WASHINGTON -- President Barack Obama's effort to overhaul the nation's health care system is expected to clear its last committee hurdle Tuesday -- but almost certainly without the strong bipartisan endorsement he and some moderate Republicans have sought.
The Senate Finance Committee is expected to vote on a plan to would require nearly all Americans to get coverage, while barring insurers from denying people policies because of pre-existing conditions and imposing excise taxes on insurers' most expensive plans.
The committee is the last of five congressional panels considering the measure. Once Finance is done, Senate leaders and the White House will merge the proposal with another one written by the Senate Health Committee over the summer, creating one bill likely to be considered by lawmakers later this month.
Three House of Representatives committees also have finished writing bills, and those, too, will merge into one. Final House action also is expected in late October.
In the Finance Committee, while virtually all 13 Democrats are expected to back the proposal, only one of the 10 Republicans, Sen. Olympia Snowe of Maine, is viewed as a possible supporter.
Obama and a parade of GOP statesmen have urged bipartisan cooperation in recent days, but even last week's report from the nonpartisan Congressional Budget Office that the $829 billion plan will cut $81 billion from the federal deficit over 10 years didn't move most congressional Republicans.
The report "masks who pays the bills. This package includes hundreds of billions of dollars in new taxes and fees," said Sen. Charles Grassley, R-Iowa, the committee's top Republican.
Republicans have offered several alternatives to Democrats' health care plans. GOP proposals usually include strengthening employer-provided insurance and offering tax benefits for those who buy coverage on their own. Democratic-controlled committees have routinely rejected Republican plans.
Outside Washington, GOP veterans are stressing not specifics, but civility.
California Gov. Arnold Schwarzenegger urged Congress to "move forward and accomplish these vital goals for the American people." Bush administration Health and Human Services Secretary Tommy Thompson said the Finance measure "moves us down the path of providing affordable, high-quality health care for all."
Bill Frist, a heart surgeon who served as Senate majority leader from 2003 to 2007, said he would've voted for some health care bill, though he has some reservations about the Finance measure. And Bob Dole, the Senate GOP leader from 1985 to 1996, also suggested Republicans want to participate and would do so at the appropriate time.
He stepped in Sunday when the Democratic National Committee prepared to launch an ad lauding the support of the GOP statesmen, while criticizing Congress' current Republican leaders.
Dole complained to the White House, which ordered the ad pulled. Obama had tried himself to encourage more comity Saturday, saying in his weekly radio address that "distinguished leaders" including Dole "understand that health insurance reform isn't a Democratic issue or a Republican issue, but an American issue that demands a solution."
While the statesman's soothing words are nice, it's important to remember, said Darrell West, vice president and director of governance studies at Washington's Brookings Institution, "They have no troops to deliver to the U.S. Senate."
Still, Elizabeth Carpenter, a health policy expert at the New America Foundation, saw the comments as having some value, noting "they're looking at policy, not politics."
So far, though, policy's having trouble breaking through the political noise and Democrats know they don't really need many Republicans, because Democrats control 60 of 100 Senate seats and 256 of the House's 435 seats.
It takes 218 House votes to get a majority, and 60 to overcome procedural hurdles in the Senate.
Snowe's vote could be important because some centrist Democrats have balked at different aspects of the health care legislation, and her endorsement would allow the White House to claim it had bipartisan support.
Carpenter thought Snowe's action could reverberate among Republicans, saying it could be "a great signal to others in her party" who may be skittish about standing alone with the Democrats.
Snowe, however, sided with Democrats in February to help pass Obama's $787 billion economic stimulus. Sens. Susan Collins of Maine and Arlen Specter of Pennsylvania, who's since switched parties, were the only other Republicans to back the bill.
Consequently, the stimulus is rarely seen as a bipartisan effort and conservatives aren't likely to see a Snowe vote adding that label to health care legislation.
"There's clear, unambiguous ownership by congressional Democrats and the president," said Michael Franc, vice president for government relations at the Heritage Foundation, a conservative research organization in Washington.
The committee will vote on a plan that CBO estimates will cover 94 percent of eligible Americans by 2019, up from the current 83 percent. About 25 million nonelderly people, about a third of whom would be illegal immigrants, are likely to remain uninsured by 2019, CBO estimated.
Committee Chairman Max Baucus, D-Mont., initially wanted a vote late last week, but Snowe wanted more time to review the CBO findings, released Wednesday.
While she's been mum on her views, other Republicans have been outspoken, and expect to continue to do so Tuesday.
"The bill spends nearly a $1 trillion and still leaves 25 million people without health insurance. That's not much bang for the buck," Grassley said.
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