Obama presses Democrats on health-care bill
Consensus emerging on public option, Reid says

By Shailagh Murray and Lori Montgomery
Washington Post Staff Writer
Monday, December 7, 2009

President Obama made a rare Sunday visit to the Capitol to urge a fractious Democratic caucus to pull together to pass landmark health-care legislation.

Obama made no mention of a government-run insurance plan, abortion or other key issues that lawmakers are attempting to resolve in closed-door meetings, including a Sunday evening gathering to address the public option. Instead, he used the 45-minute session to stress the Senate's "historic opportunity to provide stability and security for those who have insurance, affordable coverage for those who don't, and bring down the cost of health care for families, small businesses and the government," White House spokesman Bill Burton said in a statement.

Senate Majority Leader Harry M. Reid (D-Nev.) told reporters after the meeting that negotiators were inching toward consensus on the public option. He said he still aims to hold a final vote on the $848 billion package before the chamber adjourns for the Christmas break.

"There are still a few things we need to work out in the bill, but the issues are being narrowed as we speak," he said. "Progress is being made, and that's not just talk."

After working through the weekend, the Senate will reconvene Monday for an eighth day of debate and potentially the first controversial amendment, addressing the issue of abortion coverage. After the abortion vote, expected Monday or Tuesday, the Senate could tackle another high-profile amendment: a bipartisan bid to allow the importation of prescription drugs from Canada and other countries.

Meanwhile, 10 moderate and progressive Democrats tapped by Reid are expected to continue daily meetings aimed at reaching a compromise on the public option, along with improving small-business provisions in the bill.

One potential alternative being discussed Sunday would create a national coverage plan operated by private insurers but run by the Office of Personnel Management, which administers health coverage for federal workers. Senators participating in the talks said the OPM idea had been well received across the ideological spectrum, although details were sketchy. "I think it has potential," said Nancy-Ann DeParle, Obama's top health aide.

Meanwhile, on the issue of abortion, Sen. Ben Nelson (D-Neb.), working with Sen. Orrin G. Hatch (R-Utah), planned to offer an amendment Monday to bar federal money from being used for the procedure under the legislation. The amendment would mirror language adopted in the House on Nov. 7, over the strong opposition of abortion-rights groups. It would prohibit any public plan from covering abortion services, and would bar people who receive federal subsidies from using the money to buy plans that offer abortion coverage.

Democratic abortion opponents have not said what they will do if the amendment fails, as is expected. Nelson is the most outspoken of the group, and he has sent mixed signals in recent days. Although Nelson has often asserted that he cannot accept the current language on abortion, and at times threatened to filibuster the measure over the issue, he has also said he might be open to an alternative if it meets his underlying objective.

"I'm not going to start working against the language that I'm going to bring forward," Nelson said. "If it doesn't get passed, there are going to be people talking, but it certainly is not a lock that there's language in the middle. . . . I'm not going to negotiate against myself at this point."

Sen. Robert P. Casey Jr. (Pa.), another Democrat who opposes abortion, said that he would support Nelson's effort, but that the issue would not make or break his vote on the bill.

"We've got to get this done to demonstrate that we can get something this substantial done, even in a difficult economy and in a difficult political environment," Casey told reporters after Obama's meeting with the senators.

Senators huddled on the second floor of the Capitol late Sunday, haggling over the public option. Under the Office of Personnel Management's idea, national plans negotiated by the agency would be offered through state-based insurance exchanges that the Senate bill would create for small-business workers and people who do not have access to affordable coverage through an employer.

One negotiator is Sen. Joseph I. Lieberman (I-Conn.), the only member of the Democratic caucus who has pledged to oppose legislation that includes a public option in any form. Although Lieberman said the talks were preliminary, he did not rule out supporting the OPM's framework under discussion.

"If it's private, and there's no federal government financial exposure, and the government's not creating an insurance company, that's a long way toward what I've been concerned about," he said.

Nelson, another critic of the public option, was noncommittal on the compromise efforts, although he is an active participant. "There are some ideas that make a lot more sense to me than other ideas," he said.

Another key lawmaker in the mix is Sen. Olympia J. Snowe (Maine), the only Republican who has supported Democratic reform efforts. She called the OPM's approach "a very novel and innovative idea," because the agency has experience negotiating with insurance companies. Individuals without employer coverage, along with small-business workers, would have access to the OPM-administered plans, she said.

But Snowe has other concerns about the bill, such as an increase in the Medicare payroll tax for high earners, that she conveyed to Obama in recent conversations, including during a meeting at the White House on Saturday. "There are so many conversations in numerous directions. It's hard to say right now where the consensus will evolve," she said.

Democrats said they hope Obama's address will lend fresh momentum on the eve of what could prove to be a make-or-break week. "It's very easy here to get wrapped around the axle and forget about the larger significance of what this is about," said Sen. Kent Conrad (D-N.D.). "This affects millions of people's lives. This is a big deal."

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