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On Eve of State of the Union, Democrats’ Next Move on Health Reform Unclear

The State of the Union address was supposed to be a moment of triumph for President Obama: to stand before the American people and talk about passage of a sweeping overhaul of the nation’s health care system — one that would bring near universal coverage and slow spiraling health care costs.

But last week’s election of Republican Scott Brown to the late Sen. Ted Kennedy’s Massachusetts Senate seat has thrown ice water on that prospect, taking away Democrats’ filibuster-proof Senate supermajority and derailing the bill’s political momentum.

The White House says that in spite of that, the president remains firm in his resolve to pass health care reform this year and will talk about it in his State of the Union address Wednesday night. President Obama told ABC’s Diane Sawyer on Monday that part of the problem with passing legislation was the “confusing way in which the health bill was shaped.”

“The health care debate as it unfolded legitimately raised concerns not just among my opponents but also amongst supporters that we just don’t know what’s going on,” he said. “Now I think it’s my responsibility and I’ll be speaking to this at the State of the Union, to own up to the fact that the process didn’t run the way I ideally would like it to and that we have to move forward in a way that recaptures that sense of opening things up more.”

But as the president gets ready to deliver the address, it’s still not clear how that moving forward will occur. Democratic leaders are once again behind closed doors on Capitol Hill trying to figure out what to do, but said Tuesday that they don’t expect to reach a decision by the State of the Union address.

“Both the majority leader and the speaker need time to talk with their members,” said Sen. Dick Durbin, D-Ill., according to Politico.

One proposal on the table is to pass the Senate bill as it through the House, along with a package of fixes designed to appeal to more liberal members of the House. The Senate could then pass those fixes through a procedure known as reconciliation that requires only 51 votes.

But one problem with this method is that only changes that involve taxes and government spending would are allowed to pass under reconciliation, so a number of contentious issues like abortion might not be able to be included.

And conservative and moderate Senate Democrats such as Blanche Lincoln of Arkansas, Ben Nelson of Nebraska and Evan Bayh of Indiana on Tuesday all signaled their opposition to the idea.

Another idea under discussion is to start over with a new, stripped-down bill that would contain many of the insurance reforms popular with Americans, like outlawing the practice of denying coverage because of pre-existing conditions, and stopping insurance companies from dropping people’s coverage when they get sick. The problem with that is that the insurance companies agreed to those two stipulations when a universal mandate for coverage was in play. Under many scenarios now being considered the individual mandate for coverage is no longer an option.

House Majority Leader Steny Hoyer summed up the situation in a National Press club appearance Tuesday, outlining all of the options the Democrats’ have before them and saying all had “pluses and minuses.”

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