- The Washington Times - Saturday, November 21, 2009


Senate leaders rallied jittery moderate Democrats to vote Saturday for moving the health care overhaul to a full floor debate, setting up weeks of skirmishes over touchy subjects — ranging from abortion to access for illegal immigrants — and its hefty price tag that challenge the fate of President Obama’s ambitious goal.

The three Democratic senators who helped the measure clear a significant procedural hurdle in a tight vote Saturday night made clear that their support didn’t ensure their backing of the landmark measure in the future.

One of the biggest obstacles for Democratic leaders eager to push the bill forward is a government-run public insurance plan — a provision that liberal Democrats say is essential but one that many moderates are reluctant to accept.

Sen. Blanche Lincoln, who waited until Saturday afternoon to disclose her yes vote, said she wouldn’t help move the bill past the next stage of debate if a public option remains part of the legislation.

“Rather than create an entirely new government-run health care plan to compete with private insurers, I support health insurance reform that focuses on changing the rules of our existing employer-based private health insurance system,” the Arkansas Democrat said. “We should change the current rules that permit insurance companies to bully their customers and cherry pick healthy patients, so we can force them to compete with each other.”

Sen. Joseph I. Lieberman, a Connecticut independent who voted to move the bill forward, also has threatened to block the bill if it includes a public option.

“This (public option provision) is kind of an eleventh-hour addition to a debate that’s gone on for decades,” said Mr. Lieberman moments after the vote. “I really think part of the reason why it’s in there is to offer something to people who really want a single-payer system — a totally government-run system. But I think that would be a terrible idea for our country.”

Senate Majority Leader Harry Reid, Nevada Democrat, assured moderates in his caucus that he will allow an amendment to remove the controversial public insurance plan to get a vote on the Senate floor. The Senate’s 58 Democrats and two independents who caucus with them all voted “yes” to support the procedural measure, which needed 60 votes to pass. All of the 39 Republicans present for the vote rejected the meaure. Sen. George V. Voinovich was the lone no-show in the 100-member body.

The rare weekend roll call was the first of at least two procedural votes that will require support from 60 lawmakers. Republicans have promised to oppose the bill unless there are significant changes made, meaning Democrats don’t have any room for rebellion.

Republican leaders had tried to put additional pressure on the vote — normally just a procedural measure — by arguing that the legislation is far too flawed to even try to repair through floor amendments.

Sen. Lamar Alexander, Tennessee Republican, said the Democrats’ bill was “scaring the daylights out of Americans.”

“This bill is historic in its arrogance arrogance that we in Congress are wise enough to take this complex health system that is 16 percent of our economy and serves 300 million Americans and think we can write a 2,000-page bill and change it all — all at once,” he said.

But Senate Majority Leader Harry Reid, Nevada Democrat, chided the Republicans for their unwillingness to continue debate on the measure.

“I say to my Republican senators, don’t try to silence a great debate over a great crisis,” said Mr. Reid on the Senate floor moments before the vote. “Don’t let history show that when given the chance to debate and defend your position to work with us for the good of the country and constituents, you ran and hid.”

With the measure’s first hurdle clearned, the debate now turns to amendments and maintaining support from 60 members to pass the bill. But numerous issues have potential to muddy the path. Costs, deficit impact, rationing of health care, the government’s role in health decisions, abortion and immigration are all likely to be debated in the coming weeks.

The bill, which was released Wednesday, is pegged to cost $849 billion bill over 10 years. Democrats say it would cut the federal deficit by $127 billion over a decade and extend coverage to 94 percent of all Americans.

Republicans have disputed the price tag, saying the true cost would be $2.5 trillion.

“The American people are scratching their heads — they thought the idea behind all of this was to try to lower costs,” said Senate Minority Leader Mitch McConnell, Kentucky Republican. “Perversely, what we’re doing is the opposite.”

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

The measure 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.

The U.S. Conference of Catholic Bishops — a group that flexed its lobbying muscle to help insert abortion restrictions in the House health bill — told senators Friday their bill allows taxpayer funding of abortion. The bishops urged senators to change the language or they would oppose it.

Republicans also argued that the bill’s proposed cuts to waste in the Medicare program — about $500 billion — will impact seniors’ care.

They also oppose a series of new taxes in the bill, arguing that they will end up raising insurance premiums and hitting the middle class President Obama pledged to protect.

Sen. Mary L. Landrieu of Louisiana, who like Mrs. Lincoln broke her silence Saturday that she would support the action, warned that her vote “should in no way be construed by supporters of this (bill’s) current framework as an indication of how I might vote as this debate comes to an end.”

“I have decided that there are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done before I can support this effort,” Mrs. Landrieu said.

Democratic architects of the bill inserted a provision that would send $100 million to Louisiana to help it cover costs for Medicaid — a move that Republicans mockingly called the “Louisiana Purchase.”

Sen. Ben Nelson of Nebraska, a key moderate Democrat who announced on Friday that he would support Saturday’s vote, said the bill must change significantly it’s to survive.

“Nuance won’t be enough,” said Mr. Nelson, who also is wary of the public option provision. “My hope is the kinds of things I’ve laid out will be changed to my satisfaction and that others will have some improvements that I can accept.”

Mrs. Lincoln’s yes vote could come at a price. She faces a tough re-election battle next year, and a recent poll shows she would lose if she supported the health care bill.

But the Arkansas Democrat said that a majority of Arkansans want “health care solutions not stalemate,” and vowed not to be swayed by special interest groups.

“These outside groups seem to think this is all about my re-election. They do not know me very well,” she said. “Despite claims to the contrary, I am focused on reforms that will benefit Arkansans, not insurance companies, the health care industry, or my political party.”

• Sean Lengell can be reached at slengell@washingtontimes.com.

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