Senate Democrats said Monday evening it was looking likely that the Medicare buy-in would be dropped as part of a public option compromise as leaders committed to closing a gap in Medicare prescription drug coverage known as the doughnut hole once the overhaul reaches a conference with the House.
Senate Finance Chairman Max Baucus and Senate Health, Education, Labor and Pensions Chairman Tom Harkin said the buy-in appeared close to being abandoned after Sen. Joseph Lieberman, D-Conn., said he would not vote for cloture on the bill if it included the buy-in.
"It's just a matter of getting support from 60 senators, and that seems to be a condition that's necessary to get 60," Baucus said as he left a special Senate Democratic Caucus meeting Monday evening on health care.
Baucus said they discussed using the fast-track reconciliation process that only requires 51 votes, "but there's no way we're going to do that."
Lieberman said he believed those between 55 and 64 years old are better off receiving subsidies and buying insurance on the exchange.
"I think [the buy-in] would have been more expensive then the subsidies would have been. And that's the key," Lieberman said.
Leaders were waiting for a CBO score on the buy-in senators and aides said they expect today, as well as a score on a proposal to have the federal government negotiate insurance rates with providers on behalf of a national plan.
Sen. Arlen Specter, D-Pa., made a plea to senators in the Caucus to not let "obstructionists" win and received a standing ovation, according to a Senate aide. He said he joined the Caucus to be the 60th vote, referencing his switch from the Republican Party.
Two of the party's more liberal members came to the defense of a stripped-down bill.
Harkin argued the bill still accomplishes a great deal without the buy-in or even a public option.
"There's enough good in this bill even without those two; we've got all those insurance reforms, all the stuff we've worked so hard for prevention and wellness in there, the workforce development we have in there, reimbursement based on quality not on quantity," Harkin said. "There's good stuff in this bill. It's a giant step forward."
Sen. John (Jay) Rockefeller, D-W.Va., argued the bill can be improved after passage. "People feel, 'Well, you can only do this once in a while. That's not true. I think health care is now permanently on our agenda. Which is great."
"I think it's gonna be an every-year subject. An-every-session-of-Congress subject from now on," Rockefeller said.
He added that Reid told the group a vote on a final passage could come as soon as Saturday. But a Reid spokesman said that timeline requires "a level of cooperation from [Republicans] that we haven't seen yet."
Democratic leaders have estimated the Senate, in the face of an expected GOP filibuster, would need to six to nine days for three cloture votes and a vote on final passage. That means Reid must file cloture this week to set up passage before Christmas. Senators and aides said they expect a cloture filing this week if CBO returns a score today.
The Senate Democratic Caucus will meet this afternoon with President Obama. Rockefeller said Reid told the Caucus the meeting will be substantive and "not a pep talk."
The Senate will also take its first votes in a week on health care today, taking up four amendments that have been pending the entire time, including one that would allow the reimportation of prescription drugs.
Democratic leaders also pledged Monday to close the doughnut hole, not in the Senate bill, but as the overhaul moves to conference with the House. Leadership sources did not say how they would close the gap that leaves seniors paying full price for their prescriptions.
The move evoked gratitude from AARP but did not win their support for the bill just yet. "Obviously, much work remains to send the president a final healthcare reform package that works for all Americans," AARP CEO Barry Rand said. "We will continue to work with leaders in both chambers to address key priorities of our members, including strictly limiting age discrimination by health insurance companies and strengthening our system of long-term services and supports."
The move also might let the Pharmaceutical Research and Manufacturers of America off the hook for the moment from coughing up more than the $80 billion they have pledged to help fund the overhaul. Some senators have called on them to increase their contribution to help close the doughnut hole.
The issue of federal abortion funding is also causing Democrats heartburn. Sen. Robert Casey Jr., D-Pa., met with Obama Monday to talk abortion, among other healthcare topics.
"We've been working a number of days now," Casey said. "I think we've made good progress."
Part of the talks have covered including Casey's amendment to give what he called "unprecedented support" for pregnant women. Casey said he is talking to Sen. Ben Nelson, D-Neb., about the compromise as well. Nelson's amendment restricting federal abortion funding further than the Senate bill was shot down last week.
This article appeared in the Saturday, December 19, 2009 edition of National Journal Daily.
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