Sen. Max Baucus, chairman of the Senate Finance Committee, moved forward with a health reform bill today (Wednesday) that omits the public option present in all other Congressional bills and calls instead for health cooperatives.

Max Baucus

Baucus, a Democrat from Montana, unveiled his 10-year, $856 billion America’s Health Future Act without the support of Republicans. The full committee is slated to debate the bill starting Sept. 22.

The senator told CNN before releasing his plan that the legislation is “a very, very big bill” and “very, very similar” to a framework President Barack Obama laid out last week before a joint session of Congress.

Baucus added that he “expects very significant support when we do pass this bill,” but getting to that point may be difficult as Republicans and even fellow Democrats on the committee are expressing concern with the final product.

The proposed bill calls for an individual mandate for insurance and prevents insurers from discriminating against people based on health status, denying coverage due to pre-existing conditions or imposing annual caps or lifetime limits on coverage.

Rather than include a government-run health insurance program to compete with private insurers, a measure supported by President Obama and numerous Democrats, Baucus’ bill instead calls for the formation of “consumer owned and oriented plans,” or “co-ops,” as member-run mechanisms as an alternative to private insurance companies. About $6 billion of federal seed money would be provided in start-up costs for the plans to operate at the state, regional or national level. The bill permits them to be set up for any of those three levels.

Rockefeller: No public option, no support

Sen. John “Jay” Rockefeller (D-W.Va.) said he would not vote in favor of a health care proposal from the Senate Finance Committee without a public option.

“There is no way I will vote for it unless it changes during the amendment process in vast amounts,” Rockefeller told reporters during an afternoon conference call the day before Baucus’ bill was released (Sept. 15), according to published reports.

The committee’s co-chairman, Sen. Charles Grassley (R-Iowa), said Sept. 15 that while he applauds Baucus’ work toward bipartisan legislation, “an artificial deadline” set by the Democratic leadership and the White House is harming reform efforts.

“I’m disappointed because it looks like we’re being pushed aside by the Democratic leadership so the Senate can move forward on a bill that, up to this point, does not meet the shared goals for affordable, accessible health coverage that we set forth when this process began,” Grassley said in a statement. “In addition to concerns about costs to taxpayers and affordability for individuals, there are still some serious outstanding issues that have yet to be resolved like preventing taxpayer funding of abortion services and the enforcement against subsidies for illegal aliens. I have also pressed for alternatives to the individual mandate and ways to lower the overall cost of the bill, as well as tougher medical liability reform measures.”

Plan details

While Baucus’ bill shuns a public option, it does establish health insurance exchanges where individuals and small businesses can access state-based web portals for direct consumer purchasing of plans.

Other measures to provide affordable coverage under the bill include creating a health care affordability tax credit to help low- and middle- income families to purchase plans in the private market, as well as tax credits for small businesses.

Baucus’ plan also standardizes Medicaid coverage for everyone whose household income is under 133% of the federal poverty level ($30,000 for a family of four; $14,400 for an individual), starting in 2014. It also takes steps to aggressively fight fraud, waste and abuse in the Medicare system, a move many expect to save millions of dollars and be a key factor for the nation to afford comprehensive reform.

In a statement, Baucus said for too many Americans, “affordable health care is simply out of reach.”

“The Finance Committee has carefully worked through the details of health care reform to ensure this package works for patients, for health care providers and for our economy,” he said. “We worked to build a balanced, common-sense package that ensures quality, affordable coverage and doesn’t add a dime to the deficit. Now we can finally pass legislation that will rein in health care costs and deliver quality, affordable care to the American people.”