Two Senate Democrats undecided on health debate

One of the last three uncommitted Democrats, Sen. Ben Nelson of Nebraska, said Friday he would vote to begin debate on the Senate’s health care bill; meanwhile, the Republican opposition opened a new front, arguing that the legislation would lead to health care rationing.

Mr. Nelson said he would support the procedural vote scheduled for Saturday night because he didn’t want to obstruct reform efforts. He also said he hoped to improve the legislation on the floor.

“Throughout my Senate career I have consistently rejected efforts to obstruct,” he said. Saturday’s vote “is only to begin debate and an opportunity to make improvements. If you don’t like a bill, why block your own opportunity to amend it?”

But Sens. Mary L. Landrieu of Louisiana and Blanche Lincoln of Arkansas remained publicly noncommittal on Friday. Mrs. Lincoln said she’s “still reading the bill” to “make sure there is more good than bad.”

It’s likely that both senators would need to vote yes for the health care debate to move forward.

In the meantime, Republican senators on Friday accused Democrats of trying to ration health care in their overhaul plan, seizing on a federal panel’s call this week for fewer cancer screenings for women as a foretaste of cost-saving moves they predicted will become commonplace if the measure passes.

As Democratic leaders rallied support for the first pivotal vote, the U.S. Conference of Catholic Bishops - a group that flexed its lobbying muscle when the House passed its health bill with new abortion-funding restrictions - slammed the Senate Democrats’ version of the bill as “an enormous disappointment.”

“Sadly, the legislative proposal … violates the longstanding federal policy against the use of federal funds for elective abortions and health plans that include such abortions,” the bishops wrote in the letter. “We believe legislation that violates this moral principle is not true health care reform and must be amended to reflect it. If that fails, the current legislation should be opposed.”

Rationing and abortion are just two of the contentious issues that threaten to derail the health care reform legislation - President Obama’s chief legislative priority - as it heads toward debate on the Senate floor. Democratic leaders still don’t have the 60 votes nailed down that are required to start debate, but were cautiously optimistic they’d pick up the last two commitments they needed.

Democrats deny that the bill will ration care and stressed that there are some people who, because of a lack of insurance, don’t have any access to preventive-care screenings.

“Consider what we’re doing here for people who don’t have health insurance,” said Sen. Richard J. Durbin, Illinois Democrat and majority whip. For the uninsured, “this bill is the breakthrough of a lifetime.”

The Senate bill would create a nonprofit “Patient-Centered Outcomes Research Institute” to study the most effective ways to diagnose diseases, use medical drugs and treat injuries or illnesses.

Democrats argue that they merely want to give health providers more research to inform their decisions. The bill says that none of the institute’s findings, called comparative effectiveness research, can be used to mandate or deny treatment or coverage.

But Republicans warn that the process represents a slippery slope. They say similar research, when used in other countries, directs health providers on medical procedures they can use and cannot use, based on cost and research results.

Because no Republicans plan to support the procedural vote on the overhaul bill, Democrats need all 60 of their members - including two independents who caucus with them - to keep the bill alive in Saturday’s vote, putting intense pressure on moderates to vote with the party.

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