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Health Reform Deadline In Doubt
Process Could Be Slow And More Contentious

By Shailagh Murray, Paul Kane and Michael A. Fletcher
Washington Post Staff Writers
Friday, July 24, 2009

Senate Majority Leader Harry M. Reid acknowledged Thursday that his chamber is unable to pass health-care reform before its August recess, a move that highlighted internal Democratic divisions on the legislation and is likely to result in significant changes to the shape of the final bill.

The Aug. 7 deadline that President Obama set for House and Senate leaders to move their versions of reform served as a vital tool for congressional leaders in minimizing dissent as the $1 trillion package moved through five committees. But with their hopes of reaching that target date slipping in recent days, a torrent of complaints and concerns began to surface.

The comments by Reid (D-Nev.) confirmed the growing consensus on Capitol Hill that the White House's fast-track approach has failed, and that a more plodding and contentious process has taken hold. Not only would the Senate not meet Obama's timeline for passing a bill, but across the Capitol, House Speaker Nancy Pelosi (D-Calif.) was struggling to quell an uprising by conservative Democrats that had brought House action to a near halt.

Appearing at an event Thursday in Shaker Heights, Ohio, intended to rally support for health-care reform, Obama attempted to brush aside the delay, saying he is content to know that Congress is pressing ahead.

In response to a questioner at the event, the president said, "That's okay. I just want people to keep on working," adding that he wants to sign a final bill "by the end of this year."

He did not acknowledge the delay in his prepared comments, telling the crowd of 1,600 at a high school gymnasium that "reform may be coming too soon for some in Washington, but it's not soon enough for the American people." He vowed that the final bill would be deficit-neutral while making systemic changes to stop health-care costs from skyrocketing.

Like a candidate asking for votes, he urged supporters of change to press for it.

"Keep on your members of Congress, keep up the heat," Obama told the crowd. "We've got to get this done."

Lawmakers, however, appeared to be in no rush. When Democratic members of the Senate Finance Committee met Thursday morning and raised doubts about the bill coming through their panel. Sen. John F. Kerry (Mass.) questioned new Medicare formulas that could penalize high-cost states such as his. Sen. Bill Nelson (Fla.), who represents millions of elderly constituents, also expressed doubts about Medicare cuts that could add up to $500 billion over 10 years. Sen. John D. Rockefeller IV (W.Va.) lambasted the panel's tentative decision to support the creation of member-run cooperatives rather than the government insurance plan that he and many other Democrats prefer.

Some Democrats are so opposed to the cooperative idea that they are urging Finance Chairman Max Baucus (D-Mont.) to offer no new coverage option in his legislation. That would allow Democrats more time to build support for the government insurance plan included in the House bill, along with legislation approved on a party-line vote by the Senate health committee.

But dropping the cooperative provision would risk losing the support of Sen. Charles E. Grassley (Iowa), the panel's ranking Republican and a co-op advocate, whose presence at the negotiating table represents Obama's best hope of getting the broad bipartisan support he has pledged to seek for reform.

Although Baucus continued to insist in public that negotiators will be "ready when we're ready," he gave Reid and other Democrats private assurances Thursday that his panel will complete work on its bill by Aug. 7, the start of the Senate's month-long recess, and in keeping with Obama's new deadline. After asking all staff members to leave a meeting, Baucus said Thursday night, a bipartisan group of senators on the committee heard an optimistic report from Congressional Budget Office Director Douglas W. Elmendorf that their emerging plan would begin to reduce health-care costs. A formal report on the estimate is expected to be completed in several days.

If the Aug. 7 deadline holds, Reid said, he will work over the break with White House officials to merge the two Senate versions.

House Democrats, still wrangling over the scope of the legislation and how to pay for it, began Thursday with a heated meeting overseen by Majority Whip James E. Clyburn (D-S.C.), who afterward told reporters that it was one of the most "contentious" gatherings he had ever attended. Clyburn, whose job is to count votes, suggested that the leadership should cancel its five-week recess, slated to begin next Friday, and spend August working to pass the legislation.

Pelosi later described the meeting as "exciting" and "invigorating," saying she invited members with opposing views to air their opinions on the policy matters and the best schedule for proceeding. She dismissed the idea of keeping the House in session through August and said she is weighing whether to extend the current session a few days to pass the legislation or to wait until after Labor Day.

The Blue Dog Coalition, a group of 51 conservative Democrats, continued to push for delaying until the group has secured guarantees of billions of dollars in additional health-care cost savings. "This bill is the most important piece of legislation in a generation, so why are we rushing it?" asked Rep. Charlie Melancon (La.), a Blue Dog leader and member of the Energy and Commerce Committee, which is struggling to draft the final piece of the House bill.

That panel has been unable to resume action because of continued infighting among Democrats. A day after declaring she had the votes to pass the measure, Pelosi said the legislation was not ready to bring to the floor, although she remained optimistic that it would eventually pass.

"We will take the bill to the floor when it is ready, and when it is ready, we will have the votes to pass it," she said.

Republicans reveled in the chaos and reiterated their call for Democrats to scrap their efforts and start over in pursuit of legislation with a smaller scope, less government involvement and no tax increases.

"I am very pleased my Democrat colleagues have now rejected the president's strategy to force through a bad bill before anyone has had a chance to even read it," said Sen. Jim DeMint (S.C.), who has emerged as one of Obama's chief Republican critics.

Echoing Obama, DeMint urged voters to "connect with their congressmen and senators and let them know that Washington shouldn't make their families' health-care decisions."

The leading factor in the delay is the finance panel, led by Baucus, who is attempting to strike a deal with Grassley, moderate Sen. Olympia J. Snowe (R-Maine), and Sen. Mike Enzi (Wyo.), the senior Republican on the health committee. For days the group, along with Democratic Sens. Kent Conrad (N.D.) and Jeff Bingaman (N.M.), has huddled in Baucus's Senate office, attempting to write its own 1,000-page bill.

Many of Baucus's Democratic colleagues are aggravated by the panel's pace, and more specifically by the chairman's willingness to accommodate Republicans. Senate GOP leaders, meanwhile, are wary of the potential damage to their cause of defeating health-care reform if three prominent GOP senators defect.

These Republicans, including Minority Leader Mitch McConnell (Ky.), have warned the GOP negotiators that their efforts will be for naught once the bill clears the Finance Committee and Democratic leaders take control of the process. And Democratic leaders and the White House have yet to assure Grassley and his team that they will remain participants.

Reid did cite GOP concerns when he announced that the deadline had been scrapped. Snowe said she made the request to gain "the latitude and the time to work through a number of complicated issues, as well as the cost estimates from the Congressional Budget Office that will verify the cost of what we're doing."

But she said the lack of assurances about the next step looms as a concern. "We have to figure that out, in terms of what is the process beyond the committee," she said.

Snowe also suggested that Baucus's goal of passing a bill through committee by Aug. 7 could be overly optimistic. "We still have a ways to go in drafting the language and getting the cost estimates," she said.

Staff writer Perry Bacon contributed to this report.

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