Uphill Health Care Battle for Dem Leader

(AP)  Forget mission accomplished. Try mission seemingly impossible.

With the Senate Finance Committee on the verge of approving a sweeping health overhaul bill as early as Tuesday, the path might appear open for action by the full Senate.

Not so fast.

First the Finance Committee bill must be combined with a more liberal version that the Health, Education, Labor and Pensions Committee wrapped up this summer. Such a merger is so rare that Senate Majority Leader Harry Reid, D-Nev., has never attempted it on any piece of legislation, much less one as complex as President Barack Obama's top legislative priority.

Sen. Maria Cantwell, D-Wash., had a one-word description of Reid's task: "Tough."

Said Democratic Sen. Jeff Bingaman of New Mexico: "He's on the hot seat."

"I don't even want to think about it," said Sen. Kent Conrad, D-N.D. "What a daunting challenge."

Everything about health overhaul legislation seems to be unusually complicated, but this process is particularly so because of the disparities between the bills and Obama's goal of keeping the cost at $900 billion over 10 years. Reid won't go it alone; he will get some help from the White House and the committee chairmen.

"It's not going to be one silver bullet," Reid said. "There isn't any one thing, there are lots of things we're going to have to work on."

These two bills diverge on some of the thorniest issues, perhaps most notably on the question of whether the government should sell insurance to compete with private industry. The health committee bill has the government-run plan; the finance bill does not.

The health committee bill offers more generous subsidies to low-income people to help them buy coverage than the finance committee bill.

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The finance committee bill proposes a new tax on high-value health insurance plans that the health committee bill doesn't include.

The health committee bill would require employers to offer coverage to their workers or pay a tax penalty. The finance bill has no such requirement, although it would levy a charge on businesses whose workers end up getting government subsidies.

Reid must resolve all those issues and more over the next week or so to come up with a single bill to bring to the Senate floor. In its broad contours, the legislation would expand coverage to about 95 percent of Americans with a new requirement for individuals to purchase insurance. The costs would be borne partly by hundreds of billions of dollars in cuts in projected Medicare and Medicaid spending. Policies would be available for those who have coverage and those who don't through so-called insurance exchanges.

But many of the details are unresolved and it's Reid's job to decide. Every step of the way he must ensure that the choices he's making keep 60 senators happy, or at least on board. That's how many votes it takes to avoid a bill-killing filibuster by Republicans in the 100-member Senate.

Any one change could lose a senator, and losing even one could be fatal.

Move too far to the left and a moderate Democrat like Ben Nelson of Nebraska could rebel. Too far to the right, and a liberal like Ron Wyden of Oregon could be alienated.

And then there's perhaps the most important senator of all, Olympia Snowe of Maine, virtually the only Republican seen as a possible "yes" vote on the health care bill. Reid will need to bring her along every step of the way.

The process has already started in the congressional and White House staffs. Beginning this week it will shift into high gear with Reid personally involved with a handful of key senators including Finance Chairman Max Baucus, D-Mont., health committee chairman Tom Harkin, D-Iowa, and Sen. Chris Dodd, D-Conn., who led the health committee consideration of the overhaul bill.

Snowe is expected to be closely consulted, and White House Chief of Staff Rahm Emanuel likely will participate in the meetings. They'll meet in Reid's stately office on the second floor of the Capitol and elsewhere. Obama will likely call wavering Democrats and shore up support, as he did all last week with members of the Finance Committee.

It's still not clear what the product will look like finally, including whether it embraces any version of a government-run plan. Reid has been somewhat equivocal, saying last week: "Before this bill goes to the president's desk, we are going to have some form of a public option in this bill."

Whatever the legislation looks like, it will face a barrage of amendments once it gets to the Senate floor, and it could easily go down in flames like former President Bill Clinton's attempt at a health care overhaul in 1994.

[gboyd41]

Stuart- There you go again, one of the first to state your opinion. You are a MACHINE. By the way-did you ever determine what an anarchist is? Unfortunately, it appears Reid will not represent Nevada much longer, unless the Democrats can infuse several million more to his cause.

[doc_holliday76]

I still say that we should be copying the best parts of all those health care systems from countries at the top of the "Very High Human Development" list just released by the UNDP.

This would mean taking the best aspects from countries like Norway, Australia, Iceland, Canada, Ireland, Netherlands, Sweden, France, Switzerland, Japan, Luxembourg, and Finland -- the top 12 countries with the highest quality of life in the world, all with universal health care at less than half of our cost here in the U.S.

[johndevinejr]

by stuart-johns1 October 5, 2009 12:27 PM EDT
I disagree entirely that the passage of any meaningful healthcare reform is impossible. If all you know and read about reform is on CBS, than you will feel that way, probably.

Our problem right now is not with the republicans. They have been written off. It is with Democrats like Baucus who are taking lots of money from the Health Care Industry.

Keep in mind that it has been only 9 months since Obama took office, we don't know what is taking place that doesn't make the news. In my opinion, the very worst Democrat is better than the "best" republican.

[faceofus]

As I've said before, this health care measure is such a mess that it ought to be tossed!

[pubsrtoast]

Just do what the Republicans did when they passed the medicare bill. Hold the vote open for 6 hours while arm twisting, bribing and threatening the members of your party that aren't on board. You can't argue with success.

[sjc_1]

The main objection seems to be "a government take over of health care". This is not what the Public Option is, but you will never convince some people of that. The last conference meeting had Republican senators saying that it was obvious that it was a ploy to force single payer on people and it would all become single payer with a Public Option. As long as they say that it will be hard to make progress.

[doc_holliday76]

by sjc_1:
'The main objection seems to be "a government take over of health care". This is not what the Public Option is...'
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Yes, but FEARmongering is all the miNOrity republican'ts have today, being helped by their foxnewsus propagandus network of LIES and more DECEPTIONS!

[johndevinejr]

With several Democratic Senators firmly in the pocket of the Health Care Industry, passage of any meaningful health care reform is nearly impossible.

Since the bill is aimed at helping people rather than business republicans will not vote for it. Even if the Finance Committee version of the bill, The Health Care Industry Profit Protection and Enhancement Act were to be voted on, republicans will not vote for it because they seek to hand Obama a defeat. Once again repubs will show that they are Party First and country second.

So, almost no chance that the bill will pass with the Health Care Lobby practically backing a truck up to the Capital and shoveling money into the place.

[stuart-johns1]

I disagree entirely that the passage of any meaningful healthcare reform is impossible. If all you know and read about reform is on CBS, than you will feel that way, probably.

But I do agree with your assessment of the republican party and their attitude. I just don't believe they are going to be successful. I am growing weary of Obama and they way he is handling this and many issues.

I believe Obama has the right ideas but lacks the fighting spirit (so far) to simply step in, take control, and get it done.

[doc_holliday76]

by johndevinejr:
"Since the bill is aimed at helping people rather than business republicans will not vote for it. Even if the Finance Committee version of the bill, The Health Care Industry Profit Protection and Enhancement Act were to be voted on, republicans will not vote for it because they seek to hand Obama a defeat. Once again repubs will show that they are Party First and country second."
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Absolutely!

The for-profit insurance industry certainly has bought many congresscritters from both sides of the aisle with their $1.4 million daily spent to fight needed health care reform, and the GOP will always put party and the almighty American dollar well before country.

Reid certainly has an uphill battle, but hopefully he will prevail with a public OPTION to finally add some sort of competition to the for-profit GREEDY insurance bozos that are merely middlemen skimming money right off the top of the $2.5 Trillion health care industry.

Baucus and the rest of the conservitards in the Senate Finance Comm. should be embarrassed to write such an insurance-giveaway bill while thumbing their noses at the American majority wanting reform.