Senators Close to Health Accord
Panel May Vote On Bipartisan Bill Before Recess

By Shailagh Murray and Paul Kane
Washington Post Staff Writers
Wednesday, July 29, 2009

An emerging consensus among a bipartisan group of senators is poised to shift the dynamic in the congressional debate over health-care reform and could lead to a final product that sheds many of the priorities that President Obama has emphasized and that have drawn GOP attacks.

Three Democrats and three Republicans on the Senate Finance Committee are expected to wrap up their arduous multi-week talks in the coming days, and Majority Leader Harry M. Reid (D-Nev.) said he expects a panel vote before the Senate recess, which will begin Aug. 7.

Assuming the fragile committee coalition holds, the legislation it produces would scramble the reform landscape by introducing policy ideas that have their origins in the political center. The bill is bound to disappoint liberals. But with prominent GOP backing, it also could prove more difficult for Republicans to reject out of hand -- the approach they have taken to the House bill and a second Senate version, written by the health committee.

The finance panel's legislation is expected to include incentives for employers to provide health insurance for their workers, rather than a more punitive coverage mandate. The committee is also likely to endorse narrowly targeted tax increases, rejecting a controversial tax surcharge on wealthy households that the House adopted and limits on deductions for upper-income taxpayers that Obama is seeking.

GOP negotiators rejected from the outset the kind of government-run insurance plan that Obama and most Democrats are pushing for in an attempt to inject the health-insurance market with pricing competition. Instead, the committee would create coverage cooperatives modeled after rural electricity providers.

As House negotiators continued to work late Tuesday evening on breaking an impasse on their version of the bill, the bipartisan Finance Committee negotiators emerged from another meeting insisting that no final decisions had been made about the contents of the legislation. But as details trickled out, none of the components appeared ready-made for GOP opposition. Negotiators are scrubbing every provision for unintended consequences that could negatively affect small businesses or middle-class families, both of which Republicans say could be harmed by the other bills moving through Congress.

"What we do obviously would be important to our Republican conference," said Sen. Olympia J. Snowe (Maine), a member of the GOP team, along with Sens. Charles E. Grassley (Iowa), the ranking Republican on the finance panel, and Mike Enzi (Wyo.), the senior Republican on the health committee. Snowe said the primary goal of the negotiations is a bill that can draw Republican votes.

"I think it might resonate, frankly, with our colleagues," Snowe said of the emerging compromise measure. "We want the basis for a bipartisan agreement, and I think that could be the launching pad for that resolution."

Reid told reporters Tuesday that he might be willing to compromise on points of policy if it meant getting the 60 votes needed to turn back GOP procedural objections. The Senate Democratic caucus now stands at 60 members, but two members -- Robert C. Byrd (W.Va.) and Edward M. Kennedy (Mass.) -- have battled serious illness, requiring Reid to win support from at least two Republicans to make up for their absence.

"I have a responsibility to get a bill on the Senate floor that will get 60 votes," Reid said. "That's my number one responsibility, and there are times when I have to set aside my personal preferences for the good of the Senate and I think the country."

But the Finance Committee has taken weeks longer than expected to hash out its deal, and in the House, reform legislation has stalled as Speaker Nancy Pelosi (D-Calif.) struggles to quell an uprising by conservative Democrats.

Obama has encouraged the finance panel's effort, praising it as the potential foundation for the bipartisan outcome he is seeking. But he flashed his discontent with the process during a question-and-answer session sponsored by AARP. "Sometimes I get a little frustrated, because this is one of those situations where it's so obvious that the system we have isn't working well for too many people, and that we could be doing better," Obama said Tuesday.

On the House side, White House Chief of Staff Rahm Emanuel huddled with chamber leaders and a group of conservative Democrats who are the key stumbling block to getting a bill out of the Energy and Commerce Committee.

After more than six hours of meetings Tuesday, lawmakers emerged from Pelosi's office pledging to continue talking Wednesday morning to try to push for an agreement that could pave the way for the committee to finish the legislation by week's end.

"We're making progress. We're still working," Pelosi, her voice hoarse, said after the marathon negotiating session.

The holdouts, members of the Blue Dog Coalition, remain concerned about reimbursement rates for Medicare services to health-care providers and the surtax on wealthy households. They are eagerly awaiting the Finance Committee's list of tax increases, expecting that the provisions may be more politically palatable.

Senate Republican leaders are taking a wary approach to the bipartisan negotiations, and unless pressed by reporters, rarely note they are taking place. They continue to lambaste the two Democratic bills as job-killers that would inflate health-care costs.

At a news conference Tuesday, Senate Minority Leader Mitch McConnell (R-Ky.) took pains to note that GOP negotiators brief him daily. But he sidestepped questions about whether he embraces their work. "There's not a plan that I've seen that people can support on a bipartisan basis," he said.

Sen. John Thune (S.D.), a member of the GOP leadership, said he is pleased that the finance panel's bill will not include a mandate that employers provide coverage, although the legislation is expected to require individuals to carry insurance. But Thune said he worries that the co-op idea is not that much different from the public plan that both Democratic bills include.

"Without knowing what's in it, I don't think anybody's going to get that far out there," Thune said.

GOP aides say the three negotiators have been told that they should not support a bill that much of the Republican caucus opposes, and according to the aides, the trio has assured Republican leaders that they do not want to operate as outliers. The negotiators have not made such a pledge publicly, however.

To the contrary, Grassley and Snowe have repeatedly asserted their desire to cut a deal. But Enzi, a low-key certified public accountant with a solid conservative voting record, rarely speaks in public about his role. Senior Democrats say they are most skeptical about his commitment to the finance panel's bill.

As Enzi has delved into bipartisan talks, his junior colleague from Wyoming, Sen. John Barrasso (R), has emerged as one of his party's leading critics of Democratic reform efforts, highlighting his past work as an orthopedic surgeon in a Web video program he films each week with Sen. Tom Coburn (R-Okla.), the chamber's other physician.

Barrasso said he expects nothing but tough negotiating tactics from Enzi, who once chaired the health committee and is now its ranking Republican. "He's very solid," he said. "As we say in Wyoming, we're not going to be stampeded into anything. And Mike Enzi is not going to be stampeded into anything."

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