Cloture vote foreshadows conference tussle over final healthcare bill

As the Senate prepares for the dead-of-night cloture vote on its healthcare reform bill, lawmakers in both chambers have already begun jockeying over what the final bill should look like.

Starting with the dramatic announcement Saturday of an agreement between leaders and Sen. Ben Nelson (Neb.), the last Democratic holdout, House members and senators began to lay the ground for negotiations between the two chambers when they enter conference, most likely next year.

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“I think any bill is going to have to be very close to what the Senate has passed, because we're still going to have to get 60 votes,” Sen. Kent Conrad (D-N.D.), the chairman of the Senate Budget Committee, said on "Fox News Sunday." “And anyone who has watched this process has seen how challenging it is to get 60 votes.”

With Nelson’s support, the Senate is expected to pass its version of healthcare reform legislation by Christmas Eve at the latest. The House passed its bill earlier this year. Big differences remain between the two bills, such as over how to handle the contentious issue of abortion, how to pay for the reforms or whether or not to include a government-run insurance plan, known as the “public option.”

Like Conrad, Nelson said in his statement Saturday that any substantial changes to the final healthcare reform bill from the Senate compromise legislation could end up costing the Democrats his vote.

“This cloture vote is based on a full understanding that there will be a limited conference between the Senate and House," Nelson said. “If there are material changes in that conference report different from this bill that adversely affect the agreement, I reserve the right to vote against the next cloture vote.”

But a number of House members have taken issue with Nelson’s agreement that was reached in order to ease the senator’s concerns over potential federal funding of abortions. The anti-abortion House lawmaker who led the fight to add strict restrictions regarding abortion funding to his chamber’s healthcare bill was not pleased with the deal.

“While I appreciate the efforts of all the parties involved, especially Senator Ben Nelson, the Senate abortion language is not acceptable,” said Rep. Bart Stupak (D-Mich.) in a statement. “A review of the Senate language indicates a dramatic shift in federal policy that would allow the federal government to subsidize insurance policies with abortion coverage.”

Stupak could garner a number of votes against the final healthcare reform bill if changes aren’t made to satisfy abortion opponents. But sticking to the Michigan Democrat’s hard line could also lead to losing votes for the bill from those who support abortions.

In a statement Saturday, Reps. Diana DeGette (D-Colo.) and Louise M. Slaughter (D-N.Y.), leaders of the Congressional Pro-Choice Caucus, said the Nelson agreement is not good enough. They already opposed the Stupak amendment as well.


“This provision is not only offensive to people who believe in choice, but it is also possibly unconstitutional,” DeGette and Slaughter said. “As we have maintained throughout this process, health care reform should not be misused to take away access to health care.”

Other than how to deal with abortion, the House and Senate bill differ on what to tax to pay for reform, as well as whether the government should provide competition in the insurance market by offering its own coverage plan. Liberals most likely will be rooting for the House version to win out since it includes a public option and does not tax high-cost “Cadillac” insurance plans, which has upset the labor movement, a key Democratic constituency, who could see their members affected by the tax.

Howard Dean, the former Democratic National Committee chairman and ex-Vermont Governor, disparaged the Senate bill this past week, calling for them to start over at times. On "Meet The Press" Sunday, Dean praised some of the changes Senate Democrats made to their final bill but said he still favors the House bill.

“If most of the House provisions survive, then we can have a bill that we can really work with,” Dean said.