Health talks advance; Snowe skeptical

Liberal and centrist Democratic senators huddled behind closed doors throughout Tuesday seeking an elusive agreement that would enable them to propel healthcare reform forward.

But even as Democrats tentatively said the talks were promising, Republican Sen. Olympia Snowe (Maine), whose backing has been sought all year, expressed deep skepticism about key components of the tenuous Democratic framework.

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The end of the year is fast approaching and stands as a self-imposed deadline for the Senate’s consideration of healthcare reform. Though other deadlines have come and gone without a final result, the White House and the Senate Democratic leadership is eager to complete this stage of the process and move on to hashing out the Senate bill with a measure already passed by the House.

Tuesday could be a critical day for healthcare reform, Majority Whip Dick Durbin (D-Ill.) indicated.


“This is an important day. It’s a day when a lot of things have to come together if we hope to finish this in a reasonable time,” Durbin said, noting that any consensus package that emerges from the Democratic negotiations would need to be subjected to a cost estimate by the Congressional Budget Office (CBO) and would be followed by days of debate and procedural steps on the Senate floor.

Senate Majority Leader Harry Reid (Nev.) tasked a collection of about 10 Democratic senators from the two ideological factions to work out their differences by the end of Tuesday, which would facilitate a Senate vote before Christmas.

“We’re continuing to negotiate this legislation,” Reid said. “Is it possible to meet the goal by the end of this year of passing this bill? The answer is yes.”

Sen. Charles Schumer, a member of the Democratic leadership and a key liberal participant in the talks, said the liberals and centrists are seeking a balance between government and private influence over the healthcare system.

“What we’re trying to figure out here, certainly within our caucus and then maybe with Olympia, is: How much government involvement there should be in healthcare, how much private involvement. And there are disagreements,” Schumer said.

The major issue dividing the liberal majority of Democrats from a handful of centrist holdouts has been whether to create a government-run health insurance program. Efforts by Reid and others, including Snowe, to devise compromise versions of the public option failed to bring centrists such as Sens. Ben Nelson (D-Neb.) and Joe Lieberman (I-Conn.) on board with liberals.

In recent days, the liberal-centrist working group seems to have set aside the public option. Instead, they are developing a set of new provisions for the bill with an eye toward satisfying all sides.

Instead of a public option, the senators are weighing proposals to establish private, nonprofit health insurance programs set up by the federal Office of Personnel Management (OPM) as backups to traditional insurance; require insurance companies to spend at least 90 percent of their premium revenues on health services; expand Medicaid, perhaps to everyone up to 150 percent of the federal poverty level; and allow people between 55 and 64 years old to buy into Medicare.

While senators from both camps said progress is being made, they stopped short of promising to meet the year-end goal.

“We’re working as quickly as we can,” Schumer said. “There’s no deadline.”

Schumer also emphasized that any deal struck behind closed doors by members of the liberal-centrist group is contingent on how the rest of the Democratic caucus reacts. “If we can come to agreement with the people in this room, it doesn’t mean we’re home but it means we’ve made a big step forward,” he said.

Nelson, one of the toughest sells in the Democratic caucus on the healthcare reform bill, said he would continue to work with his liberal counterparts even if he did not feel he could support the final product.

“I’m continuing to try to work with a variety of different issues with my colleagues to try to be, at least, a friend of the process,” Nelson said. “Until everything is settled and you’ve got a clear view of what changes might be made and what may be there, it’s hard to say.”

In addition to the healthcare coverage and cost issues at play, Nelson’s final position may be contingent on abortion. The Senate was set to defeat Nelson’s amendment to strengthen prohibitions against federal funding of abortions under the bill Tuesday, leaving Nelson’s eventual support for the bill strongly in doubt.

Snowe emerged from a meeting in Reid’s office Tuesday, telling reporters that she is intrigued by the proposal to have the OPM, which administers the Federal Employees Health Benefits Program, offer plans on the health insurance exchange that the bill would create. Snowe opposes a public option except a version she introduced, which would “trigger” the program in states underserved by private insurance.

But Snowe shot down the Medicare and Medicaid expansions under discussion by Democrats.

“It’s an expansion of government at a time in which we should be moving in the opposing direction, frankly,” Snowe said. “...[M]y deep concern is about the breadth and scale of this legislation moving and taking a more expansionistic approach for government’s role, rather than the reverse, at a time in which people are questioning expanding the scale of government’s involvement in healthcare.”