White House escalates push for Senate health bill passage

Public option, Medicare buy-in dropped

By Kate Randall
19 December 2009

As the White House-backed health care overhaul makes its way through the Senate, it is becoming an ever more openly reactionary measure. The Obama administration is increasing pressure on Senate Democrats to pass a version of the legislation quickly, in the face of growing popular opposition.

Senate Majority Leader Harry Reid (Democrat, Nevada) is aiming for the bill’s passage by Christmas, December 25. To clear the way for a final vote, however, he must muster the support of all 58 Democrats and the Senate’s two independents to block a Republican filibuster. This vote on Reid’s “manager’s amendment” is tentatively set for 1 a.m. Monday morning, but at this point the 60 votes are not assured.

The president summoned Democratic senators to the White House on Tuesday for a closed-door meeting on the health care bill, and top White House officials have been in discussion with potential Senate holdouts to lobby for their votes.

Obama also met with Republican Senator Olympia Snowe of Maine for an hour and a half on Thursday. Snowe, considered a potential 60th vote if one of the Democrats falls through, commented Thursday evening, “I told the president I will continue to work, but the timing—final vote before Christmas—is completely unrealistic."

This week the legislation faced opposition from key members in the Democratic Caucus, who have threatened to filibuster with the Republicans, as well as from a former Democratic National Committee chairman who said the legislation has been so compromised in the interests of the insurance companies that he recommended it be abandoned.

Senator Ben Nelson, Democrat of Nebraska, says he will not vote for the legislation if it does not contain what he considers sufficient anti-abortion language. Nelson’s amendment to tighten restrictions on the use of federal funds for abortion was voted down by the Senate on December 8.

Nelson, a former insurance industry executive, favours language included in the Stupak-Pitts amendment to the House health care bill, which imposes a strict ban on abortion coverage in federally subsidized health insurance offered on the proposed insurance “exchange.”

Harry Reid has attempted to broker a compromise with the aide of another anti-abortion Democrat, Senator Bob Casey of Pennsylvania, who proposed adding funds to aid teen mothers and tax credits for adoptive parents. These measures were not enough to satisfy Nelson. He also opposes a new long-term care insurance program and proposed cuts in payments to nursing homes and home health care providers.

Nelson is still threatening to filibuster and has stated that Reid’s Christmas deadline is unattainable. Leading White House officials, including Jim Messina, a deputy chief of staff, and senior advisor Pete Rouse met Friday with Nelson in an attempt to hatch a deal. The administration has not indicated how far it will bend to Nelson’s rabid anti-abortion stance to secure his vote, but Obama has met personally with Nelson three times in the last eight days.

Earlier this week, Senator Joseph Lieberman of Connecticut, an independent who caucuses with the Democrats, said he would withhold his vote if a “public option” (an insurance option offered for sale by the government) were included in the final version of the bill. Majority Leader Reid withdrew the public option, in favour of a measure that would allow people aged 55 to 64 to “buy-in” to the Medicare program. Lieberman opposed this as well, and the “buy-in” proposal was also dropped.

The move to dump the public option and the Medicare buy-in apparently came at the insistence of White House Chief of Staff Rahm Emanuel, who urged Reid to cut a deal to win Lieberman’s vote. Although Obama promoted the public option during his presidential bid, since the early days of the health care debate in Congress he has said he would sign a bill that did not include it.

As it had been conceived, the Senate bill’s public option had already been watered down, and would have allowed states to “opt out” of the option if they chose. However, this fig leaf of reform—which would provide little competition to the private insurers—has been vigorously opposed by insurance industry lobbyists. Republicans have denounced it as the first step in a “government takeover” of the health care system.

The House health care bill passed in early November includes a public option, but stops short of allowing the government to set payment rates as in the Medicare program. Rather the secretary of Health and Human Services (HHS) would have to negotiate payments to doctors, hospitals and other providers. The Senate’s dropping of the public option makes is highly unlikely that it would survive in any form in reconciliation with the House bill.

In response to the Senate ditching the public option, former Democratic National Committee chairman Howard Dean called for the Senate to “kill the bill.” In an opinion piece in Thursday’s Washington Post, Dean wrote, “If I were a senator, I would not vote for the current health care bill.”

While Dean indicated his support for certain provisions of the bill, such as its expansion of eligibility for Medicaid, he objected to others that would fine people for not having insurance and would allow insurers to charge older people higher premium prices. He added, “The winners in this bill are insurance companies; the American taxpayer is about to be fleeced in a situation that dwarfs even what happened at AIG.”

The Obama administration fired back at Dean and his liberal advocacy group Democracy for America. While side-stepping the public option issue, White House spokesman Robert Gibbs stated that the bill would trim costs, reduce the deficit and insure 30 million currently uninsured Americans. “I don’t think any rational person would say killing a bill makes a whole lot of sense at this point,” Gibbs said.

David Axelrod, senior advisor to Obama, said abandoning the effort to pass health care legislation would be “a tragic outcome.” Former President Bill Clinton issued his own statement, writing in part, “America can’t afford to let the perfect be the enemy of the good. And this a good bill.”

Dean’s statements reflect the concern of sections of the Democratic Party over the implications of mounting popular opposition to the health care overhaul. While committed to the basic goal of reducing government spending, they looked to the “public option” as a means providing the measure with a “progressive” gloss.

The latest NBC News-Wall Street Journal poll shows support for the Democratic health care plan has dropped to a new low of 32 percent, with 47 percent calling it a “bad idea.”

The past week’s manoeuvrings on the part of the White House and Senate Democratic leaders to secure a deal have exposed just how far removed the official debate over health care is from the needs and concerns of the vast majority of Americans.

With every revision made to court the vote of this or that right-wing Senator, the true nature of the legislation comes more clearly into focus. The Obama-sponsored legislation is motivated first and foremost by a drive to cut costs for the government and to boost the profits of the giant insurers and pharmaceuticals.

Whatever version of the Senate bill is passed—assuming Obama and Reid can muster the 60 votes—it would leave an estimated 25 million people uninsured. It would mandate individuals and families to obtain coverage or pay a penalty, and impose a tax on higher-priced insurance premiums held by unionized and other workers.

The Obama administration has demanded that any bill he signs must be “deficit neutral.” To this end, the 10-year $848 billion bill would cut more than $400 billion from Medicare, threatening real reductions in care for the elderly and disabled enrolled in the government-run program for the elderly and disabled. These reductions are, in fact, the overhaul’s main purpose.

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