By Jeffrey Young - 12/19/09 11:00 AM EST
Senate Majority Leader Harry Reid (D-Nev.) started the week four shy votes of the 60 he needs to move healthcare reform forward. He ended the week in the same state.
The biggest change: Reid’s headaches are now being caused by the conference’s left wing instead of its right. Centrist Sens. Mary Landrieu (D-La.), Blanche Lincoln (D-Ark.) and Joe Lieberman (I-Conn.) have ceded the role of spoiler to liberal Sens. Roland Burris (D-Ill.), Russ Feingold (D-Wis.) and Bernie Sanders (I-Vt.).
Republican Sen. Olympia Snowe (Maine) remains in play, too. Obama and Reid are in near constant contact with the centrist who was the only Republican to support a Democratic healthcare reform bill during committee proceedings in the House and Senate this year.
Reid sparked fury on the left by giving in to demands from centrist senators to drop an expansion of Medicare that would allow people as young as 55 to buy into the program, an alternative to the government-run health insurance plan that was also dropped.
The remaining issues are inextricably tied to the four remaining holdouts and their allies in special interest groups. If Reid is to stay on track for a crucial procedural vote in the wee hours of Monday morning – not to mention a final vote on healthcare reform before Christmas -- he’s going to have to get past the problems and nail down the magic number 60.
Sen. Ben Nelson (D-Neb.): The abortion problem lurked in the background throughout the course of the year and blew up as the House approached its vote last month when Rep. Bart Stupak (D-Mich.) succeeded in attaching language to the House bill strictly limiting abortion coverage in plans that would be available under the bill’s health insurance exchange. Stupak’s victory emboldened Nelson, who has consistently said none of the Senate’s healthcare bills did enough to safeguard taxpayer dollars from paying for abortions. Nelson’s gambit to amend the bill on the Senate floor failed. He has continued to discuss alternatives with Reid, himself an abortion-rights opponent, as recently as Friday, but he has so far rejected every proposed compromise, including one devised this week by Sen. Bob Casey Jr. (D-Pa.), who opposes abortion rights.
There’s more than abortion bothering Nelson, however, who has a laundry list of complaints, including that the bill spends too much, raises taxes too much and burdens states with additional Medicaid spending.
Sen. Russ Feingold (D-Wis.): A stalwart liberal who often bucks his party on a variety of issues, Feingold was a background player on healthcare until recently. He doesn’t serve on either committee with jurisdiction over the healthcare bills and wasn’t part of the talks between Reid, the White House, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Sen. Chris Dodd (D-Conn.) of the Health, Education, Labor and Pensions Committee (HELP).
But when Reid assembled a group of 10 centrists and liberals to make a final deal, he called on Feingold to participate. Lieberman blew apart that shaky agreement however, leading Reid to side with the centrists – and casting Feingold’s vote into doubt.
Sen. Bernie Sanders (I-Vt.): Though he caucuses with Democrats, Sanders is resolutely not a party member. The veteran legislator and freshman senator is a self-described democratic socialist and a passionate supporter of replacing private health insurance with a single-payer healthcare system. As an independent, Sanders doesn’t have the same pressure points as the 58 Democrats in the Senate and doesn’t share the sense of fraternity that can unite party members against Republicans
More vocally than any member of the Senate, Sanders is sticking to his view that single-payer is the only way to go. When the bill still included a public option, Sanders was reluctantly aboard. Now that it doesn’t, his reluctance has only increased. Obama and Reid are working with Sanders to accommodate him but an easy answer to his misgivings isn’t obvious.
Sen. Roland Burris (D-Ill.): He’s been a wild card since his controversial appointment and he hasn’t shown much interest in taking marching orders from Democratic leaders. The jury is out on whether Reid can talk him into voting for a bill that doesn’t include a public option.
In the past, Burris issued strongly worded threats to go so far as join a Republican filibuster of the healthcare bill if a public option weren’t part of it. He’s since softened his language a bit – and not repeated the filibuster threat – but he’s also said he doesn’t support the bill on the Senate floor.
Sen. Olympia Snowe (R-Maine): For Obama, Snowe is the brass ring. Not only could she provide the deciding 60th vote if any Democrat doesn’t join in, she would give the legislation the appearance of bipartisanship.
Dropping the public option and the Medicare buy-in answered two of Snowe’s biggest concerns, much as it answered Lieberman, Landrieu and Lincoln’s. Snowe is still holding out, however, demanding to see the entire bill and a cost estimate before she’ll even considering extending her support. Snowe also insists that the Senate should hold off its vote until after Christmas. If any of the four Democratic holdouts don’t link hands with their leadership, Snowe will get her way on that.