Senate Democrats reach tentative deal on public option

McClatchy NewspapersDecember 8, 2009 

WASHINGTON — Senate Democratic negotiators said Tuesday that they'd tentatively agreed to a compromise plan that could alter the government-run option in their health care bill, a bid to win key moderates who've threatened to derail the effort.

Though he wouldn't offer details, Senate Majority Leader Harry Reid, D-Nev., said late Tuesday that there was a "broad agreement" how to proceed. Several alternative scenarios are being sent to the Congressional Budget Office for further analysis, and Democratic leaders maintained that all could be defined as some kind of public option.

The Tuesday evening announcement came hours after the Senate dealt with the other major sticking point for the $848 billion, 10 year plan to overhaul the nation's health care system. By a 54-45 vote, senators rejected a bid by anti-abortion lawmakers to put strict limits on federal abortion funding.

That left the government-run plan, pushed hard by Democratic leaders and designed as a competitor to private insurers, as the bill's lone major flashpoint. A group of 10 senators has been meeting privately to try to reach an accord.

Those senators have centered on expanding Medicare so that people near retirement age, from 55 to 64 years old, could qualify for coverage if their employers don't offer coverage. Medicare now covers people over 65 and some with disabilities.

In addition, negotiators have seriously discussed having the federal government oversee and perhaps negotiate details of some plans offered by private companies.

The negotiators have also considered having a government-run plan as a backup if the new system doesn't meet key goals, such as near-universal coverage and better affordability.

At least four Democratic moderates are wary of a government-run plan, saying it could be costly and expand government's reach, but they want to make coverage more affordable and available, so that plan is expected to win their backing.

Liberals think the public plan is a more effective way of achieving those goals, and expanding Medicare would provide some movement in that direction. Not everyone was immediately pleased, however.

"I do not support proposals that would replace the public option in the bill with a purely private approach," said Sen. Russell Feingold, D-Wis. "We need to have some competition for the insurance industry to keep rates down and save taxpayer dollars."

Democrats control 60 of the Senate's 100 seats, exactly enough to cut off debate. If enough Democrats, and perhaps a moderate Republican or two, vote for the new proposal, it could pass by Christmas.

Top senators would then enter into compromise talks with House of Representatives leaders — and the House measure, passed last month, does include a government-run public option.

Because of Tuesday's vote, the Senate health care bill continues to allow health plans the option of covering elective abortions. If abortions are covered, the plan must establish separate accounts with private funds to pay for them.

Fifty Democrats, two independents and Republicans Susan Collins and Olympia Snowe of Maine voted against the restrictions. Thirty-eight Republicans and seven Democrats voted for the tougher rules. Sen. Robert Byrd, D-W.Va., didn't vote.

Abortion rights proponents agree that the health legislation should follow current law, which bars federal funds from being used for abortion except in cases of rape, incest or danger to a woman's life. They also say, however, that if a woman wants to spend her own money on abortion services, she should be allowed to do so.

The restrictive language remains in the House bill, and if the Senate passes its version of health care, which it hopes to do before the end of this year, the two chambers would have to find a compromise.

That won't be easy, because discord over abortion nearly derailed the House bill; it survived only after the more restrictive language was added.

Abortion rights advocates have strong allies in the Democratic Party, however, and Senate abortion rights backers were adamant they wouldn't accept the House plan in their legislation.

"I believe we deal with this sensitive topic in a sensitive way," said Sen. Barbara Mikulski, D-Md. "I believe what we have done is found the sensible center, and it leaves the decision in the hands of the patients and doctors, not politicians or insurance companies."

Anti-abortion senators thought the truly sensitive approach was to be more restrictive.

"Most Americans, even some who support abortions, do not want taxpayer money to be used for abortions," said Sen. Ben Nelson, D-Neb., the chief sponsor of the amendment. "We should not break with precedent on this bill."

ON THE WEB

U.S. Conference of Catholic Bishops' letter on abortion

NARAL Pro-Choice America web site

National Right to Life web site

Congressional Budget Office analysis of Senate Democrats' health care bill

Text of Senate Democratic health care bill

Congressional Budget Office analysis of House health bill

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For more McClatchy politics coverage visit Planet Washington

McClatchy Newspapers 2009

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