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Democrats ponder health-care reform plans in wake of Massachusetts Senate race

By Shailagh Murray and Lori Montgomery
Washington Post Staff Writer
Wednesday, January 20, 2010; A01

Unless Democrats can thread a very narrow legislative needle, Republican Scott Brown's upset victory over Martha Coakley in Massachusetts on Tuesday could lead to the collapse of a health-care bill that, only weeks ago, appeared close to becoming law.

Brown's election to fill the seat of the late senator Edward M. Kennedy (D) will reduce the Democratic majority in the Senate to 59 votes, just short of the 60 needed to break GOP filibusters. During his campaign, Brown pledged to help stop the health-care overhaul, the centerpiece of President Obama's legislative agenda. Kennedy had championed that reform until his death last summer, but the legislation has lost public support in recent months as negotiations have turned increasingly acrimonious.

"It will raise taxes, it will hurt Medicare, it will destroy jobs and run our nation deeper into debt," Brown said in his victory speech Tuesday night.

In public, Democratic leaders sought to sound optimistic that they could remain on course. "Whatever happens in Massachusetts, we will have quality, affordable health care for all Americans, and it will be soon," Speaker Nancy Pelosi (D-Calif.) told reporters after a House leadership meeting Tuesday afternoon. In an earlier interview, Pelosi asserted: "This will happen. This is not a casual relationship with this bill. This is a total commitment."

But other Democrats saw a bleak landscape, given numerous polls in Massachusetts -- a solidly Democratic state -- showing the unpopularity of the health-care effort. The biggest worry in the party is that moderates will now begin to back away from the legislation, fearing its political effects.

"It's a serious problem, and it's probably back to the drawing board on health care, which is unfortunate, because everybody agrees we have to do something about health care, and so it would be unfortunate to lose this whole effort," Sen. Russell Feingold (D-Wis.) told a Milwaukee television reporter.

Pelosi and her top lieutenants never broached the subject of contingency plans in their meeting, participants said, and instead combed through the minutiae of talks with the Senate over a final bill.

"No matter what happens, we have to reconcile all of these provisions," said House Education and Labor Committee Chairman George Miller (D-Calif.), a co-sponsor of the House bill. "Then we can have the choices of how we might want to proceed."

The Democratic leaders reconvened briefly after Coakley conceded, and with Brown's win, lawmakers said, they will spend the coming days considering an array of long-shot scenarios, each with serious downsides.

The most obvious path is for the House to pass the health-care bill that cleared the Senate on Christmas Eve. Administration officials have not asked House leaders to pursue this course but have made clear that they see few other options for salvaging the full scope of the current legislation, the culmination of a grinding, year-long effort by five House and Senate committees.

But as she left the Capitol late Tuesday night, Pelosi told reporters that the House is unlikely to take up the Senate bill in its current form.

"I think everyone [involved in the health-care negotiations] agrees that there are certain things in the Senate bill that must be changed," she said. "We do have our differences, and our members want to resolve those differences."

Liberals see the Senate subsidies to help low- and middle-income families buy insurance as too stingy, and conservative Democrats protest that the bill would do too little to restrict the use of federal funds to pay for elective abortions.

One alternative is for House leaders to pass the Senate bill and then try to fix it using a fast-track budget procedure known as reconciliation. Such bills cannot be filibustered in the Senate -- meaning they need just 51 votes to pass -- but rules limit their contents to provisions that affect the federal budget. Senior House Democrats said they are studying the rules for reconciliation to try to better assess its potential.

In another scenario, Democrats could scrap the health-care measure and start over in the Senate with a drastically scaled-back reconciliation bill -- one that could win 51 votes in that chamber and then pass the House. But lawmakers are unsure whether the Senate could legally initiate that process.

Or Democrats could simply shelve their grand ambition to expand health-care coverage to millions of people who cannot afford it and revert to a bare-bones measure that would include some of the most popular initiatives in the existing bills.

Paring back the legislation would allow Obama to return to his quest for bipartisan support, an effort that collapsed in September.

On Friday, the president spoke at length by telephone with Sen. Olympia J. Snowe (R-Maine), who supported an earlier version of the legislation but has since abandoned talks. "We're still working hard" to win Snowe's vote, White House spokesman Robert Gibbs said Tuesday.

But other Democrats said they are pessimistic that Snowe will return to the negotiating table unless she is accompanied by other members of her party.

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