Obama heads to Senate to rescue health plan

President Obama is making another visit to Capitol Hill on Sunday afternoon in an attempt to unify Senate Democrats struggling to reach agreement on a proposed public insurance plan in their health care overhaul bill.

Moderate and liberal Democrats have yet to reach an agreement on how to structure their government-run insurance program. It is not clear whether they have the votes to include one at all.

Moderates say the program as it is now in the Senate bill gives government too large a role in health care, but liberals argue the only way to hold insurance companies accountable is to have a powerful government plan.

With Republicans uniformly opposed to the idea, Democrats have to come to a compromise that passes muster with all 60 members of their caucus, which includes two independents.

The discussions have focused on a group of five moderates and five liberals that Majority Leader Harry Reid called together, according to several lawmakers involved. Various compromise proposals and pieces of proposals have been sent to the Congressional Budget Office to get a cost analysis. A leading contender is a series of nonprofit companies to administer health care plans through the Office of Personnel Management, which runs the insurance program for federal employees and is separate from the Department of Health and Human Services.

Closing in on a goal to pass the entire 10-year, nearly $1 trillion legislation by Christmas, the Senate met Saturday to deal with amendments to other portions of the bill.

Republicans continued to hammer their message that the Democrats’ bill would cut critical funding to programs for seniors and the disabled.

A Republican amendment to strip the bill’s $40 billion in cuts to home health care services was voted down 53 to 41, far short of the 60 votes required for passage under a special agreement overruling the traditional 51-vote margin.

Similar Republican amendments to strip Medicare cuts and an in-home care insurance program from the Democrats’ bill were also defeated in recent days.

“These Medicare cuts will impact the quality of care for millions of American seniors,” Minority Leader Mitch McConnell, Kentucky Republican, said on the Senate floor Saturday.

“Nearly 11 million seniors on Medicare Advantage will see a reduction in benefits. Hospice care will see massive cuts. Hospitals that treat Medicare patients will see massive cuts. Nursing homes are cut. And more than $40 billion is cut from home health agencies - agencies that provide an appealing alternative to seniors who would rather receive the care and attention they need in the comfort and privacy of their own homes.”

But it’s the public insurance plan that continues to be one of the most significant sticking points in the bill. Several lawmakers cited improvements on Saturday and higher hopes of coming up with a compromise on the public option this weekend.

“We’re making good progress,” said Sen. Charles E. Schumer, New York Democrat and one of the senators in talks with the moderates and liberals. “It’s a long, hard slog.”

Several Democrats have floated alternatives to the current public option in hopes of finding middle ground in the Democratic caucus, where political ideologies vary from very liberal to conservative.

Sen. Thomas R. Carper, Delaware Democrat, has proposed putting government-run plans in states only where insurance competition is low, similar to a compromise plan floated by Sen. Olympia J. Snowe, Maine Republican. Other ideas include crafting a nonprofit public plan.

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