House, Senate leave Washington without passing health care reform legislation.

While the House and Senate made steady progress on the health care reform front, they failed to meet the President's goal of passing health care legislation in their respective chambers by the end of July.

In the House, the delay was created by moderate and conservative Democrats who, as part of an agreement to support the legislation being considered by the House Energy and Commerce Committee, required that the House leadership delay its vote on health care reform until September. In the Senate the delay was created by the Finance Committee, which continues to work on a bipartisan bill and where an agreement between Democrats and Republicans appears to be just out of reach.

The House slowdown began several weeks ago when moderate and conservative Democrats, commonly referred to as "blue dogs," began to express concerns about the House Democratic bill, which they said was too costly and would place huge financial burdens on small businesses.

Ultimately, the Blue Dogs signed on to a bill that would cut an additional $100 billion from the bill so that the total cost of the bill would be under $1 trillion over 10 years; eliminate a proposed mandate on small employers with payrolls of less than $500,000 per year to provide health care benefits for their employees or face steep frees; and establish a more "competitive" public plan option that would require the government to negotiate provider payments like any insurance company.

In addition, it was agreed that the public plan would not be the default insurer for individuals and families without insurance, unless those individuals and families chose the public plan. An attempt to reduce subsidies for low-income people to help them buy health care insurance was scuttled when liberal members of the Democratic caucus raised objections.

The Senate Finance Committee, which has been working very hard to develop a bipartisan health care reform bill, submitted a draft bill to the Congressional Budget Office (CBO), the non-partisan arm of the Congress charged with evaluating the fiscal impact of legislation, to determine the bill's projected costs.

The CBO's preliminary estimate was that the bill as currently written would cost under $900 billion, and that it would ultimately be deficit neutral, meaning that the cost of the proposal would not contribute to the federal government's debt since the costs would be covered a combination of savings, mostly reduced spending on Medicare and new taxes. The CBO even estimated that by 2019 the proposal would help reduce the overall deficit. Despite this, the Republican members of the committee did not sign on and discussions between Democrats and Republicans will continue through the August recess in hopes of having a bill when the Senate returns after Labor Day.

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