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Senate may drop public option
Key liberals said they were prepared to abandon a government-run insurance program if it would move the chamber closer to a final deal, provided it was replaced with other coverage options and tighter restrictions on insurance companies. "I don't think we're going to get that right now," Sen. John D. Rockefeller IV (D-W.Va.) said of the public option. "So we're going for as strong a regulation guidance as we possibly can."
Democrats made a different calculation on abortion. Although the House voted Nov. 7 to bar their public plan from offering abortion coverage and to prohibit people from using federal subsidies to purchase private policies that cover elective abortion, Senate Democrats rejected Nelson's measure, despite the potential threat to final passage. Six Democrats joined all but two Republicans to support the tighter rules, but some Democratic abortion opponents -- including Reid -- opposed the amendment as too far-reaching.
In a speech on the Senate floor, Reid said the current Senate language, which would allow individuals who qualify for insurance subsidies to purchase abortion coverage with their own money, represented "a fair middle ground."
He told reporters that he will seek other avenues in attempting to allay Nelson's concerns, but added, "This is not the right place for this debate. We have to get on with the larger issue at hand." After the vote, Nelson said he will not rule out supporting the final Senate measure. "Let's see what develops. One thing I've found is that the future sometimes can surprise you," he said.
Nearing the finish line
A series of pending amendments, including several popular measures, must be resolved before Reid can end debate on the bill and call a final vote. On Wednesday, the Senate is expected to consider a bipartisan effort to allow cheaper prescription drugs to be imported from Canada and other countries. And a group of Senate Democratic freshmen is pushing a package of cost-control provisions, including an expansion of an independent Medicare advisory board that would allow it to recommend changes to the entire health-care system.
Despite the full slate, Reid said he is optimistic. "Every day that we work on these amendments and do the negotiations we're doing," he told reporters, "the closer we get to the finish line."
After the vote, Nelson returned to the talks about the public option. In addition to the ideas accepted late Tuesday, the group had been discussing an additional expansion of Medicaid eligibility, an idea that many moderates dismissed as too expensive. Many also have doubts about letting younger people who do not have access to coverage through an employer buy into Medicare.
By some estimates, that idea could add as many as 3 million people to the financially struggling program. The Congressional Budget Office has estimated that those individuals could face annual premiums of as much as $7,600. And because such a program could encourage people to retire earlier than they might otherwise, a buy-in program could increase Social Security costs for the federal government.
Still, key senators, including Snowe, said they would be willing to discuss a Medicare buy-in program so long as states with particularly low Medicare reimbursement rates were compensated and a mechanism was adopted to ensure that Medicare would not suffer financially because of the expansion.