By Shailagh Murray and Paul Kane
Washington Post Staff Writers
Thursday, September 10, 2009
President Obama's speech Wednesday night gave the health-care debate a much-needed shot of momentum, but the direct appeal won't erase the rancor of recent months, both within the Democratic Party and among Republicans.
The contrast was starkly apparent on the House floor last night, when some House Republicans shouted catcalls as Obama spoke, while others -- a small group of GOP senators -- nodded and applauded almost as frequently as Democrats. Liberals sat silently when Obama cited "constructive ideas" that could take the place of a government insurance plan, but cheered wildly when he vowed to hold insurance companies "accountable."
Hours before Obama's address, Senate Finance Committee Chairman Max Baucus (D-Mont.) -- whose panel had been the laggard on reform -- announced a start date for debate on his panel's bill. House leaders prepared to enter final negotiations on their own legislation, and even Republicans are conceding that doing nothing is not an option.
As Congress proceeds, the template Obama provided will help to guide Democratic leaders through the minefield that lies ahead. The president even widened the cast of potential supporters by endorsing provisions that are popular among Republicans, including pilot programs to test whether medical malpractice reform could lower health-care costs and an expansion of special risk pools that allow people with preexisting conditions to buy insurance.
With Obama fully engaged, Democrats were newly confident they could deliver a bill by the end of the year.
"As the president said tonight, 'Now is the season for action,' " said Senate Majority Leader Harry M. Reid (Nev.).
Rep. Chris Van Hollen (Md.) called the speech "just what the doctor ordered" to finish a bill.
And yet the road to a White House signing ceremony remains difficult terrain. In both the House and Senate, Democratic leaders must combine several bills, factoring in Obama's priorities but also the proclivities of internal factions. The middle road is usually the path of least resistance, especially in the Senate -- but already Baucus, the only Democratic chairman seeking to forge a bipartisan consensus, has sparked a liberal backlash by tweaking certain provisions to satisfy moderate Democrats, along with the three Republicans helping to draft his bill.
In the Senate, the spotlight will remain on the Finance Committee as Baucus prepares to release a bill next week in advance of a formal debate now set to begin the week of Sept. 21. If Baucus can't produce, Democratic leaders will be forced to contemplate procedural maneuvers to bring reform legislation to the floor on a party-line vote. But if the Finance process unfolds smoothly, the committee would approve the legislation -- with or without Republican support -- by the end of the month.
At that point, Reid would take over, melding the Finance bill with the legislation produced by the Senate health committee and bringing the massive package to the Senate floor for debate. Senators would then have the opportunity to test support for controversial ideas such as the public option, malpractice protections and an individual insurance mandate.
"On the Senate floor, there will be opportunities to offer all kinds of amendments," Reid told reporters before the speech. If the bill that emerges from the two committees includes a public option, "there will be an opportunity to take it out. If there isn't one in there, there will be an opportunity to put it in."
Because the House has more authoritarian rules than the Senate, Speaker Nancy Pelosi (D-Calif.) can reshape the pending House bill with input from a dozen or more key lawmakers, including those from competing ideological caucuses.
The House legislation now includes a government insurance option that would compete with private coverage in a new exchange. When the measure was diluted at the request of moderate Democrats, liberals protested. But also unsatisfied were many Blue Dog Democrats, a group of 52 lawmakers from more conservative districts.
Members of that powerful bloc would prefer the nonprofit cooperatives that Baucus's bipartisan "Gang of Six" has endorsed. Some Blue Dogs also could support a public plan as a fallback option if private competition did not materialize. Obama pointed to both as potentially viable alternatives.
After a lengthy meeting of the 256-member Democratic caucus Wednesday morning, House Majority Whip James Clyburn (D-S.C.) told reporters he could support the fallback option, or "trigger," if the government launched a pilot public option in willing states. Still, House liberals remain staunchly opposed to compromise. Another gathering was set for Thursday.
Once the House leadership thinks it has a bill that can garner at least 218 votes, the minimum for a simple majority, the legislation will be dropped into the House Rules Committee, the body that will formally draw up a bill and dictate how the debate will unfold. Democratic sources said the House bill could come to the floor late this month. Reid's tentative goal is to produce a Senate bill by Oct. 15.
Republicans are calling for a streamlined bill that addresses the problem of the uninsured, rising health-care costs and insurance industry abuses, and some GOP lawmakers welcomed Obama's speech as an opportunity to bring some of their ideas to the table.
"I stand ready to work with the president and congressional Democrats on a bipartisan common-sense health-care solution," said Sen. John Thune (S.D.), a member of the GOP leadership.
Sen. Robert F. Bennett (Utah) was one of many Republicans who applauded vigorously when Obama proposed medical malpractice reforms. "That was one concession we were all delighted to see," he said.
Baucus said he would continue to negotiate with the three Republican members of the Gang of Six until he released his bill. "A bipartisan bill is much more durable, much more sustainable," he said.
But Sen. John D. Rockefeller IV (D-W.Va.), the senior liberal on the Finance panel, ticked off a list of provisions in the Baucus bill that he doesn't like, adding: "I think we've got a long way to go."