Release of Reid's health-care bill could come as early as Wednesday

By Shailagh Murray and Lori Montgomery
Washington Post Staff Writer
Wednesday, November 18, 2009

Senate Majority Leader Harry M. Reid scrambled Tuesday to lock down votes behind a health-care bill that he may present as early as Wednesday.

The Nevada Democrat would not confirm that he had received commitments from all 60 members of his caucus to overcome GOP procedural objections and bring the bill to the Senate floor, saying only, "I feel cautiously optimistic that we can do that. I think we're together as a caucus."

The leader was more outspoken in describing his measure, boasting to reporters: "Of all the bills we've seen, it'll be the best: saves more money, is more protective of Medicare, is a bill that's good for the American people."

Preliminary estimates by the nonpartisan Congressional Budget Office, the legislation's official scorekeeper, have indicated that the Senate measure would cost far less than the bill the House approved last week, while lowering the federal deficit further over the long term, said several senior Democratic aides who have reviewed the CBO data.

Democrats are hopeful about winning over at least one Republican, Sen. Olympia J. Snowe, on a vote for final passage. But the Maine moderate has pledged to support a GOP filibuster at the outset because Reid's bill is expected to include a public-insurance option that she opposes.

The parliamentary vote on bringing the bill to the floor could come as soon as Friday.

Democratic leaders have spent recent days wooing three party moderates who have declined to publicly commit to starting the Senate debate: Sens. Ben Nelson (Neb.), Mary Landrieu (La.) and Blanche Lincoln (Ark.).

Nelson and Landrieu appeared to be warming to Reid's strategy, Democratic aides said, provided certain concerns are addressed. For instance, Nelson wants the bill to leave in place a federal antitrust exemption for insurance companies that other Democrats have sought to repeal. He is also demanding language that would unequivocally block federal money from subsidizing abortion.

Landrieu has lobbied for additional benefits for her home state, while Lincoln has insisted on a 72-hour waiting period after the Senate bill is released to give lawmakers time to review it before voting.

The three senators and five of their Democratic caucus colleagues co-wrote a letter to Reid insisting on the 72-hour delay, but Reid and other Democrats are eager to speed the process. Nelson indicated that he is flexible on the time frame. "My sense is whether it's 72 hours or 60 hours, there will be ample time to review it," he told reporters Tuesday.

Reid is thought to have made several major changes to the bills approved by the Senate finance and health committees in the process of merging them.

To scale back a plan to tax high-cost insurance policies, an idea that is highly unpopular among labor unions, Reid is expected to propose an increase in the Medicare payroll tax for families earning more than $250,000 a year.

The provision would be expected to generate about $50 billion over the next 10 years. The extra revenue would allow Reid to reduce the number of people who would be hit by a new 40 percent tax on the most expensive insurance policies.

The merged bill is also likely to propose a new government-run insurance plan for long-term care, known as the Community Living Assistance Services and Supports Act. That idea has alarmed some moderate Democrats, including Nelson, who say the program is poorly designed and could become a drain on the government.

A recent government study appears to confirm those concerns: The voluntary program would probably attract only about 2.8 million customers by 2012, many of them already in need of home care or other community-living assistance, according to a report by Rick Foster, the chief actuary of the Centers for Medicare and Medicaid Services, the federal agency that administers those programs.

Also Tuesday, the White House released a letter from 20 economists at major universities who said they believe the Senate legislation would "reduce long-term deficits, improve the quality of care and put the nation on a firm fiscal footing. It will help transform the health care system from delivering too much care, to a system that consistently delivers higher-quality, high-value care."

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