With tentative deal, hopes grow for health care overhaul

McClatchy NewspapersDecember 9, 2009 

WASHINGTON — Hopes grew Wednesday for Senate passage of a historic restructuring of the nation's health insurance system, as key lawmakers praised and President Barack Obama endorsed a tentative deal to get the stalled bill moving.

Obama said in no uncertain terms that he supported the still-murky proposal that Senate Democratic negotiators crafted Tuesday night, "especially since it's aimed at increasing choice and competition and lowering cost."

No details were being released, but the deal appeared to solve one problem that's stymied progress: a split over whether to create a government-run health care plan, or public option. Under the compromise, such a plan would be a backup, used only if insurers failed to meet certain standards. Instead, Medicare would expand and the federal government would oversee a new national, privately run insurance system.

Sen. Joseph Lieberman, a Connecticut independent who'd threatened to try to kill any plan that had a public option component, said he was encouraged by the latest news.

Sens. Mary Landrieu, D-La., and Blanche Lincoln, D-Ark., also potential swing votes, expressed sympathy for aspects of the compromise while stopping short of an endorsement, pending a cost assessment by the Congressional Budget Office.

Clearly, however, said John Fortier, a research fellow at Washington's American Enterprise Institute, a center-right research group, "the ball's moving forward."

The fate of the agreement rests with the nonpartisan CBO, whose report on its potential costs is expected in a few days.

"We certainly will await that, as well," White House Press Secretary Robert Gibbs said, indicating that even administration officials weren't sure precisely what the compromise would look like.

This much was apparent: A new government-run plan to compete with private insurers, an idea long sought by liberals and the White House, was barely alive.

Instead, the federal Office of Personnel Management would oversee national insurance plans. Medicare, the government insurer of people older than 65 and some others with disabilities, would be expanded so that certain 55- to 64-year-olds could sign on for coverage.

As Gibbs described the White House's general understanding of the Senate's vision, U.S. consumers could purchase the private plans through a federally managed menu. It would be akin to how U.S. government employees choose their insurance coverage.

Landrieu said the 10 moderates and liberals who'd engaged in days of private talks on a compromise thought the new Medicare plan was "a good idea."

Lincoln said the government-supervised insurance idea "takes the best of both worlds. The government creates an environment where private industry can operate, but creates an environment in a way where the private industry is creating a product that meets the needs of the consumer."

At the same time, Lincoln cautioned, "There are a lot of things on the table, still."

Obama praised the Senate for making "critical progress last night with a creative new framework that I believe will help pave the way for final passage and a historic achievement on behalf of the American people."

Opponents on both ends of the spectrum pushed back.

"If the health care bill doesn't include a public option, it'll be a huge giveaway to the insurance companies," MoveOn.org, a liberal group, said in an e-mail to its members.

Rick Scott of Conservatives for Patients' Rights called the deal an "OPM plan," or "government-run health care with other people's money."

The House of Representatives' health care overhaul bill still includes a public option. If the Senate went ahead without one, that difference would need to be hammered out before any health overhaul could be sent to Obama to become law.

Many insurance and medical interests had concerns about Medicare expansion. "Any Medicare buy-in would invariably lead to (crowding) out of the private health-insurance market," the Federation of American Hospitals warned.

At the American Medical Association, President J. James Rohack, a physician, reiterated the group's long-standing opposition to expanding Medicare, "given the fiscal projections for the future."

The key to passing anything in the Senate rests with a handful of Democratic moderates. The party controls 60 of the 100 Senate seats, and 60 votes are needed to cut off debate, so any defection could doom the bill.

The latest plan offered the leaders new hope that moderates would go along, and that perhaps they'd be able to win over two Republican centrists, Maine Sens. Olympia Snowe and Susan Collins.

Leaders are hoping for a final vote on the $848 billion, 10-year plan before Christmas. On Wednesday they spent their 10th day of debate considering a provision to allow the importation of drugs from Canada and other nations. Pharmaceutical industry interests have been opposed, and the federal Food and Drug Administration has raised concerns.


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


Senate Democrats reach tentative deal on public option

Health bills would raise taxes well before changes roll out

Senate health care bill about to enter a political minefield

Reid includes public option in latest health care bill

For more McClatchy politics coverage visit Planet Washington

McClatchy Newspapers 2009

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