Alexander, Cooper warn of health-care plan costs

By Bonna Johnson, The Tennessean and Bill Theobald, Gannett

A head-spinning array of health reform proposals have barely made their way to Congressional committees, but already two lawmakers from Tennessee playing key roles in the debate are sounding their warnings, and likely offering a taste of the bigger partisan fight that's to come.

In an interview with The Tennessean on Thursday, U.S. Sen. Lamar Alexander warned that a Democratic plan being considered in the Health, Education, Labor & Pension committee, on which he sits, would require a state like Tennessee to cough up a 10 percent income tax by 2015 to pay for it.

"That's the threat of this bill," Alexander said before going into Senate committee meetings on the Ted Kennedy-sponsored health-care proposal. "The Kennedy bill is so expensive and flawed, it cannot be fixed, and we ought to start over."

By raising the specter of a state income tax, which residents and state political leaders have vehemently argued against in the past, Alexander hopes to get Tennesseans to pay attention to the details of the health-care debate.

"I don't think anyone in the state realizes this is happening," said Alexander, who conceded that nobody in the state has proposed an income tax to pay for health-care reform, but he still considers it a legitimate point.

By 2015, the state would have to come up with an additional $1.2 billion a year for TennCare, Tennessee's Medicaid program, to extend coverage to more uninsured people and to increase physician reimbursements, two key provisions in the Kennedy bill, Alexander said. The federal government would pay the state's share in the first few years but then hand the bill over in 2015, Alexander said.

"I want to warn all the candidates for governor about the unpleasant picture they would face," said Alexander, who is co-sponsoring the Wyden-Bennett Health Bill, a competing proposal.

It would cost the state some $572 million a year to expand coverage to people with household income of 150 percent of the poverty level and $600 million more a year to raise physician reimbursement rates to 110 percent of Medicare, as the bill calls for, Alexander said.

TennCare officials in Tennessee said they provided Alexander's office with cost estimates at his request. But a TennCare spokeswoman said, "It's too early to make any strong estimates because the bill is not in its final form, and there is much discussion going on at the national level."

"The state is in no way weighing in on the income tax debate," she said. "We just provided the information the senator requested."

Rule misunderstood

Separately in Washington on Thursday, Rep. Jim Cooper said that bipartisanship is vital to reforming health care, literally, in this case.

The Nashville Democrat said an arcane budget rule in Congress would require a "super-majority" in the Senate for a major health-care bill to pass, otherwise no real reform of the medical and insurance systems in the country can take place.

Generally, controversial issues in the Senate require 60 votes for passage instead of a simple majority of 51 to stop filibusters. But under a process called reconciliation, legislation in the Senate can bypass the 60-vote requirement.

Cooper said Thursday that many people, including those knowledgeable of Congress, are misinterpreting the way reconciliation would apply to health-care reform legislation. He said it cannot be used for any bill that involves major overhauls of the insurance of medical sectors, and using this method would require the bill to reduce the deficit by $1 billion over five years. Just finding enough money to cover the cost of health-care reform is among the most vexing issues facing legislators, let alone cutting the deficit in the process.

"Health-care reform under reconciliation wouldn't be health-care reform at all. It would be a deficit reduction bill relating to health care," Cooper said. Cooper made his remarks at a news conference in which he was joined by Democratic Rep. Parker Griffith of Alabama, and Republican Reps. Mike Castle of Delaware and Jo Ann Emerson of Missouri.

Cooper said he was not attempting to slow down health-care reform legislation, as some interest groups have accused moderate Democrats of doing.

"We are here because we see health-care reform bogging down in the Senate, and we're worried about the chance of achieving health-care reform this year," Cooper said.