The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Baucus Introduces America’s Healthy Future Act of 2009

Posted by Alan on September 16, 2009

Senate Finance Committee Chair Max Baucus has unveiled his health care reform proposal, the “America’s Healthy Future Act of 2009” in the form of a “Chairman’s Mark.”  This means instead of publishing legislative language, the plan is presented in a “here’s the current law and here’s how we should it” format. While specific legislative language would be nice, there’s enough detail in the 223 page document to get a good understanding of what Senator Baucus proposes. And we won’t have long to wait for the legislative language: the Committee will begin debating the bill on September 22, 2009.

No Republican members of the Senate Finance Committee have signed onto the plan, but I don’t think the lack of GOP support at this point dooms the Baucus proposal. As noted in my previous post, at least one of the three Republicans who has been negotiating with Senator Baucus towards a bi-partisan bill, Senator Olympia Snowe, has indicated she’s waiting to see how the bill is amended in committee before committing her vote. Further, the audience Senator Baucus is directing his health care reform plan to are moderate Democrats.

By directing his plan at moderates, Senator Baucus, not surprisingly, infuriates liberal Democrats. Senator Jay Rockefeller has already announced his opposition to the Chairman’s Mark and claims four-to-six other Democrats on the Finance Committee share his views. There are 23 members of the Senate Finance Committee: 13 Democrats and 10 Republicans. So Senator Baucus can afford to lose only one Democrat and still move his proposal out of the committee in the face of unanimous GOP opposition.

My expectation, however, is that neither President Barack Obama nor Senate Majority Leader Harry Reid will let liberals bottle-up the bill in the Finance Committee. If needed, they’ll arrange for some progressive Democrats to speak against the bill, while voting to move it out of committee in order to “let the process proceed.” Of course, if Senator Snowe or any of the other Republicans on the committee vote for the amended bill, fewer Democrats will be needed.

A quick review of the Chairman’s Mark indicates there have been no substantive changes from what was expected. There’s no government-run health plan, it requires individuals to purchase coverage, it establishes state health insurance exchanges. What has been firmed up is it’s price tag: $856 billion over 10 years.

I hope to post more detailed analysis of the America’s Healthy Future Act of 2009 over the next few days, but in the meantime, below are a few articles that summarize the proposal. Senator Baucus describes his proposal in an opinion piece published in the Wall Street Journal today. In reading these keep in mind that what Senator Baucus introduced today is only the beginning. On September 22nd the Senate Finance Committee will convene to debate and amend the bill. The mark-up, as it’s called, will be civil but robust. What emerges from the committee will be different than the Chairman’s Mark.

And that’s just the beginning. The Senate will need to reconcile the Senate Finance Committee’s bill with the legislation put forward by the Senate Health, Education, Labor and Pensions Committee. The result of that mash-up will then need to be reconciled with whatever health care reform legislation the House approves by a conference committee made up Senators and House members. Then both chambers must approve the resulting compromise legislation.

In other words, there’s a long journey ahead for health care reform. There will be plenty of noise and controversy along the way. The path to reform will be subjected to a multitude of twists and turns. We won’t know how it turns out for another two-to-three months. But with the introduction of the America’s Healthy Future Act of 2009, the health care reform debate takes a big step forward.


Here’s some articles describing Senator Baucus’ health care reform proposal:

Baucus Unveils $856 Billion Health-Care Legislation” from the Wall Street Journal.

Baucus unveils health care bill” from the Boston Globe.

Baucus Offers Health Plan With No Republican Backing” from

“Baucus Introduces $856 Billion Health Care Bill” from the Washington Post.

Baucus Puts Bill In Play” from National Underwriter (my thanks to Dwight Mazonne for identifying this article)


5 Responses to “Baucus Introduces America’s Healthy Future Act of 2009”

  1. Allenhip said

    The One of the biggest problem for all Democrats is the following facts.

    The Four options.
    Bronze 65%/35%
    Silver 70%/30%
    Gold 80%/20%
    Platinum 90%/10%

    No Labor Union in their right minds would support this bill because we all know if you lower the standards and create a sub-standard health care plans, management will find excuses to push all their employees into the lowest and cheapest possible option available.

    This is why I consider this bill as an anti labor and Obama supports this bill something is very wrong?

    We are now calling this bill the BUBKIS bill. Look the word up!

    There some good things in the outline bill – BUT there are more BAD news like (every state will have a different benefit) Medicare now is an 80%/20% and is a single payer system.


    Major changes will be required before it leaves the committee or lose AFL/CIO support. If it had a Strong Public Option more democrats would come on board. Democrats should fear rank and file disapproval if they vote for the (NEW BUBKIS BILL) and that is what we are now calling this bill.

    As we continue to review this bill the more we will find and this will be the downfall for Obama trying to push this bill before its time.

    The public needs more time to review the bill, but I can say this: “You know the old saying be careful what you wish for…”

    When the Tea Bag group finds out just how bad this bill is in regard to see their current doctor and have to pay $50 to $100 dollars for an office visit they may have wished for the Public Option. There are only two basic ways to lower health care premiums.

    1. Lower the benefit level to pay less in premiums and more co-pays and deductibles. (Which is what this new bill does)

    2. Require all Insurance companies to be Not-for-Profit. (Not on the table)

    We could lower cost by using new technologies. But the best way is to find cures for the most debilitating diseases that require major resources.

  2. Underwriterguy said

    Alan, any thoughts on what this, or any of the other proposed legislation, does to high deductible plans? Will plans mandated by legislation force rich benefits on consumers who don’t want/can’t afford them?

  3. Alan, with respect to “Insurance Exchanges” do you envision them as:

    1. Alternative modes for purchasing that will compete with private insurance brokers like us?

    2. Eliminate private brokers?

    3. Don’t know?

    • Alan said

      With the caveat that everything is subject to change my guess is the Exchanges will compete with brokers while also opening a new distribution channel. I’ll be posting on this soon, but in summary there’s good news and bad news.

      The good news is that Senator Baucus’ proposal gives state insurance commissioners authority to “establish rate schedules for broker commissions in the state exchanges.” This means brokers will be able to sell plans within an exchange unless the state insurance commissioner makes it uneconomical to do so.

      The bad news is that the Baucus proposal also allows consumers to enroll in health plans offered through the exchange in “local hospitals, schools, Departments of Motor Vehicles, local Social Security offices, and any other offices designated by the state.” This means there’ll be lot of doors to this particular destination.

      Overall, I’m confident brokers can compete effectively with the DMV. I’m less confident insurance commissioners will set competitive commission rates, but that’s a battle for another day and another venue.

      Hope this helps.

  4. Relations said

    We need to act and contact our senators to fight for our rights on health care. Don’t lose hope, even if the government is shaving more and more of our health care funds. We need to fight back.

Sorry, the comment form is closed at this time.

%d bloggers like this: