Congress has reached the fourth step of the health care reform legislative process, which CBSNews.com has been tracking for you with our Health Care Progress Report, shown below. But Democrats are skipping the formal process (known as the conference committee) of merging the House and Senate bills in favor of working out the differences behind closed doors.
President Obama will meet with union leaders today to discuss their concerns with one of the Senate health care bill's primary funding mechanisms -- a tax on high-end insurance policies. Labor unions have blasted the provision, arguing it would compel insurers to either pass on the cost of the tax to consumers, or to cut benefits in order to avoid the tax.
The unions are rallying their members to call their representatives this week to express their opposition to the excise tax as well as other Senate provisions. However, they're also acknowledging the provision is likely to remain in the final bill:
"When you have a president who says he wants to incorporate it and a Senate that says it wants to incorporate it and some in the House who say they want to incorporate it," Andy Stern, president of the Service Employees International Union, told The Hill newspaper, "it's hard to look that in the face and say we can just win this outright."
Along with the unions, House Democrats have also expressed concern about the excise tax. Mr. Obama reportedly said last week that he supports the policy, even though he promised as a presidential candidate to avoid taxing the middle class or imposing taxes on health benefits.
The president has also been in hot water with some this year for breaking his promise of keeping the health care debate transparent -- even Sen. Claire McCaskill (D-Mo.), one of the president's most vocal supporters, is saying Democrats should broadcast health care discussions.
Now, opponents of the excise tax are raising even more transparency complaints with the administration. The liberal blog network Daily Kos reported last week that MIT economist Jonathan Gruber, one of the leading proponents of the excise tax, had a contract worth more than $300,000 with the Health and Human Services Department to evaluate the president's health care reform plans. Gruber failed on numerous occasions to disclose the contract, and the White House has referred to Gruber as an "objective" health care analyst.
The failure to disclose this relationship prompted the New York Times on Saturday to issue a correction for an op-ed it published from Gruber on the subject of taxing health benefits. The Times wrote, "Had editors been aware of Professor Gruber's government ties, the Op-Ed page would have insisted on disclosure or not published his article."
Meanwhile, Democrats continue to negotiate over other provisions that could change the cost of the health care bill by billions of dollars, such as Sen. Ben Nelson's deal to cover the cost of Medicaid expansion in Nebraska with federal funds. In the wake of complaints from everyone from Calif. Gov. Arnold Schwarzenegger to Sen. Blanche Lincoln (D-Ark.), Nelson says he is trying to extend the deal to all 50 states, in spite of the enormous cost it would place on the federal government.