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President Barack Obamas State of the Union Address on Wednesday may give him his last, best chance to reboot his health care agenda in the minds of the public and regain momentum shattered by the loss of the Senate Democrats 60-seat supermajority.
House and Senate Democratic leaders have been talking behind the scenes about possible ways to revive their legislation but still dont have a plan a week after Republican Scott Brown rocked their world by winning the Massachusetts Senate special election, aides said.
Discussions are ongoing and options are being examined on the best way to ensure health care is available and affordable for all Americans and that insurance companies are held accountable, but no final decisions have been made, said Nadeam Elshami, spokesman for Speaker Nancy Pelosi (D-Calif.).
Obamas speech isnt expected to resolve every detail, but it could serve as an opportunity to smooth over the intraparty warring that has taken place since the Massachusetts election and make more clear whether he will still push hard for a comprehensive health care bill or dramatically scale back his ambitions, aides said.
Senators and the White House still seem to be clinging to hopes that the House will at some point agree to pass the $871 billion Senate health care bill quickly, despite Pelosis contention last week that she doesnt have the votes to do so. The challenges for the Senate bill are enormous; there is widespread disgust in the House for the special deals cut for Nebraska and other states, unions and rank-and-file Members oppose the excise tax it contains on high-cost Cadillac health plans, and a band of abortion-rights opponents led by Rep. Bart Stupak (D-Mich.) vow to oppose it. Indeed, the Houses opposition to the Cadillac tax seems to have solidified since last Tuesdays vote in Massachusetts, potentially making moot a compromise deal that unions had cut with the White House shortly before Browns victory.
Pelosi and Senate Majority Leader Harry Reid (D-Nev.) have been exploring the use of a reconciliation bill to amend the Senate bill, requiring just 51 votes in the Senate. But that requires precious additional time and likely could not be used to resolve the abortion issue.
One senior Senate Democratic aide said the Senate is basically waiting for the House to realize that passing that chambers bill is only way to ensure that sweeping insurance reforms become law. The aide added that Senate Democratic leaders are prepared to promise passage of a package of fixes to appease House concerns, most likely through reconciliation, but that it would be unlikely to happen until after the House took action on the Senate bill.
But House liberals have vowed that they will not vote for the Senate bill without changes in hand, and some have even floated the idea of adding back in a public insurance option via reconciliation to help fire up the dispirited Democratic base and to save tens of billions for taxpayers.