U.S. Sens. Chuck Grassley (R-Iowa) and Max Baucus (D-Montana) will be good stewards of the power they hold over health care reform if they recognize the benefits that have been afforded to them during their more than three decades in public service, according to U.S. Sen. Tom Harkin (D-Iowa).

Sen. Tom Harkin
“I think if [Grassley and Baucus] would recognize the benefits that we have had as government employees from this type of a program for so many years, and the benefits we get because we have a huge pool — I mean, let’s keep this in mind, the program that I’m under is the same thing that a postal worker in Iowa, or a social worker in Iowa, or someone working for the Farm Services Agency or any federal worker [uses]. So, it’s a big pool, which means that we get pretty darn good rates because we have so many people in it,” Harkin said. “I hope they keep that in mind when they think about having this proliferation of all these insurance companies. The smaller the pool, the more expensive it is going to be just by the very nature of insurance.”
Each year federal employees are allowed to purchase insurance from a pick-and-choose system that is very similar to an exchange program that was mapped out in the health care reform bill written and approved by the Senate Health, Education, Labor and Pensions Committee on which Harkin serves. As a result, the health insurance he now holds is quite different, he said, from the insurance he chose when he had young children at home.
“I also hope they keep in mind choice,” Harkin said Thursday morning during a conference call with Iowa reporters. “We have a lot of choice on who we get and what we do. We can change it every year.
“I don’t think [Grassley and Baucus] are insensitive about what is happening out there, and they both are pretty responsive to constituents too.”
In fact, because both Grassley and Baucus hail from states impacted by inequitable Medicare and Medicaid reimbursement rates, there is an optimism that a plan from their committee would include reforms to federal formulas that have historically provided higher payments to states by virtue of quantity of medical services in lieu of the quality of such services.
“I’ve not seen any direct movement on that in the Senate, because we’ve not seen a bill yet from the finance committee,” Harkin said, indicating that he has had conversations with both leaders of the finance committee on the subject. “I hope that with Mr. Grassley and Mr. Baucus representing two rural states — and especially with Sen. Grassley — Iowa, as you know, is always at the top in terms of the quality of our health care, we are the bottom in reimbursement. We’ve tried many times in the past to get that changed, but unsuccessfully. Now is our chance.”
Harkin may be optimistic, but it is also clear he is also frustrated with Baucus concerning health care reform.
“Every two years the caucus could have a secret ballot on whether a chairman should continue, yes or no,” Harkin told Alexander Bolton of The Hill. “if the no’s win, [the chairman's] out.”