Sen.
Joseph Lieberman, I-Conn, participates in a news conference on Capitol
Hill in Washington, Wednesday, Nov. 4, 2009, to discuss climate change
legislation. (AP Photo/Harry Hamburg)
WASHINGTON (AP) — Don't look for the Senate to quickly follow the House on health care overhaul.
A
government health insurance plan included in the House bill is
unacceptable to a few Democratic moderates who hold the balance of
power in the Senate. They're locked in a battle with liberals, with the
fate of President Barack Obama's signature issue at stake.
If a
government plan is part of the deal, "as a matter of conscience, I will
not allow this bill to come to a final vote," said Sen. Joe Lieberman,
the Connecticut independent whose vote Democrats need to overcome GOP
filibusters.
"The House bill is dead on arrival in the Senate," Sen. Lindsey Graham, R-S.C., said.
Democrats
did not line up to challenge him. Senate Majority Leader Harry Reid,
D-Nev., has yet to schedule floor debate and hinted last week that
senators may not be able to finish health care this year.
Nonetheless,
the House vote provided an important lesson in how to succeed with
less-than-perfect party unity, and one that Senate Democrats may be
able to adapt. House Democrats overcame their own divisions and broke
an impasse that threatened the bill after liberals grudgingly accepted
tougher restrictions on abortion funding, as abortion opponents
demanded.
In the Senate, the stumbling block is the idea of the
government competing with private insurers. Liberals may have to
swallow hard and accept a deal without a public plan to keep the
legislation alive. As in the House, the compromise appears to be to the
right of the political spectrum.
Republican Sen. Olympia Snowe
of Maine, who voted for a version of the Senate bill in committee, has
given the Democrats a possible way out. She's proposing to allow a
government plan, if after a few years premiums keep escalating and
local health insurance markets remain in the grip of a few big
companies. This is the "trigger" option.
That approach appeals
to moderates such as Sen. Mary Landrieu, D-La. "If the private market
fails to reform, there would be a fallback position," Landrieu said
last week. "It should be triggered by choice and affordability, not by
political whim."
Lieberman said he opposes the public plan because it could become a huge and costly entitlement program.
For now, Reid is trying to find the votes for a different approach: a government plan that states could opt out of.
He
will keep meeting with senators this week to see if he can work out a
political formula that will give him not only the 60 votes needed to
begin debate, but the 60 needed to shut off discussion and bring the
bill to a final vote.
Toward the end of the week, the
Congressional Budget Office may report back with a costs-and-coverage
estimate on Reid's bill, which he assembled from legislation passed by
the Finance Committee and the Health, Education, Labor and Pensions
Committee. The Finance Committee version does not include a government
plan.
Reid has pledged to
Obama that he will get the bill done by the end of the year and remains
committed to doing that, according to a Senate leadership aide.
Both
the House and Senate bills gradually would extend coverage to nearly
all Americans by providing government subsidies to help pay premiums.
The measures would bar insurers' practices such as charging more to
those in poor health or denying them coverage altogether.
All
Americans would be required to carry health insurance, either through
an employer, a government plan or by purchasing it on their own.
To
keep down costs, the government subsidies and consumer protections
don't take effect until 2013. During the three-year transition, both
bills would provide $5 billion in federal dollars to help get coverage
for people with medical problems who are turned down by private
insurers.
Both House and Senate would expand significantly the federal-state Medicaid health program for low-income people.
The
majority of people with employer-provided health insurance would not
see changes. The main beneficiaries would be some 30 million people who
have no coverage at work or have to buy it on their own. The
legislation would create a federally regulated marketplace where they
could shop for coverage.
The are several major differences between the bills.
— The House would require employers to provide coverage; the Senate does not.
—
The House would pay for the coverage expansion by raising taxes on
upper-income earners; the Senate uses a variety of taxes and fees,
including a levy on high-cost insurance plans.
— The House plan costs about $1.2 trillion over 10 years; the Senate version is under $900 billion.
By
defusing the abortion issue — at least for now — the House may have
helped the long-term prospects for the bill. Catholic bishops also
eager to expand society's safety net may yet endorse the final
legislation.
Lieberman appeared on "Fox News Sunday," while Graham was CBS' "Face the Nation."