Senate, administration begin healthcare endgame as Dem leaders express unity

The three Democratic senators charged with finding a final healthcare bill met with senior advisers from the White House on Wednesday as leaders expressed unity on an issue that has divided the party.

The group will have to meld a centrist, deficit-reducing healthcare bill that leaves liberals cold with a left-leaning measure that causes anxiety among more conservative Democrats.

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The obstacles were clearly visible on the day of the first official meeting.

Senate Majority Leader Harry Reid (D-Nev.), Finance Committee Chairman Max Baucus (D-Mont.) and Sen. Chris Dodd (D-Conn.), representing the Health, Education, Labor and Pensions (HELP) Committee, met behind closed doors with White House Chief of Staff Rahm Emanuel and several of President Barack Obama’s closest advisers.

It was the first of many such meetings that Democrats hope will culminate in a bill that will unite the party and retain the support of their lone Republican ally, Sen. Olympia Snowe (Maine).

The senators beamed with optimism before the meeting.

“We’re united. We’re all together,” Baucus said. “There may be some minor differences, but those all pale in comparison to how strongly we are working together, Sen. Dodd, myself, Sen. Reid and the White House, listening to all senators to get a good, solid bill that gets 60 votes.”

The three senators met Wednesday with Emanuel, Health and Human Services Secretary Kathleen Sebelius, Office of Health Reform Director Nancy-Ann DeParle, Office of Management and Budget Director Peter Orszag, Director of Legislative Affairs Phil Schiliro and White House-Senate liaison Shawn Maher.

“We identified the issues we wanted to work on,” Emanuel said after the hourlong meeting. “We clearly have the momentum and we’re going to keep pushing until we get it done.”

Reid underscored the importance of passing legislation, no matter if everyone agrees.

“Neither I nor any other senator has the luxury of passing a perfect bill — I wish we could — that conforms exactly to his or her beliefs. But we must act and we will act to pass a bill,” Reid said.

Reid downplayed the difficulties, saying “this is what we were elected to do.” With the help of the White House, they will get it done, he said.

“We’re going to work through the process. All four of us are legislators,” Reid said, including former Rep. Emanuel (D-Ill.). “All four of us understand that legislation is the art of the compromise and consensus.

Even with assistance from the White House — and the president himself — the three senators are going to have to mostly work it out themselves, Dodd said.

“Ultimately, we’ve got to come to the floor and convince our colleagues,” he said. “The White House is obviously critical in that but primarily, it’s [up to] us to fashion a proposal that will win this 60 votes that we need.”

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At the top of the list of unsolved problems is whether to create a government-run insurance option.

“I believe in the public option — remember, I said I do,” Reid said, adding the emphasis to make clear he was not speaking for his caucus. “There are many competing views on how best to reform healthcare within my caucus,” he said.

When asked, Reid declined even to define what a public option is, leaving the door wide open to compromises that could rankle liberals. At the same time, Snowe and a handful of Democrats are adamantly opposed to the “robust” nationwide public option the left demands.

“I’m not going to negotiate the plan to the leadership bill with all of you,” Reid said to reporters.

Liberals want the public option to be a national program available to everyone right away. Snowe has proposed setting up a “trigger” that would apply in states where insurers do not meet coverage and affordability standards. Others, such as Sen. Tom Carper (D-Del.), have floated ideas such as establishing a public option but letting states opt in or out of  the program.

Speaking of Carper’s proposal, Baucus said, “That’s very interesting. It might be a way to thread the needle, but it’s got to be thought through.”

Speaker Nancy Pelosi (D-Calif.) has been confronting the same dynamic since three House committees completed their bills in July. Pelosi told a group of members Wednesday she plans to advance a more liberal bill while reassuring centrists that the legislation will tilt in their direction when combined with the Senate’s bill in conference, people in that meeting told The Hill.

Among the supporters of the healthcare reform bills, both sides made their views plain on the public option.

Sen. Charles Schumer (D-N.Y.), appearing on MSNBC Tuesday night, said that Reid holds the power to put the public option in the bill that reaches the floor and force opponents to take it out.

Asked about Schumer’s position, Reid quipped, “He’d rather say anything so it wasn’t up to him.”

Meanwhile, Snowe reiterated that she would oppose any bill with a full public option.

“I’m against a public option because I think the government would be another vast new bureaucracy, and also create a disproportionate advantage in the marketplace,” she said on MSNBC Wednesday.

Going with a full-scale public option would complicate the White House and Senate Democratic leadership’s efforts to win over centrist Democrats and all but end the chances of picking up additional Republican support.

Democrats are feverishly seeking Maine’s other Republican senator, Susan Collins, who issued a statement Wednesday expressing openness to the reform bills but containing criticisms of many components. Though Collins did not mention the public option in her statement, she has previously stated her opposition — and her skepticism about Snowe’s trigger.

Mike Soraghan, Eric Zimmermann and Jordan Fabian contributed to this article.