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Senate Democrats Drop the Public Option to Woo Lieberman, and Liberals Howl

By Jane Norman and John Reichard, CQ HealthBeat

December 15, 2009 -- Democratic senators traveled to the White House on Tuesday for a meeting with President Obama aimed at building a united front on health care, and Sen. Joseph I. Lieberman said he'd likely join with them in backing a measure that dropped a government-sponsored insurance program.

But a firm 60 votes to limit debate remained elusive as the clock ticked down toward the Christmas recess and senators still awaited a new score from the Congressional Budget Office. Protestors gathered at both ends of the city, with liberals upset by the lack of a public option rallying at Lafayette Park facing the White House and conservatives chanting "Kill the Bill!" massed across the street from the Senate.

Obama said after meeting with Democrats that "I'm feeling cautiously optimistic we can get this done," though he also acknowledged disagreements remain that need to be ironed out. Democrats do share a broad consensus that Americans need to be protected from the worst abuses of the health care industry, he said.

"There are still some differences that have to be worked on," said Obama. "This was not a roll call. This was a broad-based discussion about how we move forward." He did not mention Democratic Sen. Ben Nelson of Nebraska, whose opposition to abortion language remains as a problem.

Senate Finance Committee Chairman Max Baucus came away from the meeting at the White House saying that members of the Democratic caucus "are more enthusiastic" about the overhaul measure. The Montana Democrat said there was a sense of "joyfulness" about moving closer toward a bill that can get through the Senate.

"This will pass," Baucus said. "This will pass. There will be 60 votes for this within the next week, ten days."

That of course would be Christmas Day. Perhaps Santa will have to be enlisted to deliver the final "yes," given how elusive 60 votes seem to be.

Democrats skittered away from a government-sponsored plan in the Senate bill (HR 3590) in the face of Lieberman's opposition, needing the independent's vote, and Lieberman said the measure now looked much better to him.

He told reporters that if a proposed Medicare buy-in for people age 55 to 64 is out and there are no similar alternatives added, "then I'm getting toward that position where I can say what I've wanted to say all along, that I'm ready to vote for health care reform."

Liberals outside Congress reacted with outrage over what they saw as a cave-in to Lieberman. Former Democratic National Committee Chairman Howard Dean said in an interview on Vermont Public Radio that the Senate legislation should die rather than go forward without a government-sponsored plan.

"This is essentially the collapse of health care reform in the United States Senate," said Dean, a physician who's been outspoken about health care legislation. "And, honestly, the best thing to do right now is kill the Senate bill and go back to the House and start the reconciliation process, where you only need 51 votes and it would be a much simpler bill."

The progressive advocacy group sent an e-mail to members urging they call President Obama and tell him they are "extremely disappointed" in how the health care debate is going. "This isn't what 70 million of us voted for last year," said the e-mail.

But Democratic Sen. Debbie Stabenow of Michigan said the main goal is to see a bill approved that will extend insurance coverage to an additional 30 million Americans. "We're in a process, a legislative process, where we have to bring everyone together and get the very best we can and then keep working," said Stabenow at a press event with faith leaders. The original Medicare bill approved in the 1960s did not include many provisions it has today but it was a framework that later was strengthened, Stabenow said.

"This is about a framework," she said. "Don't underestimate the mere principle of getting into law that every American should have access to affordable health insurance, that health care is a right and not a privilege in America. That fundamental framework will change the debate going forward."

Sen. Ben Cardin of Maryland said he's "very optimistic" the Senate bill will reduce costs and more, and rejected criticism that the measure is worthless without a government-sponsored plan of some kind. "We knew from the beginning the public option would require 60 votes to move forward," said Cardin. "At this point we don't have 60 votes. Does it mean we are going to give up? No."

Jim Winkler, general secretary of the general board of church and society of the United Methodist Church, was at the event and said in an interview that the denomination is not happy about the decision to kill the public option. He and other faith leaders have been vocal in supporting a need for change in the system. "We don't like it, not one bit," said Winkler. "It could have been, and should be, a better bill."

Sen. Sherrod Brown, D-Ohio, said he made a direct appeal to Lieberman at the White House meeting to support the Medicare buy-in, apparently without success.

Amidst the turmoil over Lieberman, Sen. Roland W. Burris popped up as a worry. He issued a statement saying "the health bill has not yet won my vote." The Illinois Democrat expressed concern about whether the goals of the public option — better cost containment, more competition, and more accountability of insurers — would be met under the legislation.

"In the process of this debate, we have all made concessions," Burris said. "We have all compromised."

Quoting Mahatma Gandhi, Burris said, "but there can be no give and take on fundamentals. Any compromise on mere fundamentals is a surrender."

Earlier in the day, the two Republican senators from Maine, Susan Collins and Olympia J. Snowe, suggested they won't be playing Santa Claus for Democrats this Christmas.

Collins sought to downplay expectations that she might vote yes given her recent joint efforts with Democrats to improve cost containment provisions in the legislation. "I'm still very concerned about the enormous cuts" in Medicare, she told reporters Tuesday.

Snowe said it would be "difficult" to address her remaining concerns about the legislation before Christmas. "I'm deeply concerned about the timeline under which we are operating," she said.

Both mentioned they have been in discussions with various White House officials and Collins said she wants to continue to work on the bill. "I think something is going to pass and I would like to make that bill as good as possible even if ultimately it's not a bill I can support," she said.

"I believe I have an obligation to improve the bill, not to just say no," she said. "I've had extensive discussions with the president, with his chief of staff, with the OMB director, with the White House health policy director. Those have been helpful and I appreciate the dialogue we're having but they certainly have not moved me to support the bill at this point."

On the Senate floor, meanwhile, Sen. Frank R. Lautenberg, D-N.J., offered an amendment that would gut an amendment by fellow Democrat Byron L. Dorgan of North Dakota allowing Americans access to brand-name drugs at lower prices charged in certain foreign countries.

Lautenberg said such access could be "catastrophic" and a "matter of life and death."

"As much as we want to cut costs from consumers we cannot afford to cut corners," he said. "Drugs from other countries have dangerously high counterfeit rates."

Lautenberg's language would require the Food and Drug Administration to certify that imports of the lower cost drugs would be safe, something FDA has already said it would not do.

However the Dorgan amendment failed to get the 60 votes it needed to be adopted. A total of 51 senators voted for the amendment while 48 voted against it.

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