Centrists set strict guidelines for Senate-House healthcare talks

Democratic centrists have informed Senate Majority Leader Harry Reid (D-Nev.) they will accept few changes in the final healthcare bill negotiated between the House and Senate.

Sens. Mary Landrieu (D-La.), Blanche Lincoln (D-Ark.) and Ben Nelson (D-Neb.) have made clear there is little room to deviate from the bill the Senate passed on Christmas Eve.

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They are the most vocal of nearly two-dozen senators who have indicated they see little wiggle room in the conference talks.

Centrists have said they will not vote for a healthcare reform bill that imposes a tax surcharge on the nation’s highest income earners or reduces the tax burden on so-called Cadillac health insurance plans, which are held by many unionized workers.

They have also threatened to vote against the bill if it includes a government-run health insurance program, a proposal that liberal Democrats in Congress acknowledge has little chance of winning inclusion in the final bill.

Lawmakers in the House will have to accept the Senate legislation with little change if a final bill is to muster 60 votes to overcome procedural hurdles and make it to President Barack Obama’s desk, the centrists say.

“There’s very little room for this bill to change,” said Landrieu. “The framework really has to stay basically in place.

“It’s not just me,” Landrieu added. “There are probably two-dozen Democratic senators who feel very strongly about the framework.”

Landrieu said she would not support the final legislation if negotiators tinkered with the Senate proposal for taxing high-cost insurance plans.

“I can only support a bill if the Cadillac plans are taxed at the level they are in the Senate [bill,]” said Landrieu. “It’s not because I’m thrilled about taxing those plans, which I’m not, but it is the No. 1 cost-containment measure in the bill. It’s what is going to drive costs down over time.”

Nelson said he would not support the final bill if it included the House proposal to impose a tax surcharge on individuals earning more than $500,000 and families earning more than $1 million.

“I’ve already said that would be a deal-breaker,” said Nelson.

Lincoln also said she has great concern. “If it moves very much at all from where we are, it’s going to be hard,” she said.

That’s not to say the centrists will not accept any concessions to House negotiators.

Landrieu said she would prefer the implementation date for health insurance exchanges set by the House. The exchanges would offer people a variety of plans to choose among.

The House bill sets up these insurance marketplaces by 2013; the Senate bill does it by 2014. Advancing the implementation of the insurance exchanges by a year would add an estimated $100 billion to the cost of the Senate bill.

Lincoln said she supported a provision in the House bill — not included in the Senate version — that would set up automatic health insurance enrollment for infants.

Landrieu, Lincoln and Nelson proved to be among the toughest holdouts Reid had to deal with in an effort to unify the entire Democratic Conference.

But other centrists have drawn similar lines.

“I’m going to be reluctant to vote for any significant changes to the Senate bill,” said Sen. Evan Bayh (D-Ind.). “There are a number of members who feel that way.”

Reid declined to discuss publicly his plans for bicameral negotiations in the run-up to the final passage of the Senate bill on Dec. 24.

Senate Finance Committee Chairman Max Baucus (D-Mont.) said this week that leaders would begin planning immediately for conference talks with the goal of getting a final bill to President Barack Obama by his State of the Union address.

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White House officials have tried to downplay expectations by warning that final passage of the bill may not happen until February, after Obama’s address.

Sen. Chris Dodd (D-Conn.), who has played a central role in Senate healthcare talks, said lawmakers needed a rest after the end of one of the longest Senate debates in recent history. The Senate was in session for 25 consecutive days after Thanksgiving, the longest stretch since 1917.

A Democratic aide said staff would take off between Christmas and New Year’s and begin working on merging the Senate and House bills in January. The aide predicted lawmakers would begin talks in earnest during the second week of next month, making it difficult for Obama to sign a bill by the State of the Union.

Baucus, however, said lawmakers would begin discussing ways to merge it with the House legislation immediately after Senate passage.

“We’ll be working on it as soon as it passes,” Baucus said.

Sen. Tom Harkin (D-Iowa), chairman of the Senate Health Education, Labor and Pensions (HELP) Committee, said Senate staff has already begun preparing for conference.

But liberals acknowledge there is not much room for negotiations.

Sen. Jay Rockefeller (W.Va.), a leading liberal who expects to participate in conference talks, said there would be “very little” room to change the Senate bill because the defection of a single Democratic centrist would stall progress.
 
“We can’t stray one vote from 60 since there’s nothing on the other side,” Rockefeller said in reference to the lack of any Republican votes for the Senate measure.