Democrats look to navigate tougher path to health reform

Stung by the loss of a Senate supermajority, President Obama and Democratic leaders in Congress searched for a way to salvage the health care overhaul, looking toward scaling down the bill or passing part of it through a complicated procedural process that can't be filibustered.

Senate Majority Leader Harry Reid of Nevada said he didn't know how Democrats would proceed but, echoing Mr. Obama, ruled out ramming the measure through the chamber before seating Sen.-elect Scott Brown of Massachusetts, whose surprise victory on Tuesday sent shock waves across Capitol Hill and provided Republicans newfound leverage in Congress.

Mr. Obama insisted that health care reform isn't dead, despite rumblings from a handful of Democrats on Capitol Hill anxious about the anger among Massachusetts' typically solid-blue voters.

"We know that we need insurance reform, that the health insurance companies are taking advantage of people," the president said in an interview with ABC News. "We know that we have to have some form of cost containment, because if we don't, then our budgets are going to blow up. And we know that small businesses are going to need help."

Republicans said Mr. Brown's victory, after his pledge to vote against the health care bill, was a sign that Democrats should stop.

"I think we heard a large and resounding message yesterday in one of the most, if not arguably the most, liberal state in the America," said Senate Minority Leader Mitch McConnell of Kentucky.

When asked whether he thought Mr. Brown's election would kill health care reform, he said, "I sure hope so."

In Boston, Mr. Brown said voters sent a "very powerful message" against the backroom wheeling and dealing driven by special interests on Capitol Hill.

"Game's over. Let's get to work," said Mr. Brown, who will be in Washington on Thursday.

On Capitol Hill, Democratic leaders in both chambers weighed their options.

"There are many different things that we can do to move forward on health care, but we're not making any of those decisions now," Mr. Reid told reporters.

Several Democratic senators suggested that House Democrats swallow hard and accept the Senate's bill as it is, eliminating the need for another vote in the Senate. But many, including Sen. Benjamin L. Cardin of Maryland, warned, "It's not easy to tell the House to take the Senate bill without changes."

House Democrats want to remove a provision by Sen. Ben Nelson of Nebraska that would have spared his state the costs of expanding Medicaid.

Sen. Olympia J. Snowe, a Maine Republican who has been in regular contact with Mr. Obama, roundly criticized the Democrats' pressure to pass their bill, but she would not rule out voting for reform legislation.

"I never say anything is dead, but clearly, I think they have to revisit the entire issue," Mrs. Snowe said.

House Democratic leaders spent the day in meetings with rank-and-file members who have different ideas on how to proceed: They could try to scale down the bill that has passed both chambers in pursuit of at least one Republican vote in the Senate to push them over the 60-seat threshold required to overcome a filibuster. They could either reduce the size of the entire bill or break it up to enact the most popular provisions, such as insurance industry reforms. Or a new bill could emerge, said House Majority Leader Steny H. Hoyer, Maryland Democrat.

Details of the scaled-down plan were still evolving Wednesday, but it likely would include a ban on denial of coverage for pre-existing conditions, Medicare reforms, some Medicaid expansion and tax credits to help small businesses buy insurance coverage.

Another option that some liberal House Democrats support is to pass the Senate's legislation as it is and immediately pass another bill to remove any provisions with which they disagree, such as the federal funding for Nebraska's Medicaid expansion. Senate Democrats could push that bill through their chamber by way of reconciliation, a complicated procedural tool typically saved for budget measures and needing only 51 votes.

White House officials said they were still focused on health care reform and dismissed the suggestion that Mr. Brown's victory was a referendum on the bill. They argued that voter anger is a product of policies that preceded this administration.

"It was a priority then; it's a priority now," White House spokesman Robert Gibbs told reporters Wednesday. "We are working through the best way forward, as the president continues his commitment to get health care reform done."

Mr. Obama appeared to suggest that he would be willing to accept the stripped-down version.

"I would advise that we try to move quickly to coalesce around those elements of the package that people agree on," he told ABC News' George Stephanopoulos without being specific. "After all this work and all this pain, there should be a way of taking what's best in both [House and Senate] bills and going ahead and getting that done."

• Joseph Curl contributed to this article, which is based in part on wire service reports.

About the Author

Jennifer Haberkorn

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Kara Rowland

Kara Rowland, White House reporter for The Washington Times, is a D.C.-area native. She graduated from the University of Virginia, where she studied American government and spent nearly all her waking hours working as managing editor of the Cavalier Daily, UVa.’s student newspaper.

Her interest in political reporting was piqued by an internship at Roll Call the summer before her ...

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