The Senate is heading toward Christmas Eve passage of a massive health care bill, but Democratic leaders signaled it will still see changes when it is merged with a House version in January, perhaps affecting how people would be taxed under the plan.
Sen. Tom Harkin, D-Iowa, an architect of the Senate bill, said he does not anticipate the House will simply sign off on the Senate health care plan, projected to cost $871 billion in its first 10 years.
"It will be a meaningful conference," Harkin said, describing the traditional House-Senate meetings in which legislation is combined.
In the pre-dawn hours Monday, the Senate passed a bill that would expand Medicaid, the health care program for poor Americans, and would have the federal government offer access to group rates on private insurance policies to Americans who don't have insurance through their jobs. The bill would also require that Americans buy private insurance and force many employers to provide coverage.
The bill is far different from a version passed last month in the House, which costs more than $1 trillion for the first decade and calls for the creation of a government-run insurance plan.
Harkin said the Senate could compromise on the method of raising taxes. The House bill includes a 5.4 percent surtax on individuals earning more than $500,000 and couples whose incomes exceed $1 million. In the Senate version, expensive insurance plans are taxed at 40 percent.
"There is some room for negotiation in that area as we go into conference," Harkin said.
Specifically, Harkin said there may be changes to the Senate plan to tax so-called "Cadillac plans" worth more than $8,500 for individuals and $23,000 for families. The tax is particularly unpopular with unions because many of their members would be hit with the tax and many House members want to get rid of it.
Many House liberals are opposed to language added Saturday imposing tighter restrictions on the funding of abortion and most of the 80-plus members of the House Progressive Caucus want the final bill to include a government-run plan.
"They are making it impossible for me to see any kind of middle ground that would work for the American people," Progressive Caucus co-chairwoman Lynn Woolsey, D-Calif., told The Examiner.
Former Congressional Budget Office Director Douglas Holtz-Eakin suggested the two sides may not be able to come to agreement without strong-arming from the White House, which will also have to use its influence to secure congressional approval for additional troops in Afghanistan, which liberals also oppose.
"Where are they going to spend their political capital," Holtz-Eagen said. "That is the question the White House is going to have to answer."