Senate nears final health care vote

Deal is struck to replace government-run plan

December 09, 2009|By Shailagh Murray and Lori Montgomery | The Washington Post

WASHINGTON — — Senate negotiators struck a tentative agreement Tuesday night to replace the controversial government-run insurance plan in their version of health-care legislation, hoping to remove one of the last major roadblocks preventing the bill from moving to a final vote in the chamber.

"We have a broad agreement," Senate Majority Leader Harry Reid, D-Nev., told reporters at the Capitol. "Tonight, we've overcome a real problem that we had."

The announcement came after six days of virtually round-the-clock negotiations between five liberals and five moderates who had been tasked by Reid to work out their differences on the public option. Appearing with Sen. Charles Schumer, D-N.Y., the leader of the liberal faction, and Sen. Mark Pryor, D-Ark., the moderate leader, Reid declined to detail the agreement, pending a review by congressional budget analysts.

However, when asked whether the agreement means the end is in sight after nearly a year of work on President Obama's most important domestic initiative, Reid smiled. "The answer's yes," he said.

Earlier in the day, the Senate turned back an amendment that would have barred millions of Americans from purchasing subsidized insurance policies that cover abortion, as Democratic leaders struggled to maintain a delicate party coalition in their push for the landmark legislation.

Both issues have made the $848 billion Senate bill move forward slowly, despite Reid's pledge to hold a final vote before Christmas.

The abortion amendment was rejected 54 to 45. Although the outcome of the vote was not a surprise, the amendment's defeat could cost Reid the support of Sen. Ben Nelson of Nebraska, a conservative Democrat who has threatened to join a GOP filibuster bill unless restrictions on abortion are tightened.

Nelson is one of five moderates in the Democratic caucus demanding changes to the legislation, forcing Reid to balance their concerns with those of liberals as he seeks to maintain the 60 votes needed to push a bill across the finish line. The biggest challenge has been determining the fate of the public option, a chief priority for Democratic progressives.

Key liberals said they were prepared to abandon a government-run insurance program if it would move the chamber closer to a final deal, provided it was replaced with other coverage options and tighter restrictions on insurance companies. "I don't think we're going to get that right now," Sen. Jay Rockefeller, D-W.Va., said of the public option. "So we're going for as strong a regulation guidance as we possibly can."

Democrats made a different calculation on abortion. Although the House included language that would restrict funding for the procedure in its version of the bill, Senate Democrats rejected Nelson's measure, despite the potential threat to final passage. Six Democrats joined all but two Republicans to support the tighter rules, but some Democratic abortion opponents - including Reid - opposed the amendment as too far-reaching.

Reid said the current Senate language, which would allow individuals who qualify for insurance subsidies to purchase abortion coverage with their own money, represented "a fair middle ground."

He told reporters he would seek other avenues in attempting to allay Nelson's concerns, but added, "This is not the right place for this debate. We have to get on with the larger issue at hand." After the vote, Nelson said he would not rule out supporting the final Senate measure.

A series of pending amendments, including several popular measures, must be resolved before Reid can begin ending debate on the bill and calling a final vote.

After the vote, Nelson returned to join 10 Democratic moderates and liberals in finding alternatives to the public insurance plan. Senators involved said the group is considering four approaches.

The most popular idea would create at least two national insurance plans offered by private firms but with rates negotiated by the Office of Personnel Management, the agency that oversees coverage for federal workers. Under the proposal, OPM would lay out criteria for coverage and seek responses from private firms, which the agency could authorize to participate.

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