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Democrats Inch Closer to Sweeping Health Care Overhaul

December 15, 2009 at 12:00 AM EDT
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President Obama urged Senate Democrats to push forward with health care reform and pass legislation before the year ends. The majority party remains divided over the proposals, disagreeing on key elements such as expanding Medicare and providing a public option.
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BETTY ANN BOWSER: Emerging from an hour-long White House meeting with Senate Democrats, President Obama said they were on the precipice of passing a health care overhaul.

U.S. PRESIDENT BARACK OBAMA: There are still some differences that have to be worked on. This was not a roll call. This was a broad-based discussion about how we move forward.

BETTY ANN BOWSER: The president had summoned members of the entire Democratic Caucus to work out their differences and pass legislation before Christmas.

BARACK OBAMA: Now, let’s be clear. The final bill won’t include everything that everybody wants. No bill can do that. But what I told my former colleagues today is that we simply cannot allow differences over individual elements of this plan to prevent us from meeting our responsibility to solve a longstanding and urgent problem for the American people.

BETTY ANN BOWSER: The meeting followed reports that Democratic leaders may drop a proposal letting uninsured Americans as young as 55 buy into Medicare. That provision was supposed to replace a government-run public insurance option.

Connecticut independent Joe Lieberman threatened to bolt over the Medicare buy-in, leaving Democrats one vote short of the 60 they need. Today, he said he would relent if the provision was indeed dropped.

SEN. JOSEPH LIEBERMAN, I-Conn.: If, as appears to be happening, the — the so-called public option, government-run insurance program is out and the Medicare buy-in, which I thought would jeopardize Medicare, cost taxpayers billions of dollars over the long haul, increase our deficit, is out, and there’s no other attempts to bring things like that in, then I’m — I’m going to be in a position where I can — I can say — I’m getting toward that position where I can say what I have wanted to say all along, that I’m ready to vote for health care reform.

BETTY ANN BOWSER: Liberal senators favor the Medicare buy-in. And, although none would confirm what was agreed to, West Virginia Senator Jay Rockefeller described the feeling in the White House meeting.

SEN. JAY ROCKEFELLER, D-West Va.: There was the frustration and angst. Everybody has things they want. And they didn’t all get what they want. That includes me, big-time.

BETTY ANN BOWSER: Even with Senator Lieberman’s opposition seemingly out of the way, sticking points remain. One is what language should be in the bill about abortion coverage. The other is whether the legislation should completely close the so-called doughnut hole: the Medicare prescription coverage gap.

Throughout it all, Democratic leaders have had to focus on keeping all of their members on board. Republicans said today none of the changes to the legislation would sway them back.

Minority Leader Mitch McConnell:

SEN. MITCH MCCONNELL, R-KY: What we know for sure, no matter what kind of deals are struck behind closed doors, what we know for sure is that this bill will include a half-trillion dollars in Medicare cuts, $400 billion in new taxes, and higher insurance premiums for everyone else. That isn’t going to change.

That is the problem that the American people are fully aware of. The polls are overwhelming. Every single poll that’s been taken, every public poll that I have seen for weeks has shown opposition to it.

BETTY ANN BOWSER: And just outside the Capitol Building today, conservative activists rallied against the health care bill again.

JIM LEHRER: For more on the story now from Naftali Bendavid, congressional correspondent for The Wall Street Journal, and Amy Walter, editor in chief of The Hotline, The National Journal’s political daily.

So, not correct to say there is a deal, right?

NAFTALI BENDAVID: Well, there’s not a deal quite yet, but there’s no question that they’re getting closer. Certainly, dropping the Medicare buy-in provision was huge in terms of attracting people like Joe Lieberman and possibly Olympia Snowe.

And, certainly, Democratic leaders are pushing for this. And they feel that they’re on the cusp of something, that they’re on the verge of getting it done.

JIM LEHRER: Verge, close, Amy?

AMY WALTER, editor in chief, The Hotline: They have to get something done. And the — the thought that this can drag out much longer, I think, for so many of these Democrats in the Senate and quite frankly in the House as well, is more problematic to them than having to give up certain provisions in order to get that so-called 60th vote.

JIM LEHRER: Well, we will get back to Lieberman and the moderates in a moment. But the Democrats, the liberal Democrats, what are they giving up and how unhappy are they about having to do so?

AMY WALTER: Well, Joe Lieberman is definitely part of this story…

JIM LEHRER: Yes.

AMY WALTER: … because they’re very upset at him for various reasons.

But, look, when you saw Jay Rockefeller in that setup piece, here’s somebody who said we — what I would really want to see is something like a Medicare buy-in. What we really wanted to see was something like a public option.

But I think liberals recognize this, and they have recognized this for some time, that getting a bill requires 60 votes. And it requires moderates, who are not fans of a public option. So, I think the question is, how many other things can they get from this to feel good about it? The other piece of this, too, is that, fundamentally, these senators have been waiting and members of Congress for a long time to be able to vote and pass something that they can call health care reform.

They know that this would be historic. They know that, in terms of setting policy for the next how many more years, they’re the ones sitting at the table doing this. I think that is — that desire is stronger than the frustration about losing some of those key elements.

JIM LEHRER: Now, you have been covering the Lieberman story heavily the last several — the last couple of days or so. What — what — what was going on here? Why — why was he — how did he become so important, or was he as important as it’s been portrayed?

NAFTALI BENDAVID: Well, certainly, he’s made himself important. I mean, there are a number of senators, of course, that could be seen as the 60th vote. Really, 60 of them could be seen that way.

But he’s had a way of making these provocative statements, of announcing his opposition to certain things at key times that seem to undermine what Senator Reid is trying to do, just at the moment when he most needs his support.

And the vitriol that he has earned from liberals should not be underestimated. I mean, they really hate the guy.

JIM LEHRER: They really don’t like him, do they?

NAFTALI BENDAVID: They see him as an absolute villain. They have been uncomfortable with him for years. And they see this as sort of the final straw. And some of the attacks on him recently have really been fairly, fairly virulent.

I mean, there’s people that are trying to get his wife, Hadassah, thrown off of a — of a breast cancer group that she’s involved with. It’s personal. And it’s fierce. And it’s angry.

JIM LEHRER: But how — what finally — if they dislike him so much, why did they finally say, OK, you want that, Joe, we will give it to you?

NAFTALI BENDAVID: I mean, I think they have no choice.

You know, they need 60 votes. You need 60 votes in the Senate to do anything. And liberals feel like what they really wanted was a single-payer system. They didn’t get that, so they compromised. They were going to take a public option. Then they didn’t get that. So, they were going to take the Medicare buy-in.

Now they’re being told, sorry, you’re not getting that either. So, they’re very frustrated. They are very unhappy. But I think, ultimately, they feel like they face the choice of having health reform, something they have wanted for decades, or not having it. And if you want it, you have got to give that up.

AMY WALTER: And the reality, too, is that it’s more likely than not — and as we’re seeing a lot of these polls coming out for Senate races coming up in 2010 — that Democrats aren’t going to have 60 votes in 2011. This could be the only time. If it doesn’t get done now…

JIM LEHRER: Now or never. Mm-hmm.

AMY WALTER: … it’s not going to happen.

JIM LEHRER: Well, what about the other moderates besides Lieberman, Ben Nelson, Blanche Lincoln?

AMY WALTER: That’s right.

JIM LEHRER: What — what — where — are they OK now because of this — quote — “deal”?

AMY WALTER: Right. And that’s what we’re all waiting to see.

I mean, it is funny to sort of watch the spotlight move from one, whoever the 60th vote is at that moment, to the next. It was Olympia Snowe. Then it was Ben Nelson for a long time. Blanche Lincoln has been in that spotlight, but she sort of takes herself out of it. She’s not quite as high-profile as some of these others.

I think that is what we’re looking for is Blanche Lincoln from Arkansas, Ben Nelson from Nebraska, still two of the — the big names that everybody is waiting to see. The one who has popped up recently has been Jim Webb from Virginia, simply because he’s been voting with the Republicans on a lot of these amendments.

There’s now some concern that maybe…

NAFTALI BENDAVID: Uh-oh.

AMY WALTER: … he’s not as strong as we thought he could be.

NAFTALI BENDAVID: Uh-oh.

AMY WALTER: And he could be the 60th vote.

JIM LEHRER: Well, when — when the president said, as we had in a clip after the meeting with the Democrats, he said there are still differences, what’s he talking about?

NAFTALI BENDAVID: Well, the biggest difference, I think, by far has to do with abortion language and how tough the restrictions should be on abortion.

Senator Ben Nelson of Nebraska, who we have been talking about, that is a very big issue for him. And with the removal of this public option, it may be the big issue for him. And it’s unclear how that’s going to be resolved. And I think, if they can solve that, then they will really be pretty much there.

There are other issues that have to do with how this is all paid for. There are some controversial taxes and levies that would be involved. But the two big issues were the public option and abortion. They have now taken the public option off the table, more or less, in the Senate, but the question remains how they’re going to deal with the abortion issue.

JIM LEHRER: What do you hear about that, Amy, about what — what kind of deal could be structured on the abortion issue?

AMY WALTER: Well, and Ben Nelson seems to be more…

JIM LEHRER: Lay out what the issue is. First of all, lay out what the issue is.

AMY WALTER: Well, the issue is in the start — and we heard about this originally in the House. It is about the ability for a government program and how it would pay for, or not pay for in this case, abortions. Do women have the choice of being able to essentially pay for their own abortions if they’re getting…

JIM LEHRER: Federal…

AMY WALTER: … federal…

JIM LEHRER: Any kind of — part of a federal funding.

AMY WALTER: Any kind of federal…

JIM LEHRER: Yes.

AMY WALTER: That’s right.

So, the reality of it doesn’t seem as much of the issue as the politics of this, right, which is that what you have seen is big pro-choice groups, like NARAL and Planned Parenthood, taking very strong positions on this, asking their members, those who support them in Congress, to take strong positions, and the right-to-life community also taking strong positions on this.

What — it seems to — it seems to be happening, at least with Nelson — and I think we have been seeing this in the last few days — is, he seems to think, I might not get exactly what I want. There was already a vote on that amendment. It was voted down, but that he had not said that’s the deal-killer for me, that he’s still open to finding some way to do this.

I don’t know how they do this. But…

JIM LEHRER: Yes.

What — what would you add to that?

NAFTALI BENDAVID: I mean, this whole thing is really a gigantic Rubik’s Cube in many ways. You know, if they lose Ben Nelson, maybe they can get Olympia Snowe. There are 60 people…

JIM LEHRER: Because she is pro-choice and would have no problem with this.

NAFTALI BENDAVID: She is pro-choice. She…

JIM LEHRER: She goes on the other issue, yes.

NAFTALI BENDAVID: Right, although she has said that she would support a public option as long as it were something that was only triggered under certain circumstances.

So, there’s myriad issues. There’s 60 senators they have to put together. Some people want something, but not other things. And it’s Harry Reid’s job, this incredibly difficult task, of assembling this puzzle that is going to manage to get 60 people to vote yes on the floor in the next couple weeks. It’s very hard. But, you know, inch by inch, I think they’re getting there.

JIM LEHRER: Amy, is it a given that the only potential for a Republican vote is, in fact, Olympia Snowe?

AMY WALTER: It sure seems that way. Even — it was interesting, Susan — Senator Susan Collins was standing with Joe Lieberman in that Senate piece. But she sure doesn’t sound to be very interested in supporting this. She sounds very reluctant.

And you heard Senator McConnell saying, we have 40 votes against this bill. It’s not happening.

JIM LEHRER: Is it possible or even constructive at this point to look at the possibility of when there could be a final vote?

NAFTALI BENDAVID: Yes.

I think, you know, they clearly have a plan. They have a schedule. Whether they stick to that schedule is — is an open question. But they really feel like they want to have this thing signed by the president by the State of the Union address, which is in late January.

To do that, certain things have to happen at certain times. They need to pass it through the Senate by the end of the year. And, then, of course, there is going to be an agreement between the House and the Senate. They need to pull that off. And then the two Houses have to vote again in January. So, that’s the schedule.

It’s very important to them to stick to that. They want the president to be able to get up at his State of the Union and say: We promised change.

JIM LEHRER: Here I am.

NAFTALI BENDAVID: Here it is. I have delivered it. I have done something that no president has done for a century.

And the other reasons it’s important to them, they want to start talking about jobs and the economy. And as long as they’re talking about health care, they’re talking a lot less by jobs.

After January, they feel like they need to turn to jobs as soon as they can. So, the schedule is very important to them. And that’s why they’re pushing so hard right now.

AMY WALTER: That’s exactly right.

JIM LEHRER: You agree?

AMY WALTER: Yes, absolutely.

JIM LEHRER: OK. Thank you both very much.

AMY WALTER: Thanks.

NAFTALI BENDAVID: Thanks.