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Senate Machinations Begin Anew

By Joseph J. Schatz, CQ Staff

November 10, 2009 -- Senate maneuvering on health care has started in earnest, with members preparing amendments and plotting strategy on flash points such as abortion.

And one Republican moderate hopes to change key parts of the bill by teaming up with moderate Democrats who support the legislation's goals, but not all of its details.

"There is considerable unease on both sides of the aisle about the impact of this bill," said Susan Collins of Maine. Collins has been talking to several Democrats about potential amendments, some focused on helping small businesses navigate new requirements in the health care overhaul. Majority Leader Harry Reid, D-Nev., said Monday that he will do his "utmost" to bring the bill to the floor the week of Nov. 16.

While narrow passage of a House health care overhaul package (HR 3962) on Nov. 7 did little to diminish the contentious issues facing the Senate—what the bill costs, whether it will include a government-run "public option" and how it will deal with politically difficult topics such as abortion and immigration—it has spurred some moderates to search for common interests.

Still, it has not taken long for some senators to jump into the divisive issue of abortion funding under the new programs the bill would establish. A group of female senators who support abortion rights are joining forces to find an alternative to tough restrictions adopted by the House.

Sen. Barbara Boxer, D-Calif., a staunch abortion rights supporter, said the Pro-Choice Caucus would meet Nov. 12 in an effort to ensure that the House amendment sponsored by Bart Stupak, D-Mich., does not find its way into the Senate bill.

The provision would extend a ban on federal funding for abortion to the insurance programs created by the bill and bar insurers selling plans through a new government-run "exchange"—including a government-run plan—from offering policies covering elective abortion to women whose premiums are subsidized by federal funds.

Despite renewed deal-making, the Senate remains in a holding pattern, waiting for the Congressional Budget Office to finish estimating the cost of alternative health care proposals sent by Reid.

The alternatives were based on the bills approved by the Finance Committee (S 1796) and the Health, Education, Labor and Pensions panel (S 1679). Democratic leaders still anticipate the estimates will be available late this week or over the weekend, aides said.

Unlike in the House, the Senate's Democratic moderates and Republicans will wield far more influence during its debate. "Honestly, I'm not even focused on the House bill," said Jon Tester, a moderate Democrat from Montana. "My focus is on the combined bill Sen. Reid is putting together."

Collins said Monday she hoped to attract support from Democratic and GOP moderates for varied amendments, tapping into concerns about the bill's impact on small businesses and other constituencies that have made vote-counting difficult for Democratic leaders. Collins has been talking to the "usual suspects," moderates in both parties, she said.

"Small businesses should be able to purchase insurance across state lines," Collins said, adding that small businesses should also be allowed to pool their workforce to get more affordable coverage in employer-sponsored plans. She also wants to change the structure of tax credits, included in the Senate Finance bill, that are designed to help small companies provide health insurance.

Questions on Abortion
Abortion, meanwhile, appeared destined to roil the majority's drive to advance the bill.

The version the Finance Committee approved does not change existing law, which bars federal funds from being used for any abortion services. Under the bill, state insurance exchanges would have to include at least one plan that provides abortion coverage and one that does not. The Health and Human Services secretary is required to ensure that only private funds are used for abortion coverage services, a Finance aide said.

In its September markup, the committee rejected an amendment from Orrin G. Hatch, R-Utah, similar to the amendment the House adopted. "I think the Senate Finance Committee did a good job of putting up a firewall" that would prevent federal funds from being used for abortion services, said Collins, an abortion rights supporter.

Still, the Finance version does not include a government-run health insurance option, and if one is added, language ensuring existing restrictions will have to be extended to the new program as well, Collins said.

But Boxer declared that the House language singles out women for "unfair treatment," adding that she will fight to ensure that the Finance Committee language stands.

On the other side, Ben Nelson, D-Neb., an abortion rights opponent, said Monday that he wants the final Senate bill to include the Stupak language, a position that could draw other conservative Democrats, as well as Republicans.

Finance Chairman Max Baucus, D-Mont., said he had hoped his committee's approach would resolve the abortion issue. "We have to find a solution. We need 60 votes. We're going to be burning the creative midnight oil," he said.

The issue poses a dilemma for Reid: Should he include the more restrictive House abortion language in the bill he will send to the floor and force abortion rights advocates to try to strip it, or should he leave the House abortion language out of the Senate bill and dare abortion rights foes to try to win an amendment adding language mirroring Stupak's to the bill?

Baucus said he doubts supporters of the House language would have sufficient votes to add similar language as a floor amendment.

Reid, an opponent of abortion rights, will be "talking to colleagues about this and other issues in the days ahead as we work on bringing a bill to the Senate floor," spokesman Jim Manley said Monday.

Conservative Bob Corker, R-Tenn., meanwhile, is preparing varied amendments aimed at the bill's cost and cuts in Medicare. He plans to offer them with five or six other senators, he said. "We have a long number of amendments we're looking at," Corker said.

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