators agreed that the federal government should provide funding for states to experiment with a range of alternatives to lawsuits.

On abortion, the negotiators are trying to come up with language that would extend current restrictions that prohibit federal funding for the procedure, except in cases of rape, incest, or to save the life of the mother.

Baucus' plan would require all Americans to get health insurance, either through an employer, a government program, or on their own. New consumer protections would prohibit onerous insurance companies practices, such as denying coverage because of a prior health problem, or charging more to those who are sick.

The majority of people already covered through an employer plan would not see major changes. But self-employed people and small businesses would now be able to buy more affordable coverage through a new purchasing pool called an exchange. Government tax credits would be provided.

The plan would be financed mainly through cuts in Medicare and Medicaid, but Baucus has also proposed a new tax on high-cost insurance companies, an assessment on employers whose workers end up getting government subsidies, and a series of multibillion-dollar "fees" on medical industries.

Even if Baucus can't get Republican support, the plan already reflects some major GOP priorities. For example, Baucus opted not to include a government insurance plan to compete with private carriers.

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