Posted on 23 Nov 2009
Political pragmatism began to emerge Sunday after Democrats in the Senate barely won the vote on Saturday night to begin the debate on a sweeping health care bill proposal presented by the blue party.
Some legislators got a head start Sunday, reciting well-honed arguments for and against the bill and offering perspectives on the political realities facing Congress.
Senator Dick Durbin of Illinois, the chamber's second-ranking Democrat, acknowledged he was open to changing the bill's controversial government-run public health insurance option favored by the left.
"We are open because we want to pass the bill," Durbin told the NBC program "Meet the Press."
Senator Jeanne Shaheen, D-New Hampshire, summed up the situation to CNN's "State of the Union" program: "Listen, in the end, this is going to be a compromise. It's not going to be a perfect bill, but it's going to be a very important starting point."
Senator Michael Bennet of Colorado, a Democrat appointed last year to fill the seat vacated when Ken Salazar became interior secretary, told CNN he would support the health care bill even if it meant losing his job in his first election for the seat next year.
Republican opponents continued attacking the bill, calling it an unnecessary takeover of the health care system that would harm, not help, the economy and the American people.
"We do not believe completely restructuring one-sixth of our economy is a good idea at any time," Senate Minority Leader Mitch McConnell, R-Kentucky, told CNN. "It is a particularly bad idea when we're looking at double-digit unemployment."
McConnell and other Republicans call for an incremental approach that they say would reduce the costs of health care without creating new bureaucracy and taxes.
"We think we ought to go step-by-step to improve the system," McConnell said. "The American people are not complaining about the quality of health care. They're complaining about the cost of health care."
Democrats respond that the Republicans are ignoring millions of Americans who can't get health insurance.
Senator Arlen Specter, a Pennsylvania Democrat who was a Republican for most of his long career until changing parties this year, told "Fox News Sunday": "The one option which is not present in my judgment is the option of doing nothing."
"We have the opposition refusing to admit that there's any problem with health care, refusing to admit that there's any problem with global warming, refusing to take a stand on the economic crisis," Specter complained about his former party.
The 60-39 Senate vote Saturday to open debate revealed the partisan divide on the issue, and the fragility of the Democratic support. Democrats needed their entire caucus, including two independents, to muster the 60 votes required in the 100-member chamber to overcome a Republican filibuster. Share your thoughts on health care reform
Now several conservative and moderate Democrats say they won't support a final bill that includes a public insurance option. Republicans unanimously oppose the public option, which means it cannot survive in the chamber without unanimous Democratic support.
"I don't think anybody feels this bill will pass" in its current form, Independent Sen. Joe Lieberman of Connecticut told NBC's "Meet the Press." Lieberman voted to start debate on the bill, but reiterated Sunday he would join a Republican filibuster if the public option remains in the proposal when it comes time to end the debate.
He called the public option a "radical departure" from the government regulation and litigation traditionally used to deal with failed competition in the U.S. market economy.
Other risky issues for Democrats include abortion and tax increases to pay for health care reform. A comic moment occurred when Republican Senator Jon Kyl of Arizona and Democratic Senator Charles Schumer of New York responded simultaneously when asked on the CBS program "Face the Nation" if the Senate bill would raise taxes, Kyl saying "yes" and Schumer saying "no."
The bill includes tax increases aimed at those earning more than $200,000 a year and insurers providing "Cadillac" health plans worth more than $8,500 a year for individuals or $23,000 for families. It also would set a 5 percent tax on elective cosmetic surgery.
In contrast, a separate health care bill that the House of Representatives narrowly passed this month includes an income tax surcharge on individuals earning more than $500,000 a year and couples making more than $1 million.
Republicans say any tax increase is bad in a struggling economy because it hinders growth and gets passed on to consumers. Democrats argue the bill's tax provisions don't hit the lower or middle class and will create incentives for private insurers to lower the cost of policies.
On abortion, the House bill has more restrictive language regarding the use of federal funding, and some Senate Democrats said Sunday they would resist adding it to their chamber's proposal.
"We shouldn't be using health care reform to rewrite long-standing policy from the federal government on abortion," Bennet said on CNN. "It's just not right. It's not the place we should be doing it."
If the Senate manages to pass a bill, a congressional conference committee will then need to merge the House and Senate proposals into a consensus version requiring final approval from each chamber before moving to President Obama's desk to be signed into law.
According to the nonpartisan Congressional Budget Office, the Senate health care bill would extend health coverage to 31 million additional Americans and reduce the federal deficit by about $130 billion over the next 10 years, through 2019. Any effect on the deficit in the following decade would be "subject to substantial uncertainty," but probably would result in "small reductions in federal budget deficits," the CBO report said.
Both the Senate and House bills would require individuals to buy health insurance, with penalties for non-compliance. Unlike the House version, the Senate bill does not mandate that all employers offer health care.
The two bills are virtually identical on a broad range of changes, including creating health insurance exchanges, expanding Medicaid, subsidizing insurance for low- and some middle-income families, and capping out-of-pocket medical expenses, while preventing insurance companies from denying coverage for pre-existing conditions.