Insurance companies, unions, medical device makers and others in the health care industry are furiously lobbying lawmakers to shift burdens onto someone else _ anyone else _ before they find themselves saddled with billions of dollars in taxes under new health care legislation.
Their gain would be another industry's loss, of course, unless the entire overhaul effort collapses and Congress fails to agree on how to pay to provide health coverage for millions of uninsured Americans.
The lobbying and jockeying worry some lawmakers, who say the proposed $829 billion, 10-year Senate plan that advanced Tuesday is a delicate balance of opposing forces. The Senate Finance Committee endorsed it, 14-9, making it the first health care bill to draw a Republican vote in either house.
But new barriers lie ahead. About 30 unions said they will run full-page newspaper ads in Wednesday's editions opposing the measure because it would tax generous employer-provided health plans. On Sunday, the insurance industry released a report saying the bill would raise insurance costs for people who already have policies. And the industry this week began a TV ad campaign in six states accusing Democrats of seeking to cut $100 billion from subsidies for Medicare Advantage, under which private insurance companies provide Medicare benefits.
The bill will be blended with a rival Senate version, and then face many amendment attempts by liberal, moderate and conservative senators. A final Senate bill will have to be reconciled with a House health bill that is likely to differ in many ways.
President Barack Obama will play a huge role in the process this fall. He has vowed not to sign a bill that will add to the long-term deficit.
That means lawmakers must hold the plan's 10-year cost to about $900 billion, while finding enough savings and revenue sources to cover that amount. Key industries are scrambling to avoid being a target.
"They need to raise $900 billion, and no one wants to fork over the money," said Michael F. Jacobson, executive director of the Center for Science in the Public Interest, which wants Congress to raise money by taxing sugary soft drinks. The soft drink industry responded with a TV and newspaper ad campaign opposing the idea.
The prevailing attitude everywhere, Jacobson said, is "don't tax us, tax them."
Indeed, when 14 Democratic senators recently wrote to party leaders, they said the health proposals must be fully paid for. However, they wrote, they are "extremely concerned" about a proposed $39 billion, 10-year tax on medical devices in the Senate Finance bill.
The tax "could threaten jobs in our states," the senators said, and reduce access "to lifesaving medical devices for patients." (continues here at CBS News)