Health Care: Public Plan, 'Pay or Play' Provision May Go

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As for taxing health benefits—an option to pay the costs of expanding health coverage—the Senate committee wants to tax only the most expensive health plans, but levy the fee on the employer rather than the employee.

Whether any of this will make it into the final Senate Finance version—or helps form the basis of a grand compromise that brings on board the "Blue Dog" conservative Democrats who currently are blocking passage of a bill in the House—remains to be seen. After a July 29 Washington Post story made it appear as though a bipartisan bill from the Senate committee is imminent, Russ Sullivan, staff director for the finance committee, sent out an e-mail to staffers that said, as reported in the online news site Politico.com, "While progress has been made in recent days, neither an accord nor an announcement is imminent. In fact, significant policy issues remain to be discussed among the Members, and any one of these issues could preclude bipartisan agreement. Members will continue their methodical work."

Senator Mike Enzi (R-Wyo.), a member of the Finance Committee, sought to cool expectations for an imminent deal. "We still have several areas where we haven't been able to come to a consensus. No deal is at hand, and substantive issues, big and small, remain under discussion and need to be resolved," Enzi said in a prepared statement. He said he wanted to see an estimate from the Congressional Budget Office "before I can agree to any health-care reform bill," and added: "I also need commitments from Senator [Harry] Reid (D-Nev.) and Speaker [Nancy] Pelosi (D-Calif.), as well as the Administration, that the bipartisan agreements reached in the Finance Committee will survive in a final bill that goes to the President."

President's Must-Haves

Meanwhile, Obama is working hard to shore up public support for reform, which has been wavering as more details on both the proposals and the $1 trillion price tag become available. Today he attended a town hall meeting at Broughton High School in Raleigh, N.C., and is flying to a Kroger (KR) supermarket in Bristol, Va., where he'll take questions from store employees on the need for health-care reform.

The White House said Obama will unveil eight specific consumer protections he insists will be in any health-care bill:

1) Insurers will not be allowed to refuse coverage because of preexisting conditions.

2) There will be yearly caps on how much can be charged for out-of-pocket expenses.

3) All preventive care, including regular checkups and screening tests, will be fully covered.

4) Insurers will not be allowed to drop or reduce coverage for those who become seriously ill.

5) No gender discrimination—men and women will pay the same premiums.

6) No annual or lifetime caps on the coverage received.

7) Children will be eligible for family coverage through the age of 26.

8) Insurers will be required to renew any policy as long as premiums are paid in full.

Arnst is a senior writer for BusinessWeek based in New York.

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