Dan Balz's Take
Senate Dems Look to Obama to Move Health-Care Votes
By Dan Balz
For many months, advocates of health care reform have implored President Obama to outline in greater detail the provisions he's prepared to push and defend. So far he has largely resisted, offering broad principles but still leaving the details to Congress. But the time of hanging back is quickly coming to an end if he hopes to find the 60 votes needed to pass a bill in the Senate.
Tuesday's votes in the Senate Finance Committee against the public health insurance option -- which saw five and then three Democrats vote no -- moved the health care debate to a new point, though one long anticipated.
With all Republican and a number of centrist Democrats, including Finance Committee Chairman Max Baucus, opposed to the public option, it has been clear for some time that it would not survive debate in the committee. The option now faces potentially insurmountable odds in the whole Senate, though proponents vowed to keep pushing for it.
Obama supported the public option, but has strongly signaled his willingness to allow it to die if that is the price of winning broader support for overhauling the health care system. He will soon have to choose between those Democrats who favor it, including many of his most passionate supporters from last year's election, and those who oppose it, many of whom come from states or districts won last year by Sen. John McCain. And he will have to persuade the losing side to stick with him, regardless.
Sen. Tom Harkin (D-Iowa), the new chairman of the Senate Health, Education, Labor and Pensions Committee, dismissed the Finance Committee vote on the public option, saying "a vast majority" of Democrats senators favor the public option and that he expects the president to continue to support it.
The public option, as Obama has said repeatedly, is only one aspect of the health care battle. There will be more for the president to adjudicate once Senate Majority Leader Harry Reid (D-Nev.) begins the process of trying to meld together the Finance Committee bill with a more liberal version approved earlier by the Senate Health, Education, Labor and Pensions Committee. That will start once Finance finishes its work, with the committee likely to complete action on a bill by the end of this week.
The votes Tuesday on the public option were the most dramatic decisions during the long month of September, though much else has happened since lawmakers returned to prepare for the final chapters of the long debate. Preliminary work has begun behind the scenes, partly of a procedural nature but also including assessments of whose votes may be most difficult to get and what it may take to get them.
The story of August was all about angry town halls and eroding support for the president's top domestic initiative. September eventually may be seen as a month in which the erosion stopped, public opinion began to tick back in the other direction, however imperceptibly, and the White House and congressional leaders began to set the table for eventual passage of the bill.
The month of September also helped to crystallize some of the decisions senators will face. In August, much of the opposition to the bill focused on the cost of reform and the injection of more government into the health care system. But what Democrats also learned then and in September is that there are considerable concerns among middle and lower-middle class Americans about whether they'll be able to afford insurance, even in a newly revamped system.
Much now will depend on the president's leadership. October could be all about Obama and whether he and his White House team can find the solutions to remaining issues of cost, affordability financing and coverage necessary to assemble the votes to pass a health-care bill in the Senate and move it to a conference committee with the House for a final resolution.
White House officials and Senate leaders are frank in their assessment that, at this point, they don't have the 60 votes necessary to stave off a Republican filibuster. Sen. Charles Schumer (D-N.Y.), the sponsor of one of the public option amendments that was defeated Tuesday -- the other was submitted by Sen. John D. Rockefeller IV (D-W.V.) -- acknowledged that reality during the committee's deliberations.
Publicly, the health-care debate has been marking time as the Finance Committee deliberates. House leaders have awaited the decisions of the Finance Committee before plunging ahead with the process of putting together various committee bills that will then go to the floor, though Speaker Nancy Pelosi (D-Calif.) has long insisted the public option must be included in the House bill.
Reid will be at the center of the deliberations in the Senate. He will create, in essence, a mini-conference committee inside that chamber, comprising members of the two committees, White House officials and his own team. Under Reid's leadership, these groups have been meeting to ascertain common areas of agreement between the competing Senate bills -- in essence clearing away the underbrush to prepare for the big debates.
While there has been an assumption on the part of some analysts that the Finance Committee bill would form the basis for a Senate bill, there are a few Democrats who argue that, because neither bill can attract 60 votes, both will have to give ground on some key issues.
Although this will be a discussion mostly among divided Democrats, Sen. Olympia Snowe (R-Maine) will play a pivotal role in the outcome. Her support for the bill remains crucial, if only for providing a patina of bipartisanship for centrist Democrats.
Democrats believe there is room for further negotiation with her in part because the Finance Committee bill did not include some provisions she favors. One Senate staffer said that Democrats like some of the elements of that wish list more than did Snowe's Republican colleagues on the Finance Committee.
Beyond Snowe, there are seven or eight centrist Democrats whose support is still not certain. The White House has been wooing these Democrats, but also will have to mollify liberals if the public option is jettisoned.
Reid has made clear he is looking for considerable help from the president as the Senate begins the next phase of the process. If they can't get 60 votes, they will have to follow the route of reconciliation, which would require just 51 votes for passage.
But it's doubtful some of the insurance reforms championed by the Democrats (and some Republicans), such as prohibiting insurance companies from denying coverage for preexisting conditions, can be included in a reconciliation package. That is why 60 remains the goal, one way or another.
What the month of September has shown is that there remains a commitment among Democrats to pass a bill. But Obama and his party still have a difficult road ahead. No one yet has the formula that will attract the necessary votes. Senators are looking to Obama to help make it happen.
Posted at 5:36 PM ET on Sep 29, 2009
Dan Balz's Take
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