Health Insurance Services

Louisiana senators say they're skeptical of key elements of the health care plans moving through Congress and would prefer to see more focus on a market-based approach and on reducing health care costs.Reducing costs is particularly important in allowing American businesses to compete with foreign companies, Democratic Sen. Mary Landrieu said.

"We can't continue to shell out as much money on health care, then think we can compete in the global market," said Landrieu, chairwoman of the Small Business and Entrepreneurship Committee.

As the focus in the health care debate shifts to the Senate, Louisiana's lawmakers are sorting through several plans, particularly the latest proposal from Sen. Max Baucus, D-Mont., chairman of the Finance Committee. The committee will play a major role in the overhaul.

"My fundamental problem is this mega-bill approach, this huge, radical, complete redo of U.S. health care," said Republican Sen. David Vitter. "We need to take a more focused approach. We need to take a scalpel and not a sledgehammer."

Louisiana's House lawmakers say they will continue to press for health care reform, which has stalled.

"It's halftime in the process," said Rep. Charles Boustany, a doctor and GOP point man in the health care debate. "We need to continue to work to find a bipartisan consensus to drive down the cost of health care for families and small businesses. ... I'm not sure that the Senate proposal does that, and clearly the House bill does not."

The bills in the House and Senate contain many similar provisions. They would require most people to buy insurance, provide subsidies for people who can't afford insurance, ban lifetime caps on insurance coverage, and bar insurers from denying coverage based on pre-existing conditions.

But the proposals differ on cost, how they'd be paid for, whether they'd add to the deficit, and whether to create a government-run "public" health insurance option that would compete with private insurance plans.

The Baucus plan omits a public insurance option, calling instead for non-profit insurance co-ops. It would cost $856 billion over 10 years.

That cost would be covered through cuts in Medicare payments, a tax on high-cost insurance plans, penalties for people who refuse to purchase coverage and large companies that refuse to offer it to employees, and fees and taxes on insurance companies, the pharmaceutical industry and other health care providers.Another bill passed by a Senate committee includes a public health insurance option. Three House committees approved different versions of a health care bill that also would create a public insurance option.

Landrieu said she doesn't support a public option because she's "not sure it can be structured in a way that does not undermine the private sector."

Vitter, a member of the Small Business and Entrepreneurship Committee, has sharply criticized the proposal and said his constituents also oppose it.

"This is part of a trend ... government intervening in the private sector," Vitter said earlier.

Both Landrieu and Vitter support the provision in the Baucus plan that would ban insurance companies from denying coverage to those with pre-existing medical conditions.

Landrieu, who meets regularly with moderate Democrats on the issue, said she also supports insurance changes that would allow businesses to pool together to buy insurance more cheaply. She said she has reservations about proposals to require businesses to provide health care insurance.

"We should continue to have choices," Landrieu said.

Vitter said he favors proposals to limit medical malpractice awards and lower prescription drug costs, particularly by allowing cheaper drugs to be imported.

He said he worries that the co-ops included in the Baucus plan are a "government option in another form." And he's concerned about increasing taxes and cutting Medicare programs to pay for the bill.

"It doesn't appear to be a meaningful bipartisan bill," Vitter said.

In the House, plans to vote on a measure this summer were delayed in part because members of the Blue Dog Coalition of fiscally conservative Democrats complained about the high tab.The coalition, co-chaired by Charlie Melancon of Napoleonville, called the Baucus plan, which is budget-neutral, an important step forward.Melancon said he's still reviewing the bill, but it appears to be "more in line in what people like myself and the rest of the Blue Dogs feel should be out there in terms of affordable, transportable programs for insuring people."

Melancon said his constituents don't support a public option, but he said Blue Dogs will talk about "anything that is put on the table and want to know what it's going to cost and what its effects are going to be."

Boustany, who gave the Republican response to President Barack Obama's health care speech to Congress on Sept. 9, called the Baucus plan a "good-faith effort" to start a bipartisan discussion on health care reform. He noted that the proposal to ban insurers from denying coverage based on pre-existing conditions has garnered support from both sides.

But Boustany said there are still major concerns, including how co-ops would work.

"Looks like it's just another way of setting up an additional federal bureaucracy," he said.