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Larger Health Hurdles Loom

Bill Clark/Roll Call
Sen. Chris Dodd will play a key role in the coming weeks in Democratic Senate leaders’ difficult task of merging two competing health care reform bills into one that can win the support of a diverse Conference.

Even if Finance finishes its markup by Friday, the merger negotiations would likely not begin until next week at the earliest, given the Senate isn’t in session on Sept. 28 to observe Yom Kippur.

To begin trying to unify Members around a single bill, the Senate Democratic Conference held a closed-door strategy session on Thursday, just before adjourning for the weekend.

In addition to the internal debate over the public insurance option, Democrats are at odds — or at least in mild disagreement — over several issues.

Democratic centrists, particularly concerned about the federal deficit and the overall health care reform price tag, have taken issue with the expensive and expansive HELP bill. Democratic liberals, more focused on expanding coverage to the uninsured and underinsured, don’t believe the Finance legislation goes far enough to provide quality care and access to it.

Harkin cautioned that the bill that comes of the Finance and HELP merger is not guaranteed to be the final Senate product. Harkin said Senators unhappy with the legislation are likely to offer amendments on the floor that could substantially alter what eventually clears the Senate, with further changes possible in a conference committee with the House.

“There’s a lot of steps ahead,” Harkin said.

Given the Republicans’ solid opposition to both the Finance and HELP bills, the Democrats are unlikely to get much help from the other side of the aisle as they try to cobble together 60 votes for health care reform. At this point, the only Republicans whom Democrats may persuade to come on board are Sen. Olympia Snowe (Maine) and possibly Sen. Susan Collins (Maine).

The looming HELP/Finance merger was a concern for the three Republicans who attempted to negotiate a bipartisan Finance bill in the now-defunct gang of six Senators. Finance ranking member Chuck Grassley (R-Iowa), Sen. Mike Enzi (R-Wyo.) and Snowe repeatedly expressed concerns that any deal they might reach with Baucus and Democratic Sens. Jeff Bingaman (N.M.) and Kent Conrad (N.D.) would be nullified in a merger with the more liberal HELP bill.

Republicans often cited the merger as a reason they were reluctant to support any bipartisan bill that might emerge from Finance. Grassley said he could never get a commitment from Obama or the Democratic leadership that any Finance measure would not ultimately be “obliterated” in the marriage.

“That endgame was as important as the product,” Grassley said, “not only to Sen. Snowe, Enzi and me. It was very, very important to a lot of people in our caucus that would have liked to have seen a bill.”

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