Health Care Via Reconciliation May Spell Political Doomsday For Dems 2010, 2012

House Republican Leaders Demand Halt to Talks on Compromise Bill


House Republican leaders on Friday demanded that House and Senate Democrats halt their ongoing efforts to resolve differences between the versions of major health care legislation adopted by each chamber late last year.

In a letter to House Speaker Nancy Pelosi and the Senate majority leader, Harry Reid of Nevada, the House Republican leaders asserted that the efforts by Democrats to reach a compromise plan would undermine negotiations at a bipartisan summit scheduled by President Obama for Feb. 25.

Mr. Obama has said all along that he wants to be able to present a unified Democratic health care proposal at the summit and then debate the major provisions with Republicans and independent experts to see if they have better ideas.

But in their letter, House Republicans suggested that the ongoing work by Democrats to resolve their differences would amount to a “backroom deal among the White House and Democratic leaders” that would “make a mockery of the president’s stated desire to have a ‘bipartisan’ and ‘transparent’ dialogue.”

The letter was signed by the House Republican leader, Representative John A. Boehner of Ohio; the party whip, Representative Eric Cantor of Virginia; and the Republican conference chairman, Representative Mike Pence of Indiana.

The letter was the latest sign that Republicans are increasingly anxious that Mr. Obama and the Democrats will score a political victory with the bipartisan summit. Earlier on Friday, Representative Tom Price, Republican of Georgia, published an op-ed piece online in which he accused Mr. Obama of using the summit “to intimidate his way into a government takeover of health care.”

The Republicans have demanded that Democrats discard the health care bills adopted by the House and Senate late last year and start the process over. Mr. Obama and the Democrats have refused, and they called on Republicans to negotiate on the proposals already approved by majorities in both chambers.

In the letter to Ms. Pelosi and Mr. Reid, the Republican leaders wrote, “Your response will help clarify whether Democratic leadership is serious about genuine bipartisan negotiations and whether the proposed summit will be a truly open forum or merely an intramural exercise.”

By raising questions about the Democrats’ motives, Republicans seem to be anticipating that Mr. Obama will move quickly after the summit to win passage of a revised health care bill, and they seem to wish to blunt any effort by the president to suggest that Republicans offered few workable alternatives.

Even as they have criticized the Democrats and cast doubts on the summit, Republicans have not put forward any new, comprehensive health care proposal that would meet the president’s goal of extending coverage to most of the nation’s uninsured. Republicans say that doing so would be too costly and that they do not share the president’s goal of a broad expansion in coverage, but instead want more modest efforts to help control costs.

Here is the full letter:

February 12, 2010
The Honorable Harry Reid
Majority Leader
United States Senate
Washington, DC 20510

The Honorable Nancy Pelosi
Speaker
U.S. House of Representatives
Washington, DC 20510

Dear Mr. Leader and Madam Speaker:

As you know, we welcomed the President’s call for bi-partisan health care talks. The American people have made it clear that they strongly oppose the comprehensive health care bills you have passed and want them shelved in favor of a step-by-step approach focused on lowering costs for families and small businesses.

Given the President’s statement that he is “open to any ideas” at the proposed summit, it is our responsibility as congressional leaders to see that the views of our Members and our constituents will be heard in good faith. The existence of any kind of backroom deal among the White House and Democratic Leaders would certainly make a mockery of the President’s stated desire to have a “bipartisan” and “transparent” dialogue on this issue.

To that end, we were taken aback by a report in the Tuesday, February 9 edition of Politico stating that President Obama “hopes to walk into the Feb. 25 summit with an agreement in hand between House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid on a final Democratic bill, so they can move ahead with a reform package after the sit-down.”

We were further taken aback by a report in CongressDaily later the same day in which an aide to the Speaker, appearing at the National Health Policy Conference, described the legislative “trick” Democratic Leadership intends to use to jam through a “pre-negotiated” health care bill. It has also been reported that other congressional aides present concurred with this assessment.

Additionally, the Christian Science Monitor reported today that special interest groups are calling for Democrats to finalize a deal in advance of the proposed summit.

To ensure we can move forward in good faith, we ask that you publicly disavow these reports and assure the American people that Democratic Leadership is not putting together any kind of backroom deal or plotting any kind of legislative trickery to pass it. Your response will help clarify whether Democratic Leadership is serious about genuine bipartisan negotiations and whether the proposed summit will be a truly open forum or merely an intramural exercise.

We appreciate your immediate response in this matter and look forward to further efforts to foster bipartisan cooperation.

Sincerely,

House Republican Leader John Boehner (R-OH)
House Republican Whip Eric Cantor (R-VA)
House Republican Conference Chairman Mike Pence (R-IN)









Failure Of Health Care Overhaul Will Add More Woes


It's anybody's guess whether Obama's health remake will survive in Congress, but there's no doubting the consequences if lawmakers fail to address the problems of costs, coverage and quality.

What could be worse than health care overhaul? No health care overhaul.

It's anybody's guess whether President Barack Obama's health remake will survive in Congress.

But there's no doubting the consequences if lawmakers fail to address the problems of costs, coverage and quality: surging insurance premiums, more working families without coverage, bigger out-of-pocket bills, a Medicare prescription gap that grows wider and deeper, and government programs that pay when people get sick but do little to keep them healthy.

"They complained, 'If you pass this bill, prices will go up,'" said Sen. Maria Cantwell, D-Wash., who helped shape the Senate Democrats' bill. "Well, you don't pass it, and prices will still go up."

For economist Douglas Holtz-Eakin, a top adviser to 2008 GOP presidential nominee John McCain, "no one has the luxury of saying we're not going to worry about this." While he's no fan of the Democrats' approach, he said Republicans "are going to have to deliver something at some point. The question is whether they do it with this president leading or wait for a Republican president."

Health care spending hit $2.5 trillion last year, growing faster as a share of the economy than at any time in a half century, yet with results that compare poorly with other advanced countries spending less. Government programs — mainly Medicare and Medicaid — will soon cover more than half the nation's health care tab, a staggering burden for federal and state budgets.

For those with private insurance, the recently announced double-digit premium increases for people purchasing their own coverage with Anthem in California could be a harbinger. Medical costs are rising in a weak economy, causing healthy people to drop coverage and raising costs for those left behind, with no limit in sight.

"We will see real changes in the way health care is delivered, regardless," Holtz-Eakin said. "The question is whether they are coordinated and done proactively or whether they are done on the ground by providers, insurance companies and employers, reacting to their costs and their risk pools."

A look at how some major groups would fare if the health care overhaul collapses and present trends continue unchecked:

OLDER PEOPLE

Both Democratic bills would begin experiments aimed at providing quality care at lower cost for Medicare recipients, particularly those with chronic conditions such as heart failure and diabetes. Co-payments for preventive care would be eliminated. The House bill gradually would close the "doughnut hole" prescription coverage gap, now growing wider and deeper because of inflation. Those improvements would be lost.

On the plus side, private insurance plans in the Medicare Advantage program, serving about one-fourth of seniors, would be spared cuts proposed by Democrats. Still, insurers and other service providers won't get a free pass. With Congress looking to cut the federal deficit, Medicare will be on the chopping block again.

"The irony is that major interest groups — hospitals and drug makers — had agreed to take reductions this time," said John Rother, top political strategist for AARP, which supports the Democratic bills.

WORKERS

The divide between those who have health insurance and those who don't will get deeper. Many more will find themselves with inadequate coverage that leaves them with hefty bills if they get seriously ill.

"More employers will drop coverage. More consumers will get increased co-payments and deductibles," said Sen. Ron Wyden, D-Ore., a moderate who has not given up hope of a deal with Republicans. "I believe that would be so corrosive for the country that we would not let it be the outcome."

By 2019, the number of uninsured would rise to 54 million, most of them low-income workers paying federal and state taxes to support health care programs for older people and the poor. The Democratic bills would expand Medicaid to pick up more people near the poverty line, while providing subsidies for many middle-class households to buy private coverage.

PEOPLE WITH HEALTH PROBLEMS

Insurers would be able to continue denying coverage to people with medical problems, or charge them higher premiums. People who get sick could face cancellation of their coverage in certain circumstances.

People in their 50s and 60s, when many medical conditions emerge, would face premiums up to six times or seven times higher than what those in their 20s pay.

Conversely, 20-year-olds would continue to enjoy access to low-cost health insurance. The Democratic bills would have forced them to subsidize premiums for older generations. Still, young people would not escape unscathed. The Democratic bills would have allowed children to stay on their parent's coverage until their mid-twenties, a particularly valuable benefit for those with health problems.

EMPLOYERS

Big employers were hoping that the Medicare experiments would provide a template for their own efforts to try to control costs and maintain quality. Small employers were leery of the Democratic bills, although some would have received subsidies to help them provide coverage.

If nothing gets done, large employers will be the front line in efforts to rein in health care spending. They will keep passing on costs to employees through higher premiums and copayments. But they're also expected to take a more aggressive approach to get workers to shape up by quitting smoking, losing weight and making other lifestyle changes. Employers won't just be insurance sponsors any longer; they could start acting more like the health police.

Small companies are likely to keep dropping coverage, as are employers with lots of low-wage workers.

"The fact that we had a mandate from voters to do something, and that a major effort to respond led to such a deep partisan divide and gridlock is not positive," said AARP's Rother. "The gridlock that's developed on health care is a very serious and negative omen for our ability to tackle Social Security and deficits."


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Sources: Fox News, NY Times, Google Maps

C-Span Wants Access To Health Care Debate Like Obama Promised

C-SPAN Seeks Access as Final Health Deal Goes Behind Closed Doors


As a candidate for president, Barack Obama criticized the Bush White House for its code of secrecy on everything from Dick Cheney's energy task force to details on the intelligence that led to the Iraq war.

On the campaign trail, Obama promised that his White House would operate differently. On health care, he pledged in August 2008, "We'll have all the negotiations around a big table. . . . But what we will do is, we'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies."

Today, Brian Lamb, the president of C-SPAN sent a letter to the Democratic and Republican leaders of the House and Senate, asking them to live up to the promise of opening health care negotiations to C-SPAN cameras.

Although the non-profit cable channel has broadcast hundreds of hours of committee mark-ups and floor debate on health care reform, Democratic leaders are attempting to bypass a formal conference committee and negotiate the final deal behind closed doors.

"President Obama, Senate leaders, and many of your rank and file members have all talked about the value of transparent discussions of reforming the nation's health care system," Lamb wrote. "Now that the process moves to the critical stage of reconciliation process between the chambers, we respectfully request that you allow the public full access, through television, to legislation that will affect the lives of every single American."

C-SPAN has made similar requests for access to negotiations and control over coverage in the past. In 1994 and again in 2006, Lamb asked House Speakers Newt Gingrich and Nancy Pelosi to allow C-SPAN, not the House staff, to control the movement of cameras that cover the House floor. Lamb also pushed to televise the Supreme Court's oral arguments. Neither effort has succeeded yet.

Terry Murphy, vice president of programming for C-SPAN, told Politics Daily that the network hasn't gotten a response from the congressional leaders yet on the health bill negotiations, but emphasized the need for covering the deliberations.

"The more openness the better," Murphy said. "No matter who's in power."


Sources: C-Span, Politics Daily, Republican.Senate.gov, Youtube

Health Care Bill Debate Resumes Tomorrow...Pelosi's Caving In

Health Care Debate Resumes With WH Meet


The health care debate resumes in earnest on Tuesday after more than a week of quiet following Senate passage of its landmark bill on Christmas Eve.

The four relevant House chairmen will meet with Speaker Nancy Pelosi and her leadership team at 1 o'clock in the speaker's Capitol office to start setting the parameters for negotiations with the Senate.

Then, Pelosi and House Majority Leader Steny Hoyer (D-Nev.) will head to the White House for an early-evening meeting with President Barack Obama to discuss the final bill, according to Democratic officials. Senate Majority Leader Harry Reid (D-Nev.) and party Whip Dick Durbin (D-Ill.) will participate in the meeting via conference call because neither has returned to Washington from the holiday break.

House negotiators have their work cut out for them because Reid – and his wavering moderates – will be reluctant to make any changes that would upset the fragile accords that paved the way for last month's historic, hard-fought, party-line vote to approve the Senate bill. This spells trouble for the public option, but there are plenty of other substantive differences between the two bills that could give House leaders a foothold to make other changes.

Democrats in the House are expected to push for increased subsidies for the lowest-income Americans who don't qualify for Medicaid. On the eve of the Senate vote, Democratic aides in the House also suggested they would push for a blend of new taxes to help pay for the subsidies and new programs created by the bill. That could include a tax on high-end insurance plans at a higher threshold organized labor could accept along with a tax on the wealthiest Americans.





But House aides acknowledge they don't have much room to maneuver. For starters, congressional negotiators need to keep the final 10-year price tag below $900 billion, forcing Democrats to pick priorities, since the House bill costs more than $1 trillion compared with a Senate measure that would cost an estimated $871 billion over the next decade.

House leaders also want the Senate to adopt a national insurance exchange, instead of the state-by-state exchanges established under the Senate bill, and add tougher mandates for employers and individuals. And, of course, Democrats get another chance to spar over the public option, coverage for abortion and whether illegal immigrants can purchase insurance through the exchanges.

Other issues are sure to pop up. For example, Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) wants to squeeze more money from drugmakers by reimbursing them at a lower rate for seniors who qualify for both Medicare and Medicaid, and a pair of senators is pushing to include more money for the state-run Children's Health Insurance Program, while the House bill would fold it into the new exchange program.

Congressional Democrats are embarking on an abbreviated negotiation to save Reid the hassle of overcoming more procedural hurdles, but that means the resulting negotiations will be held behind closed-doors as the various stakeholders push for final changes. Liberal Democrats in the House have taken exception with the revised process, but most aides argue a drawn-out conference negotiation would give Senate Republicans too many opportunities to derail the process.

The White House is expected to take a very active role in melding the two bills after keeping quiet publicly during negotiations in the House and Senate. Obama's top aides took a much more hands-on role crafting the Senate bill, so it includes administration priorities that the House bill lacks, like the tax on high-end health care plans and language giving an outside panel the authority to increase efficiency and advocate cost-containment under Medicare.

They also want to make sure congressional negotiators wrap up work as quickly as possible so the administration and its congressional allies can turn their attention to the economy and job creation. That means bartering with lawmakers on other issues. According to TalkingPointsMemo, the Congressional Hispanic Caucus might relent in their push to let undocumented immigrants buy insurance on the exchange if the president pushes a comprehensive overhaul of the country's immigration laws – one that grants immigrants who seek a path to citizenship the right to purchase this insurance.

During the Tuesday session, the speaker is expected to set loose parameters for the abbreviated conference negotiations with the four chairmen with jurisdiction over the final legislation, Waxman, Education and Labor Chairman George Miller (D-Calif.), Rules Chairwoman Louise Slaugher (D-N.Y.) and Ways and Means Chairman Charlie Rangel (D-N.Y.).

Democrats are also scheduled to hold a caucus meeting on Thursday at noon in the Capitol. But since few lawmakers are expected to be in town to attend, party leaders are setting up a conference call that will give every member a chance to participate in the dialogue and hear how the process will work. Aides suggested Pelosi might even walk her members through some of her early priorities for the final bill. The speaker also wants to hear from her members frequently as the process moves along.


Sources: Politico, MSNBC, The Ed Show, Youtube

Senate Increases National Deficit By $290B

Senate Lifts Debt Ceiling By $290B


A $290 billion increase in the Federal debt ceiling narrowly cleared Congress on Thursday, giving Treasury just enough leeway to pay the government’s bills into February and setting the stage for a showdown over fiscal policy early next year.

Senate Republicans insisted that 60 votes be required for passage and then held back their own members in order to force as many Democrats as possible to walk the plank on what has never been a popular or easily explained decision back home.

The same issue returns with a vengeance Jan. 20th when senators will be asked to vote on a still larger, long-term debt increase within days of President Barack Obama’s new budget and State of the Union address.

Treasury’s daily statements this week indicate it is still about $65 billion under its current $12.1 trillion ceiling, and conservatives argued that special measures could be invoked still to avert default over New Year’s. But with Congress leaving for the holidays, Senate Banking Committee Chairman Chris Dodd (D-Conn.) said that failure to act would have been “catastrophic” for the U.S. internationally. And Senate Finance Committee Chairman Max Baucus (D-Mont.) said that payments to Social Security recipients were also at risk.

“The bottom line is we have no choice,” Baucus told his colleagues. “We have to approve it.”

Between now and the January votes, there will be renewed efforts to try to reach some compromise on a bipartisan deficit reduction commission championed by the leadership of the Senate Budget Committee and more than a third of the full Senate. Without these votes, Treasury has no chance of prevailing, and the White House is already promising to take a more aggressive stance on deficits in its 2011 budget, due about Feb. 1.

But with the economy still fragile, Obama can’t afford to ignore the political threat of high unemployment and demands in his party for greater efforts to spur job creation. And for a man who campaigned on the promise of going through the budget page-by-page, the president has been remarkably silent on the new spending — and billions of dollars in parochial projects — included in annual appropriations bills approved this month.

In recent days, Obama has signed measures totaling more than $1 trillion with scarcely a comment. And going into House-Senate negotiations on health reform, he faces a major task now in convincing the public that the bill’s often tenuous financing schemes will actually hold up and not make the debt worse.

The bitter residue of that historic health care debate hung over the proceedings in the Senate on Thursday. And amid all the Christmas Eve hugs on the Senate floor, the debt ceiling vote was a moment of old-fashioned revenge for what many top Republicans view as a political betrayal last November after they joined in a bipartisan vote supporting the financial industry rescue plan championed by the Bush administration’s own Treasury Department.

The Democratic Senate campaign apparatus — overseen by Sen. Chuck Schumer (D-N.Y.), a strong ally of Wall Street — later ran highly effective ads attacking Republicans for supporting big bankers. And Minority Leader Mitch McConnell (R-Ky.) has never forgiven Democrats for those tactics and worked hard to hold back his colleagues.

“Mitch is hard over on this,” said one Republican, and the sole concession on the 60-39 roll call was among Midwest neighbors: retiring Sen. George Voinovich (R-Ohio) voted “yes” allowing Sen. Evan Bayh (D-Ind.), up for reelection next year, to vote “no.”

Sen. Judd Gregg (R-N.H.) had been a second Republican vote Democrats had hoped for — and one that might have been there if a real crisis arose.

As the ranking Republican on the Senate Budget Committee, Gregg had played a lead part in negotiating a deal with Senate Majority Leader Harry Reid (D-Nev.) this week guaranteeing him a chance to amend the next debt ceiling increase next month with legislation setting up a bipartisan deficit reduction task force or commission.

The 18-member group would be charged with making recommendations by the end of 2010, which would be voted on in the next Congress in 2011. Gregg is insistent that there be a statutory requirement that the House and Senate consider the commission’s findings under expedited proceedings, without amendment.

In return for getting a sure vote on his proposal, he had argued in Republican circles for more bipartisan support Thursday for the short-term debt ceiling adjustment. But ultimately he voted no in apparent deference to McConnell’s strategy.

“We’ll be back in January to consider yet another increase in the credit limit that probably will only allow us to borrow through the middle of next year if we’re lucky,” Gregg said in a statement later. “While it is critical to protect the government’s ability to meet its financial obligations, Congress should not consider passing a long-term debt limit increase unless the legislation also includes enforceable and meaningful measures to curb out-of-control government borrowing and spending.”

In explaining his vote for the debt increase, Voinovich also alluded to the January debate and the promise by Reid for a vote then on the Gregg commission, also backed by Senate Budget Committee Chairman Kent Conrad (D-N.D.)

“As one who knows all too well about our debt crisis, unbalanced budgets and unfunded liabilities — and one who is keenly aware of how closely the United States is being watched by the international community — I felt conscience-bound to vote for this short-term debt extension,” the Ohio Republican said. “For too long, I have felt alone in the desert in my calls for reform. ... I am … I am truly grateful for the leadership of Sens. Conrad and Gregg and was happy to help move this issue forward.

To hammer home the point further, Conrad released a letter immediately after the debt vote, urging Obama to come off the fence and back the commission. Signed by more than 30 senators, the letter takes note that the president has signaled he intends to make “deficit and debt reduction a center piece” of his State of the Union address.

“To accomplish these goals, we believe it is necessary to put in place a process that is bipartisan, accountable, comprehensive and which assures a vote on recommendations before the end of this Congress. Your support for and involvement in such a process is crucial for it to be a success.”


Sources: Politico

Senate Dems Pass Final Procedural, "Earmarked" Health Care Vote 60-39

Health Care Overhaul On Track For Final Passage



Senate Democrats pushed the health care bill past its final major procedural test Wednesday, voting 60-39 to end debate and putting the $871 billion overhaul on track for final passage Thursday morning.

Majority Leader Harry Reid (D-Nev.) kept his caucus together for the third time in three days, delivering the 60 votes necessary to break a Republican filibuster on the bill.

Reid also announced he’s moving up the time of the Christmas Eve vote by one hour, to 7 a.m. Thursday.

After the vote, congressional Democrats will turn to reconciling the House and Senate bills, which include different approaches to restrictions on abortion coverage, the role of government in health care and the mandates placed on employers to provide insurance.

Sen. Ben Nelson (D-Neb.), the last holdout on Senate passage, threw what could be a complication into the mix Wednesday, saying he didn’t want to see the overall cost of the bill grow much beyond the $871 billion in the Senate version.

"I am going to be much very aware of what goes into the conference committee and what comes out of the report and watching it very closely," said Nelson.

His ceiling on spending? "The current number — $871-ish," Nelson said.

House leaders have already indicated they want to make changes in the Senate bill, including possibly increasing tax credits to help people buy insurance and moving up start dates for some programs. But both steps would boost the cost of the overall bill, so Nelson’s comments signal there could be tough negotiations ahead.

The White House privately anticipates health care talks to slip into February — past President Barack Obama’s first State of the Union address — and then plans to make a “very hard pivot” to a new jobs bill, according to senior administration officials.

Obama has been told that disputes over abortion and the tight schedule are highly likely to delay a final deal, a blow to the president, who had hoped to trumpet a health care victory in his big speech to the nation. But he has also been told that House Democratic leaders seem inclined, at least for now, to largely accept the compromise worked out in the Senate, virtually ensuring he will eventually get a deal.

Democrats originally hoped to finish before Obama’s speech to Congress to allow Democrats to turn their focus to the nation’s economy ahead of the 2010 elections. But by Wednesday, they weren’t so sure anymore that they could do it.

"I'm not making any promises on that one," Iowa Sen. Tom Harkin said about finishing before the speech. "We will have it to him, I would hope, before the end of January, but I don't know before the State of the Union. There are a lot of differences between the Senate and the House."

On the Senate floor Wednesday, the partisan sniping over the bill continued, with Republicans continuing to hit Democrats for last-minute changes to the bill designed to secure Democratic votes, such as a fix to win over Nelson that would save Nebraska nearly $100 million in state Medicaid spending in the first 10 years.

“There has been growing public concern that earmarks were used to buy votes for this legislation,” said Sen. Jim DeMint (R-S.C.). “It has been argued by some that this practice is acceptable because it’s necessary to get things done in the Senate. I reject that argument, and I urge my colleagues to put an end to business as usual here in the United States Senate.”

The Senate rejected a proposal from DeMint to prohibit earmarks for the explicit purpose of obtaining votes. Democrats objected, saying the idea sounded good in theory but would be unworkable in practice.

DeMint said he expected Democratic support because Majority Whip Dick Durbin (D-Ill.) co-sponsored a similar measure in 2007.

"Not anymore," Durbin said, waving off DeMint from the Senate floor.

Democrats made a last-minute attempt to recast the focus of the debate, away from the growing tensions between the parties and toward the people whom the majority leader said the bill would help.

“Each has been a party-line vote, and much of this debate has focused on politics,” Reid said shortly before the vote, pointing to a stack of letters. “But the health care debate is not about procedure … but about people.”

Health and Human Services Secretary Kathleen Sebelius and White House health reform director Nancy-Ann DeParle were on hand at the Capitol for the vote, as they had been Monday and Tuesday.

The only suspense in recent days had been when the Senate would take the final vote. Republicans were prepared to run out the entire clock on the procedural motions — a move that would have forced senators to vote at about 10 p.m. Christmas Eve. But Reid and Minority Leader Mitch McConnell (R-Ky.) worked out a deal Tuesday to have the final vote at 8 a.m. Thursday, and then Reid bumped it one hour earlier.

Unlike the three procedural motions, which required 60 votes, the vote on final passage requires only 51 votes.

Even though final passage is still hours away, Senate Democrats planned to celebrate early. The entire caucus was invited to a news conference at 4 p.m. Wednesday.

The Senate bill would extend coverage to 31 million uninsured Americans by expanding Medicaid, creating new insurance subsidies, setting up a national insurance marketplace and offering private plans nationwide administered by the same federal agency that oversees federal employee benefits. No longer could firms deny insurance over pre-existing conditions or set a lifetime limit on benefits.

But the plan falls far short of Obama’s initial vision for reform in one key regard — Democrats stripped out a government-run insurance option after several moderate Democrats said they’d block the bill if it remained.

That decision has drawn sharp fire from the party’s liberals, who have said the Senate plan isn’t true reform and would merely enrich private insurers — setting up a showdown with moderates, who have threatened to walk if liberals try to force it back in.


Sources: Politico

Will Harry Reid Meet His Christmas Eve Deadline? Dems Infighting

Dem infighting threatening health bill. Can Dems pass Health Care Reform by Christmas Eve?

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Health care deadline obstacles pile up


With the clock ticking down on health care reform, Senate Majority Leader Harry Reid (D-Nev.) has until Saturday to strike a 60-vote compromise if Democrats hope to meet a Christmas Eve deadline - but the obstacles kept piling up Thursday.

Reid still had no legislative text and no cost analysis to release. One of the final moderate holdouts, Sen. Ben Nelson (D-Neb.), rejected compromise language on abortion funding and said he's doubtful a bill can pass by Christmas. Two powerful unions blasted the bill. House Democrats threatened to undo the Senate bill during a conference committee. And a Democratic war over the bill raged on the Internet and cable news.

The White House sunk deeper into the fight within its own party, working throughout the day to discredit the claims of former Democratic National Committee Chairman Howard Dean that the Senate bill is so weak it should be scrapped.

The net effect was the loss of any sense of inevitability surrounding the passage of health care legislation by the end of the year as Reid struggled to keep it on track.

"If we are going to get a bill out of the Senate, which will be very close to getting a bill enacted, we have to do it in 2009," said Sen. Bob Casey (D-Pa.), who is working on the abortion compromise with Nelson. "Some might not think so, but what I would worry about is losing momentum."

"We're down to 48 to 72 hours," he said at 2 p.m. Thursday.

Reid needs a commitment - privately or publicly - from Nelson and other undecided senators by Saturday night, which is the drop-dead time at which the majority leader must begin the procedural steps necessary to finish the bill by Christmas Eve. The current timeline would have the Senate taking a series of votes: at 1 a.m. Monday, 7 a.m. Tuesday, 1 p.m. Wednesday and 7 p.m. Christmas Eve.

If the Senate fails to break a Republican filibuster early Friday morning on a Department of Defense appropriations bill, the timeline will be set back by a day, potentially pushing the vote to Christmas Day.

But even this schedule depends largely on Nelson, who remains the biggest concern by far for the White House and the Senate Democratic leadership. He has given no indication of which way he will go.

"I don't have a timetable to do that," Nelson told POLITICO of his decision. "We're still working on language, and a number of issues are under consideration right now that I've requested. And we'll have all that information back and see the [Congressional Budget Office] numbers on the package that was sent over a week ago. Then we'll look at everything, and I'll make my decision."

Nelson rejected a compromise from Casey as insufficient in terms of preventing public money from being used on abortions. This was a significant blow to Reid's effort to line up 60 votes because Nelson has said he would filibuster the bill unless the abortion language mirrored what was included in the House bill.

Nelson said his concern with the compromise language was that policyholders would be required to "opt-out" of abortion coverage, and their premiums would subsequently be reduced. By contrast, the language in the House bill requires people to proactively seek abortion coverage, Nelson said.

One reason why Reid continues to wrangle with the Congressional Budget Office over the cost estimate is that he is trying to find ways to accommodate Nelson, according to an official familiar with the negotiations.

Reid spokesman Jim Manley said the majority leader is "not unduly alarmed" by Nelson's concerns with the bill and is "still working to address" them.

At the same time, Democrats worked to protect their left flank. In a reversal of fortune for Obama, progressives attacked the plan moving through the Senate as "hollow," "unsupportable" and a sellout to corporate interests.

The theory has always been that as long as Democrats kept the moderates happy, liberals wouldn't thwart a deal in the end. But for the first time in this lengthy debate, it looked like some of them might. Sen. Bernie Sanders (I-Vt.), who favors a government-financed health care system, remains uncommitted on the bill.

The disagreement broke into the light of day Thursday when senior White House adviser David Axelrod slammed Dean, who argued in a Washington Post op-ed that the bill meets none of his benchmarks for "real reform."

"As it stands, this bill would do more harm than good to the future of America," Dean wrote, then took to the airwaves to amplify his case.

Axelrod called in to MSNBC's "Morning Joe" to argue that Dean's criticisms are "predicated on a bunch of erroneous conclusions."

"To defeat a bill that will bend the curve on this inexorable rise in health care costs is insane," Axelrod said. "I think that would be a tragic, tragic outcome. I don't think that you want this moment to pass. It will not come back."

Both the AFL-CIO and the Service Employees International Union released statements Thursday condemning the Senate bill - but stopped short of explicitly opposing it.

While the liberal revolt flared outside the Capitol, progressives in the Senate were showing no sign Thursday of peeling away.

Sen. Debbie Stabenow (D-Mich.), who supported the public option, said she had has "no hesitation voting for this - and I am someone who would vote for a single-payer system."

The one bright spot Thursday for Democrats may have been Sen. Roland Burris (D-Ill.), who backed away from threats to block the health care bill because it lacks a public option.

"We'll see what it is, but what the situation is now is the realization that we can't kill the bill," Burris told POLITICO. "That's the realization."


Sources: Politico, MSNBC

Michael Moore Slams Current Health Care Bill & Wall Street

"This bill is worse than the Status Quo. This is a huge, big wet kiss to the Health Insurance Industry. This is just deplorable that it comes from somebody who calls themselves a Democrat. They are just desperate to get anything on the floor."

"They shouldn't be handing out bonuses. They should he handing out warrants for arrests. ... If you have money in any of these banks that took TARP money, take the money out. Take the money out of those banks. Don't reward them. Don't ever trust your money with these people again. Put it in a bank that didn't take TARP money. Put it in a credit union. Just refuse to participate in this."

"People should be calling Congress (202) 456-1414".

Michael Moore on Morning Joe, Thursday, October 15th, 2009

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Sources: Michael Moore.com, MSNBC, The Insider, Youtube, Google Maps

Harry Reid Ordered To Cut Deal With Joe Lieberman

White House to Harry Reid: Cut deal with Joe Lieberman



The White House is encouraging Senate Majority Leader Harry Reid (D-Nev.) to cut a deal with Sen. Joe Lieberman (I-Conn.), which would mean eliminating the proposed Medicare expansion in the health reform bill, according to an official close to the negotiations.

But Reid is described as so frustrated with Lieberman that he is not ready to sacrifice a key element of the health care bill, and first wants to see the Congressional Budget Office cost analysis of the Medicare buy-in. The analysis is expected early this week.

"There is a weariness and a lot of frustration that one person is holding up the will of 59 others," the official said. “There is still too much anger and confusion at one particular senator’s reversal.”

Lieberman threw health care reform into doubt Sunday when he told Reid that he would filibuster the bill if it allowed Americans ages 55 to 64 to purchase coverage in Medicare. His comments on CBS’s “Face the Nation” set off a series of private meetings Sunday between the Senate leadership and top White House aides, including Chief of Staff Rahm Emanuel, who encouraged Reid to cut the deal with Lieberman, the official said. The White House declined to comment.

Reid has called a special Democratic caucus meeting for 5:30 p.m. Monday.

If they still hope to pass a bill by Christmas – which is still a top consideration at the moment — Democrats have only limited options:

• Reach an agreement with Lieberman, which would mean stripping out the provisions that have kept progressives on board. This will likely cause problems on the left – maybe even defections – unless the White House steps in to persuade senators such as Russ Feingold of Wisconsin and Bernie Sanders of Vermont.

• Win over Sen. Olympia Snowe (R-Maine), but she has also voiced serious reservations about the Medicare expansion, and has resisted pressure from the White House and Senate Democrats to finish the bill by Christmas.

Reconciliation, a procedural maneuver to get around a filibuster, remains on the table, but it’s not a viable option at the moment, the official said. It would push the issue into next year with no guarantee of success.

Democrats are frustrated because they believe Lieberman keeps moving the goal posts. He supported the Medicare buy in the 2000 presidential campaign, and in September reiterated support for the plan in an interview with the Connecticut Post.

Lieberman has denied giving his approval of the Medicare buy-in during the negotiations last week among a group of 10 moderate and liberal senators.

"Contrary to the claims of anonymous aides, Senator Lieberman told Reid on Friday that he had problems with the Medicare provision," Lieberman spokesman Marshall Wittman said in a statement.

"This position was also told to negotiators earlier in the week. Consequently, Senator Lieberman's position came as no surprise to the Democratic leadership. Any contrary charge by aides who cowardly seek to hide under the cloak of anonymity is false and self-serving," he added.

Wittman issued the statement in response to reports that Lieberman, according to anonymous Senate Democratic aides, had initially indicated support for a proposal allowing uninsured individuals as young as 55 to purchase Medicare coverage.


Sources: Politico

Lieberman Rejects Medicare Buy-In Plan...60 Votes Needed

Medicare Plan meets resistance

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Joe Lieberman says No to Medicare Buy-In


Sen. Joe Lieberman told Senate Majority Leader Harry Reid Sunday that he couldn’t support a new Medicare proposal floated as a compromise to the public option, a development that complicates the bill’s path towards passage before the end of the year.

In a meeting in Reid’s office just off the Senate floor, aides said the Connecticut independent reiterated his concerns with the public insurance option and told the Nevada Democrat that he couldn’t support a new plan to allow people as young as 55 to buy into Medicare.

“On Friday, Sen. Lieberman told Sen. Reid that he had problems with the Medicare buy-in proposal,” said Marshall Wittmann, a spokesman for Lieberman. “Sen. Lieberman affirmed that position with Sen. Reid today.”

A Democratic leadership aide confirmed Lieberman’s comments in the face-to-face meeting, which was first reported by the Huffington Post.

Lieberman’s opposition means that Reid may once again be short of the 60 votes needed to break a filibuster if the majority leader moves forward with a health care bill that includes a Medicare buy-in proposal, whose costs are currently being analyzed by the Congressional Budget Office. Both Lieberman and fellow centrist Sen. Ben Nelson (D-Neb.) laid out their concerns Sunday with the Medicare buy-in plan on CBS’ “Face the Nation.”

“On part of it - the so-called Medicare buy-in - the opposition to it has been growing as the week has gone on," Lieberman said. "Though I don't know exactly what's in it, from what I hear I certainly would have a hard time voting for it because it has some of the same infirmities that the public option did.”

Nelson worried that the plan was a “forerunner of single payer,” a label that Sen. Jay Rockefeller (D-W.Va.) strongly rejected.

The opposition from Lieberman and the concerns of centrists adds a new wrinkle to efforts by Reid to strike a compromise – since all 40 Republicans are expected to vote to sustain a filibuster. Reid will need the support of Lieberman, Independent Sen. Bernie Sanders (Vt.) and 58 Democrats to advance the measure.

If he kills a public option or the Medicare buy-in plan, he could lose the support of Sanders and several of the more liberal members of the Democratic conference. But keeping either of those plans, or one that would “trigger” a public option if private insurers don’t hold down costs, would lose Lieberman - forcing Reid to find at least one moderate GOP senator to advance the proposal.

To win the most likely potential GOP defector, Sen. Olympia Snowe (R-Maine), Reid would likely have to make modifications and slow the debate down since she’s signaled that the Senate needs to take more time to deal with the expansive issue.



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Sources: Politico, MSNBC, Google Maps

Moderate Dems Skeptical About Newly Proposed Medicare Plan

Moderates Democrats uneasy with Medicare plan


Senate moderates who are the linchpin to passing a health care reform bill raised fresh worries Thursday about a proposed Medicare expansion, complicating Majority Leader Harry Reid’s hopes of putting together a filibuster-proof majority for the legislation in the coming days.

Two days ago, the Medicare proposal appeared to be the elusive bridge between liberals, who were being forced to give up a public health insurance option, and moderates, who said they couldn’t vote for a bill that included one.

But by Thursday, the shine had dimmed, as senators grew restless over a lack of information and declined to commit their votes until they could review the legislative language and the Congressional Budget Office cost estimate. Republicans also stepped up their criticism of the plan.

The three moderates — Sens. Joe Lieberman (I-Conn.), Ben Nelson (D-Neb.) and Olympia Snowe (R-Maine), whose votes could make or break health reform this year — expressed varying degrees of resistance to the Medicare idea.

Snowe said the Medicare expansion exacerbates an “already-serious problem,” with the low government reimbursement rates for doctors and hospitals that serve Medicare patients. It could force her to vote no, she said.

Lieberman indicated that he was growing “increasingly concerned” about the proposal.

And Nelson said allowing people ages 55 to 64 to purchase Medicare coverage could simply be an intermediate step on the way to an entirely government-run health care system — “which I do not like.”

“I wouldn’t be surprised if this thing does not become a viable option,” Nelson said. “I think it is going to be the lesser of the popular things, but I am keeping an open mind.”

On the floor, Republican senators waved around a scathing editorial from The Washington Post, reading the headline several times throughout the day: “Medicare sausage? The emerging buy-in proposal could have unintended consequences.”

They seized upon one sentence in particular — that the proposal “is a far more dramatic step toward a single-payer system than lawmakers on either side realize.”

“I’m very puzzled ideas like this are being cooked up behind closed doors two weeks before Christmas, and we don’t know what they are,” said Sen. Lamar Alexander (R-Tenn.).

Reid will not release details — even to senators — until he receives the CBO analysis, which isn’t expected until early next week. At that point, Reid has less than two weeks to tweak the plan if the price tag is too high, brief his caucus, lock down the votes and clear a series of procedural hurdles for final passage.

The Medicare buy-in proposal has been kicked around policy circles for years, but it has been absent from the current health care debate. Democrats had become intimately familiar with the ins and outs, benefits and ramifications of the public option because it was all anybody talked about for the past year.

Senate moderates who are the linchpin to passing a health care reform bill raised fresh worries Thursday about a proposed Medicare expansion, complicating Majority Leader Harry Reid’s hopes of putting together a filibuster-proof majority for the legislation in the coming days.

Two days ago, the Medicare proposal appeared to be the elusive bridge between liberals, who were being forced to give up a public health insurance option, and moderates, who said they couldn’t vote for a bill that included one.

But by Thursday, the shine had dimmed, as senators grew restless over a lack of information and declined to commit their votes until they could review the legislative language and the Congressional Budget Office cost estimate. Republicans also stepped up their criticism of the plan.

The three moderates — Sens. Joe Lieberman (I-Conn.), Ben Nelson (D-Neb.) and Olympia Snowe (R-Maine), whose votes could make or break health reform this year — expressed varying degrees of resistance to the Medicare idea.

Snowe said the Medicare expansion exacerbates an “already-serious problem,” with the low government reimbursement rates for doctors and hospitals that serve Medicare patients. It could force her to vote no, she said.

Lieberman indicated that he was growing “increasingly concerned” about the proposal.

And Nelson said allowing people ages 55 to 64 to purchase Medicare coverage could simply be an intermediate step on the way to an entirely government-run health care system — “which I do not like.”

“I wouldn’t be surprised if this thing does not become a viable option,” Nelson said. “I think it is going to be the lesser of the popular things, but I am keeping an open mind.”

On the floor, Republican senators waved around a scathing editorial from The Washington Post, reading the headline several times throughout the day: “Medicare sausage? The emerging buy-in proposal could have unintended consequences.”

They seized upon one sentence in particular — that the proposal “is a far more dramatic step toward a single-payer system than lawmakers on either side realize.”

“I’m very puzzled ideas like this are being cooked up behind closed doors two weeks before Christmas, and we don’t know what they are,” said Sen. Lamar Alexander (R-Tenn.).

Reid will not release details — even to senators — until he receives the CBO analysis, which isn’t expected until early next week. At that point, Reid has less than two weeks to tweak the plan if the price tag is too high, brief his caucus, lock down the votes and clear a series of procedural hurdles for final passage.

The Medicare buy-in proposal has been kicked around policy circles for years, but it has been absent from the current health care debate. Democrats had become intimately familiar with the ins and outs, benefits and ramifications of the public option because it was all anybody talked about for the past year.


Sources: Politico

Ben Nelson To Introduce Senate Anti-Abortion Amendment...Showdown

Abortion Emerges as Top Health Care Bill Threat



Anti-abortion lawmakers in the Senate plan to introduce an amendment as soon as Monday to restrict insurance coverage of abortion in the health bill, setting up a showdown that has no clear path to resolution.

Both sides agree the amendment likely doesn't have enough votes to pass, but antiabortion groups and Sen. Ben Nelson (D., Neb.) say they will continue insisting on tough language as a condition for supporting the overall bill.

The lack of a clear meeting point makes abortion somewhat different from the other top obstacle to the bill's passage, the publicly run insurance plan that some Democrats oppose. There, both sides are weighing a handful of compromises.

On abortion, said Sen. Nelson, "it's certainly not a lock that there's language in the middle."

As it stands now, the Senate health bill would include abortion coverage in the new public plan and would allow women who receive government tax credits for insurance to enroll in a plan that covers the procedure. The tax credit would be segregated so none of it could go toward funding abortion.

Antiabortion advocates say that's too lenient and want to prevent any insurance plan that receives federal funding from covering the procedure, except in the case of rape, incest or danger to the life of the mother

Sen. Nelson plans to introduce an amendment that mirrors the tighter funding restrictions the House added to its health bill, based on a proposal by Rep. Bart Stupak (D., Mich.). The measure would prevent the public insurance plan from covering abortion. It would also prohibit any woman who got the tax credit from enrolling in a plan that covers the procedure.

Sen. Nelson has said he won't vote for a bill that doesn't include these restrictions. With no signs the measure will pass, Sen. Nelson said Friday that "we're going to keep talking" to reach a compromise on the issue. But his antiabortion allies say they won't accept anything less than the Stupak language.

"That's not a negotiation we're prepared to have," said Richard Doerflinger, associate director of the secretariat of pro-life activities for the U.S. Conference of Catholic Bishops, which pushed for the abortion restrictions in the House bill. "I really don't know how you compromise further."

Abortion-rights advocates are taking a similarly rigid line, saying that such a change would represent the biggest setback for them in decades. "As far as I'm concerned, this bill is a compromise," said Cecile Richards, president of Planned Parenthood Federation of America, which supports the bill in its current form. "People are really ready to move on on this issue and not have a protracted debate about legal abortion in this country."

Both sides see the Senate bill as a turning point in the abortion debate and are making a big push to rally supporters. Abortion-rights advocates brought hundreds of supporters to the Capitol last week to meet lawmakers and have been running television advertisements calling the amendment an attempt to roll back women's rights. The Catholic bishops on Friday sent an alert to parishes urging their members to contact their lawmakers in support of Sen. Nelson's amendment, and plan to oppose the bill if they don't win the change.

The abortion fight could prove decisive as Democratic leaders seek to build the 60-vote majority needed to ensure passage of the broader legislation. If Sen. Nelson ultimately decides to oppose the legislation, Democratic leaders will have to look for support across the aisle from Maine's two Republican senators, Olympia Snowe and Susan Collins, both of whom are supportive of abortion rights. If that happens, the Maine contingent would have big leverage to dictate further changes to the bill, especially on the issue of the government-run insurance plan.

Some senators say they regret that abortion has taken on outsize importance in the health bill, which is designed to expand insurance to tens of millions of Americans and slow the growth of health costs. "It is a shock to all of us...that this has come down to an abortion issue," Sen. Patty Murray (D., Wash.) said last week.


Sources: Wall Street Journal, The Daily Beast, Politico

Public Option Is Slipping Away...Compromise Only Hope

Reid: Obama pledges to help pass health reform. Senate Majority Leader Harry Reid says that President Obama pledged to work with Senate Democrats to help pass a health care overhaul, in their closed-door meeting on Capitol Hill. Watch his news conference.

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Republicans: Heath care bill "Partisan". Senate Republican leaders say President Obama's health care overhaul has become a closed-door, partisan effort that is aiding drug companies and other medical providers. Watch their news conference.

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Chances shrink for pure Public Option


Senate Democrats in search of a health reform compromise Sunday zeroed in on a new alternative to a government-run insurance plan – signaling that the chances a final bill will include a pure public option are diminishing.

The new idea — for the government to create a national health insurance plan similar to the Federal Employee Health Benefits Plan – seemed to gather momentum as the weekend went on, and the differences between liberals and moderates on the public option became even clearer.

The proposal would take the place of a new government insurance plan currently included in the Senate version of the bill, according to officials involved with the negotiations.

The plan would be administered by the Office of Personnel Management, which oversees the federal plan for members of Congress, and all of the insurance options would be not-for-profit offered by private companies.

Sen. Ben Nelson (D-Neb.), a public option opponent who is participating in the talks, said the new proposal would do away with the government insurance program in Majority Leader Harry Reid’s current bill, which allows states to “opt-out” of a public option.

“Seems to me it would be in lieu of the public option,” Nelson said. He also said Reid’s “opt-out” idea “is no longer being talked about.”

If the Senate goes in this direction, the challenge for Reid (D-Nev.) is framing this alternative as an acceptable compromise for progressives. Politically, the idea holds appeal for moderates, who have opposed establishing a new government insurance plan, but might also satisfy liberal demands for more choice and competition to private insurers.

“The proposal under consideration can be said to provide access to the same type of insurance plans that members of Congress and federal employees get. People think of that as government health insurance; progressives could portray this in the same vein,” said a Democratic Senate aide, who spoke on the condition of anonymity to discuss the negotiations. “But moderates can simultaneously point to the fact that the government isn’t the payer and say competition was enhanced without growing the government.”

That feature – that the plan would offer policies similar to those members of Congress get – could prove a potent selling point for members of Congress to their constituents back home.

Progressive senators emerged from a three-hour negotiating session Sunday night declining to comment. Asked if the public option has been taken off the table, Sen. Russ Feingold (D-Wis.) said: “I’m not going to respond to that one.” Sen. Tom Harkin (D-Iowa) would say only that he was hopeful a deal could be reached Monday.

Aides familiar with the negotiations said the meetings are not focused solely on the public option, and that senators who want the public option are seeking other concessions, including stronger regulation of the insurance industry.

There is also discussion of including a public option "fallback" provision, which would trigger a government health plan if private insurers did not choose to take part in the program — an unlikely outcome.

Jacob Hacker, a Yale University professor who originated the public option concept, posted a blog item on The New Republic website titled “You Call This a Compromise?” He said the latest crop of alternatives, including the plan modeled after the federal employees’ health program, represent “abandonment of the public option altogether.” It appears to be nothing more than a new kind of insurance exchange, which is already in the bill, he said.

And Timothy Jost, a health-law expert at Washington and Lee University School of Law, wrote on POLITICO’s Arena that replicating the federal employees’ health plan “was the dumbest idea yet.” Nonprofit insurance plans currently dominate the market, and they haven’t reduced the cost of insurance, he wrote.

The group directed their staff to work through the night on the proposals in preparation for what could be a key meeting Monday afternoon.

“You have people of very diverse and strong views who are making a real effort to come together,” said Sen. Chuck Schumer (D-N.Y.), a public-option supporter who has become an intermediary between liberals and moderates. “But people have strong views and we’ll have to see where people end up.”

Progressives are represented by Feingold, Harkin, Sen. Sherrod Brown (D-Ohio) and Sen. Jay Rockefeller (D-W.V.). The moderate side is represented by Nelson, Sen. Mary Landrieu (D-La.), Sen. Blanche Lincoln (D-Ark.), Sen. Thomas Carper (D-Del.), and Sen. Mark Pryor (D-Ark.).

Sen. Joe Lieberman (I-Conn.), a public option opponent, did not attend the meeting but his staff was present.

The group came together only in the last few days, representing the first time in the months-long process that key liberals and moderates sat at the same table.

Earlier Sunday, President Barack Obama paid a rare weekend visit to the Senate as the talks heated up. Obama and Vice President Joe Biden called on Senate Democrats to set aside differences and pass legislation by the end of the year. “They’re doing great; they’re going to get it done,” Obama said as he departed the 45-minute closed-door meeting in the Mansfield Room.

On Sunday night, with progress being reported, the senators ordered Chinese food from Schumer’s favorite restaurant, Hunan Dynasty on Capitol Hill, and at one point, they turned on the Giants-Cowboys game. Senators later attributed raucous applause heard from the hallway to the football game, not a sudden breakthrough in the talks.

Reid said he had personally asked five moderates and five progressives to work things out on the issues that they care about, including the public option and small business coverage. “Progress is being made, and that’s not just talk. We’ve made a lot of progress,” Reid said.

“There are still a few things we have to work out [in] the bill, and the issues are being narrowed as we speak. We’re working toward a consensus. We’re not there, but we understand how important it is that we arrive at a consensus, and we’re going to do that just as quickly as we can.”

Senate Majority Whip Dick Durbin (D-Ill.) said there are several options on the table that liberal and conservative Democrats are considering in order to strike a deal on the public insurance option in the health care debate — and that negotiations are still ongoing.

And Durbin, who is a big supporter of the public option, is very much open to striking a deal.

“I’m looking for an alternative that creates competition for the health insurance companies,” he said on “Fox News Sunday.”

Reflecting on the moment, Sen. Bob Casey (D-Pa.) said that Democrats should be able to get a bill done when they have a Democratic president and a pair of congressional majorities. “We've got to get this done in order to demonstrate we can get something this substantial done, even in a difficult economy and a difficult political environment,” he said.

Reid doesn’t have much wiggle room if he expects to finish the bill by Christmas.

Under the best-case scenario, Reid could reach a tentative deal on the public option during the first half of the week and send the revised plan to the Congressional Budget Office for a cost estimate, which is likely to take several days.

Once he receives the estimate, Reid would seek firm commitments on votes, which he will want to lock in before taking the procedural steps necessary to cut off debate on the bill. Aides say the goal is to start taking those procedural steps by the end of this week.

Democrats would then need to hold together 60 senators on three procedural votes and three votes on the bill. The votes could unfold over a roughly nine-day period, ending just before the Christmas break.

Democrats remain seriously concerned about Nelson, who is considered less likely by Senate aides to vote for the bill than are Sens. Olympia Snowe (R-Maine) and Lieberman, whose interests align more closely with the caucus. As long as the public option is sufficiently tailored to their liking, Snowe and Lieberman can likely be persuaded, aides said.

Snowe met with Obama on Saturday, and the two discussed her “trigger” proposal, under which a public option would kick in if private insurers didn’t adequately expand coverage. Snowe also met with moderate Democrats on the floor, and they plan to continue talks Monday. Snowe, however, is not part of the talks among Democratic liberals and moderates

Nelson is a tougher case. He has not only taken an uncompromising position on abortion, demanding stronger language to prohibit federal funding of abortion. He has also voted against all but one Democratic amendment so far, aside from those that received unanimous support from the body. Nelson’s voting record on the bill suggests a general dislike for key aspects of it.

Nelson’s position could become clearer after an expected vote this week on his anti-abortion amendment. Nelson has said he will not compromise, but he also signaled Friday that he wouldn’t do so until after the vote.

With Nelson as a wild card, the need to win over Snowe and Lieberman become all the more important — and that means progressives will be asked to make serious concessions on the public plan.

Obama’s visit came ahead of a busy time in his schedule that could make another Capitol Hill visit difficult, with a pair of trips to Europe for the Nobel Peace Prize and the Copenhagen climate summit. Then he’s scheduled to depart for Hawaii shortly before Christmas.

Despite repeated calls from lawmakers for more direction, Obama has picked his spots over the last 11 months. He has taken significant steps – a visit to the Hill, a major speech, a private meeting at the White House – only when he and his aides considered them necessary.

But given the decisions Reid needs to make in the coming days, Sunday may prove to be a pivotal moment.

Along with Obama and Biden were Deputy Press Secretary Bill Burton, senior adviser David Axelrod, health care “czar” Nancy-Ann DeParle, HHS Secretary Kathleen Sebelius, Secretary of the Interior Ken Salazar, and chief legislative liaison Phil Schiliro.

The only speakers, senators said after, were the president and Reid.

“We're really pretty much staying out,” said Sebelius when asked if the administration would take a side on the negotiations over the public option. “The discussions are really among the members of the Senate.”

Sen. Roland Burris (D-Ill.) said Obama “said it would be the greatest legislation since FDR passed Social Security."

Lieberman, who is open to supporting the bill so long as it does not include a public option, noted that Obama didn’t bring up the idea: “He didn't. I don't think he once talked about the public option. He didn't. That's what I'm saying. I thought it was interesting.”

Reid, asked about the comment, responded, “the President didn't say a lot of things. Senator Lieberman said that to me after the meeting also, but that doesn't mean it's not an issue because the President didn't talk about it.”

But Lieberman said even the benefits of health reform legislation wouldn’t outweigh his concerns about a public option enough to vote for the bill if that provision stays in.

“No!” Lieberman told reporters. “That’s exactly what I’ve been saying to my colleagues who are pushing for the public option. This bill has so much good in it, and it does so much good — it’s deficit neutral and all the rest. Why are you insisting on getting a foot in the door for single-payer?”


Sources: Politico, MSNBC