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Consensus on Health Elusive

Tom Williams/Roll Call
Finance Chairman Max Baucus (top) is trying to craft a bipartisan health care package, but the effort is proving increasingly difficult.

Senators conceded Tuesday that it appears increasingly unlikely that Congress will reach a bipartisan consensus on health care reform this year, with a rift growing over whether to include a government-run insurance option in the legislation.

Senate Democrats, charging that Republicans are unwilling to compromise, are sending strong signals that they have no intention of settling for weak reforms just to achieve bipartisanship. Democratic leaders now appear to be considering a repeat of the final negotiations over President Barack Obama’s $787 billion stimulus package, which curried favor with just three GOP Senators.

“I really believe that we ought to pick a handful of Republicans who really are interested in health care reform, and sit down and find out what it will take,” Senate Majority Whip Dick Durbin (D-Ill.) told reporters. “This reminds me of the stimulus bill. ... I think there’s a similar opportunity here.”

“I’m listening to these speeches on the floor,” Durbin added. “And I’m not sure if many [Republicans] are willing to step out and make suggestions that are realistic.”

Republicans are equally pessimistic, both because of the state of the negotiations and because they believe Obama isn’t interested in their input. Republicans were similarly critical of Obama during the negotiations over his stimulus package, saying that while he talked a good game on bipartisanship, he included few GOP ideas.

Obama and his aides continue to insist that the president wants a bipartisan bill. But despite his rhetoric and efforts by Finance Chairman Max Baucus (D-Mont.) to fashion a compromise, Republicans remain unswayed.

Beyond their view of Obama, the GOP’s lack of confidence is based on a process that calls for the Finance bill — however substantively bipartisan it might be in committee — to be merged with a decidedly liberal bill being marked up in the Senate Health, Education, Labor and Pensions Committee. GOP Senators fear that the the final measure or whatever comes out of the final House-Senate conference committee report will be too liberal to support.

The Democrats “are trying to ram one of the most important bills in the history of the country through in weeks. It took us two years to do the [SCHIP] bill, and some thought that was too quick,” said Sen. Orrin Hatch (R-Utah), who sits on HELP and Finance. Hatch worked with HELP Chairman Edward Kennedy (D-Mass.) to draft the original State Children’s Health Insurance Program bill to provide health care to children back in the 1990s.

“They’ll probably try and push some cockamamie bill through on reconciliation,” Hatch charged, referring to the procedural tool that would allow Democrats to pass health care with 51 votes, rather than 60.

Sen. John McCain (R-Ariz.) acknowledged that Obama is on record as wanting a bipartisan bill — the president has met with Finance ranking member Chuck Grassley (R-Iowa) and HELP ranking member Mike Enzi (R-Wyo.). But McCain, who has been complimentary of Obama on some issues, is displeased with his handling of health care.

“Nothing so far in his approach to the legislation has indicated that” Obama wants a consensus bill, McCain said. “There’s been no bipartisan negotiations, there’s been no sit-down with people for serious negotiations.”

Democratic leaders in the House and Senate, to comply with Obama’s demand that a health care reform bill reach his desk no later than Oct. 15, have targeted the beginning of August recess to clear bills out of their respective chambers. Senate Democrats are leaving open the option of using the budget reconciliation tool to pass health care with a simple majority should resistance make it impossible to achieve the filibuster-proof, 60-vote consensus.

The fundamental disagreement impeding bipartisanship, even as both sides continue to butt heads on the cost of health care reform and how to pay for it as well as the role employers will play, centers on a proposal to implement a government-run insurance option as a part of the overhaul. The Democrats generally favor the creation of a robust, Medicare-like public plan to compete with private insurers; the Republicans are almost unanimous in their opposition.

The HELP Committee’s bill will include a proposal for a public plan option, although language had yet to be made public at press time Tuesday. The Finance Committee, set to begin marking up its bill after the July Fourth recess, is hoping to craft a compromise built around Senate Budget Chairman Kent Conrad’s (D-N.D.) proposal for medical cooperatives.

But ultimately, the government-run insurance option is likely to win out because it is what most Congressional leaders, rank-and-file Democrats and Obama want. Should that be the case, most House and Senate Republicans will oppose the bill.

“To truly reform our health care system, Congress must pass legislation that includes a public option. And a fig-leaf public option is no plan at all. I will not support such a fig leaf,” Senate Democratic Conference Vice Chairman Charles Schumer (N.Y.), who sits on Finance, said Tuesday in remarks delivered on the floor. “We can only bend so much to try to win over the opponents of health care reform. We cannot bend so far that we break.”

Added Sen. Barbara Mikulski (D-Md.), a HELP member: “I will not forsake my principles.”

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