Senators await price tag on health bill

Liberal and centrist senators at the center of the healthcare debate bought themselves more time Wednesday, saying they would decide how to vote after they saw the bill’s final price tag.

Centrist Sen. Mary Landrieu (D-La.) and other senators emphasized they are withholding any promises until they hear from the Congressional Budget Office (CBO) about the cost of the new proposals.

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“There was a lot of agreement to send, you know, a package, but until it’s scored we really just can’t talk about the specifics because the scores will have a great effect on what’s ultimately done,” Landrieu said.

Landrieu and fellow centrist Sens. Blanche Lincoln (D-Ark.), Ben Nelson (D-Neb.) and Joe Lieberman (I-Conn.) have said they would support a Republican filibuster if the final healthcare bill contains a robust public option.

Tuesday’s compromise measure reportedly contains a “trigger” provision but not a straight-out public option.

“There are a lot of things on the table still and until, you know, we hear back from CBO, it’s going to be hard to see whatever I can support, for sure,” Lincoln said, echoing a similar comment by liberal Sen. Russ Feingold (D-Wis.).

But Feingold said the talks were productive.

“I do think that there is psychological momentum being created by the fact that these discussions occurred,” he said.

Sen. Jay Rockefeller (D-W.Va.), a strong supporter of the public option and one of the 10 negotiators, also expressed optimism.

“No deal is sealed until the language is written and the scores are back — but right now I am optimistic,” he said in a statement.

Nelson also suggested he could support the package if the numbers come out favorably. “I’m not aware of anything that was raising serious objections about it. I think it was about, ‘Well, that sounds OK, but let’s see how it scores,’ ” he said.

The senators also downplayed Senate Majority Leader Harry Reid’s (D-Nev.) comments at a hastily convened press conference Tuesday evening where he said: “It’s been a long journey. Tonight we’ve overcome a real problem that we had.”

“There’s no specific compromise. There were discussions,” said Landrieu, one of a handful of centrist holdouts Reid must win over.

“I don’t know yet. I have concerns myself still about some aspects of it,” Feingold said.

Since neither liberals nor centrists seem inclined to give in on their principles, the path to 60 votes remains rocky. “I think we’re moving toward that but, believe me, there are legitimate and serious questions being raised by members of the caucus,” said Majority Whip Dick Durbin (D-Ill.).

President Barack Obama offered encouraging words of support, saying the Senate had made “critical progress with a creative new framework” that he believes would help pave the way for final passage.

“I support this effort, especially since it’s aimed at increasing choice and competition and lowering costs,” Obama said.

Reid and other senators have been mostly tight-lipped about what exactly is in the package they sent to the CBO for scoring, which Sen. John Kerry (D-Mass.) said would take four to five days.

The agreement appears to establish private, nonprofit health insurance programs that would be set up by the Office of Personnel Management.

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These programs would be run by private companies, but a new government insurance plan could be triggered if the private plans are not acceptable. Centrists strongly resisted other forms of the public option.

In addition, the pending agreement would allow uninsured people between the ages of 55 and 64 who lack insurance to buy into the Medicare program.

The package also would accept a liberal demand to require health insurance companies to spend at least 90 percent of the premiums they collect on medical services and would expand the Children’s Health Insurance Program and Community Health Centers. Senators have set aside a proposal to broaden the Medicaid expansion in the healthcare bill from 133 percent of the federal poverty level to 150 percent.

The Medicare buy-in has received the most positive reviews from Democrats. Liberals have long sought this goal, but Landrieu said even the centrists are on board in principle. “We, all 10 of us, think that that’s a very good idea given our negotiations,” Landrieu said. “But until we get a score, nothing can be settled.”

Liberal activist groups such as MoveOn.org and Healthcare for America Now rejected the apparent move away from the public option, but prominent liberals such as former Vermont Gov. Howard Dean and Rep. Anthony Weiner (D-N.Y.) praised the Medicare buy-in.



The American Medical Association and the American Hospital Association, however, came out strongly against the Medicare buy-in, largely based on their argument that Medicare’s payment rates are too low.


Sen. Bernie Sanders (I-Vt.), a liberal and staunch proponent of the public option, went so far as to argue that the Medicare buy-in might be superior to the forms of public option previously under discussion.

“I think it is not fair to simply say they are abandoning the public option,” Sanders said on MSBNC Tuesday night. “What you’re looking at is trade-offs, which in fact, at the end of the day, may be stronger than the very weak public options that both the House and the Senate have already passed.”

Liberals on and off Capitol Hill have grumbled all year that Obama has not pushed strongly enough for the public option, a notion White House press secretary Robert Gibbs rejected Wednesday. Asked if the president believed he did everything he could for the public option, Gibbs responded, “Yes.”

Lieberman, however, indicated he doesn’t think the Senate has moved far enough from the public option, suggesting his vote will continue to be difficult for Reid to secure.

In a statement issued Wednesday, Lieberman said he is “encouraged” by Reid’s announcement but reiterated his opposition to even a public option with a “trigger” and his concern the Medicare buy-in could harm the program’s finances.


Ian Swanson, Walter Alarkon and Sam Youngman contributed to this article.