Two issues threaten to divide Senate Dems on healthcare reform

Two issues threaten to divide Senate Democrats as they struggle with the higher-profile question of whether to create a government-run health insurance plan.

Amendments that would forbid taxpayer-funded abortions and allow the importation of cheaper prescription drugs are complicating Majority Leader Harry Reid’s (D-Nev.) efforts to gather the 60 votes he needs to advance the bill.

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Sen. Ben Nelson (D-Neb.) introduced an amendment Monday to strengthen the prohibitions against federal funding of abortions in the healthcare reform bill.

“As written, the Senate healthcare bill allows taxpayer dollars, directly and indirectly, to pay for insurance plans that cover abortion,” Nelson said.

The amendment is scheduled to be voted on Tuesday.

Not only is abortion a perennially explosive political issue, Nelson — who does not appear to have the votes to prevail — has threatened to join a Republican filibuster of the whole bill if he does not get his way. Because Reid needs to hold his entire 60-member Democratic caucus together, a defection by Nelson would force Reid to seek at least one GOP supporter.

Nelson’s amendment is co-sponsored by Sen. Orrin Hatch (R-Utah) and six other GOP senators. Democratic Sen. Bob Casey Jr. (Pa.) also co-sponsored the amendment but has assured Reid he would not filibuster a healthcare bill without the abortion language.

The Nelson amendment is based on language authored by Rep. Bart Stupak (D-Mich.) and attached to the House-passed healthcare reform bill over the objections of abortion-rights supporters, who have vowed to fight a healthcare bill that includes the Stupak amendment or similar provisions.

Nelson would not rule out the possibility of putting together 60 votes for his amendment, noting that senators who support abortion rights have supported previous legislation prohibiting taxpayer dollars from paying for abortions.

“We’ll have to see. We’re still working and it could be possible to get that. I don’t know,” he said.

However, Republican Sens. John Thune (S.D.) and Tom Coburn (Okla.), both of whom co-sponsored Nelson’s amendment, said they do not expect it to pass.

“A lot of us on the Republican side will support that,” Thune said. “The question is whether or not you can get 60, which I think is very much in doubt.”

Meanwhile, Reid has agreed to allow Sen. Byron Dorgan (D-N.D.) to bring an amendment to a vote this week that would allow the importation of cheaper prescription drugs from abroad despite the fact that it could blow up a truce between the White House, Senate Finance Committee Chairman Max Baucus (D-Mont.) and the Pharmaceutical Research and Manufacturers of America (PhRMA) on healthcare reform.

What’s more, Dorgan has the support of co-sponsor Sen. Olympia Snowe (R-Maine) and other Republicans. And he could assemble a bipartisan coalition of more than 60 votes to disregard the agreement to limit PhRMA’s financial exposure in exchange for its support of reform, which would risk a battle with a powerful industry that has fought healthcare reform in the past.

“I think we’ve got a decent shot at winning,” Dorgan said. “I don’t think we can pass healthcare reform without trying to put the brakes on the steep increases in prescription drug prices.”

In addition to Snowe — a critical swing vote whose support for the healthcare bill is being ardently sought by President Barack Obama and Senate Democratic leaders — Dorgan said that Republican Sens. John McCain (Ariz.), David Vitter (La.) and Chuck Grassley (Iowa) have also pledged to support the amendment.

Asked about the White House deal with the drug companies, Dorgan noted that then-Sen. Obama and White House Chief of Staff Rahm Emanuel, a former House Democrat, supported the legislation in 2008.

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“The only thing I know about the White House is the president was a co-sponsor of the bill last year and Rahm Emanuel was one of the lead sponsors in the House, so my hope would be they’d be supportive,” Dorgan said.

As these floor battles loomed, Democratic senators and White House aides continued to try to find a way to bridge the impasse dividing the party over whether to create a form of government-sponsored health insurance known as a public option. A handful of centrist Democratic holdouts who continue to reject the public option are forcing Reid to scramble for a way around the problem that does not anger the party’s liberal wing.

As the Senate worked during a rare weekend session, talks between liberal and centrist senators began to turn in the direction of establishing a network of not-for-profit insurance plans organized by the federal Office of Personnel Management, which runs the Federal Employees Health Benefits Program (FEHBP), as alternatives to traditional insurance.

While not a public option, the proposal would give the government more direct control over these insurance products without erecting a government-run program itself.

Talks continued into Monday evening and the state of play remained highly tentative, but Democratic senators from both the centrist and liberal camps hinted that progress was being made.

“The discussions are going in the right direction in moving away from the government-run plan.” Nelson said. “To the extent that they continue to go in that direction, it’s obviously very positive.”

Sen. Charles Schumer (D-N.Y.), a liberal public option supporter and member of the Senate Democratic leadership who has been a central player on the issue all year, also described the talks as productive.

“There’s [a] very good feeling in the room. We’re not there yet, but, you know, we’re getting there,” Schumer said. “There’s push and pull and we have to find the right balance that satisfies the party as to how much government involvement there should be and how much private-sector involvement there should be.

“Each side realizes to get something, they’re going to have to give something.”

Schumer confirmed that liberals are looking for concessions of their own, particularly related to the Medicaid program for the low-income and the Medicare program for retirees.

One proposal would allow people between 55 and 65 years old to enroll in Medicare, currently available only to those over 65 or with a disability, by paying the full, unsubsidized cost of the premiums. Another would raise the income limit for Medicaid benefits in the bill from 133 percent of poverty to 150 percent of poverty.

The Medicare proposal, Schumer said, is not favored only by the liberal wing of the party. “The Medicare buy-in is something that has broader appeal than just progressives,” he said. “I think people like Medicare and would like to see it more available.”