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Shaken Democrats Weigh Health Care Overhaul Options, Including 'An Individual New Bill'

By John Reichard, CQ HealthBeat Editor

January 20, 2010 -- When it comes to a massive overhaul of the health care system, staying the course in the face of adversity may make a nice slogan, but it's lousy politics and policy, many Democrats said on a Wednesday full of woe after Massachusetts Senate election results that brought an end to their ability to move an overhaul with a filibuster-proof 60 votes in the Senate.

Paramount in their minds appeared to be hewing to what they read as the mood of the national electorate, based on the election results in the Bay State that gave Republican state Sen. Scott Brown the seat held for decades by the late Democratic Sen. Edward M. Kennedy.

"I would advise that we try to move quickly to coalesce around those elements of the package that people agree on," President Obama said in an interview with ABC News that addressed the election results.

"I think that's a reasonable alternative," responded House Majority Leader Steny H. Hoyer, D-Md., whose House Democrats still possess the sheer numbers they need to accomplish a massive overhaul that would cover 31 million uninsured people—simply by taking up and passing the health care overhaul measure (HR 3962) adopted by the Senate.

The Brown victory would not block that path to an overhaul—an historic change that has eluded presidents going back more than 100 years. But Democrats focused heavily on reading the tea leaves from Massachusetts, voicing concern about the public angst they observed in the results, which of course have a bearing on their own election prospects.

"Given the public's concern, I think we ought to focus on that we think the public can support and will be possible in terms of making health care more affordable" and attainable, Hoyer said. "You could do it in a number of ways," he added. "You could do it in an individual new bill."

Obama shed some light on what he thinks lawmakers should coalesce around.

"We know that we need insurance reform, that the health insurance companies are taking advantage of people," he said in the interview. "We know that we have to have some form of cost containment because if we don't, then our budgets are going to blow up and we know that small businesses are going to need help so that they can provide health insurance to their families. Those are the core, some of the core elements of, to this bill."

But how can premiums be made affordable without an individual mandate that people buy insurance—the element that makes an overhaul sweeping in scope? Many policy analysts say that to bring down premiums for those who can't find affordable coverage, a mandate is needed to bring young and healthy uninsured Americans into insurance pools where they can offset the costs of treating older and sicker Americans.

House Democratic leaders who met Wednesday afternoon appeared to be focusing on that very question. "That's where we're talking," said Rep. Xavier Becerra, D-Calif.

Not all Democrats were thinking major change in their approach to an overhaul, however, including some senators once viewed as on the fence about the Senate bill before they voted yes. Sen. Joseph I. Lieberman, I-Conn., said he thought a bipartisan approach is needed to a heath care overhaul, but noted pointedly that he was a yes vote for the Senate bill.

Two red-state Democratic senators, Ben Nelson of Nebraska and Mary L. Landrieu of Louisiana, also renewed their expressions of support Wednesday for the Senate-passed measure as the right approach to an overhaul.

But other Democrats described a dramatically altered political landscape. California Democratic Sen. Dianne Feinstein said "the situation has changed dramatically and I think it's a sweep across the country. I think that. . .the administration has to see it and we have to see it. And therefore everything is jobs and the economy and education. People are worried about education.

"I think we. . .go slow on health care," she added. "It is so big it is beyond (people's) comprehension" and makes the issue vulnerable to distorted criticisms by opponents.

Asked if Democrats were overreacting in that they still have 59 votes in the Senate and the election results Tuesday were only from one state's special election, Democratic Sen. Kent Conrad of North Dakota expressed incredulity.

"Ha, ha, ha," Conrad responded. "Anybody that doesn't get the message of what's happening across the country politically is really tone deaf. I don't know what could be more clear than people are angry, they're upset, they're anxious and if you don't deal with that you do so at your peril."

So you pull the plug on the whole overhaul effort? a reporter pressed. "No, that's not what I've said," Conrad replied. "That's not what I've said." But Conrad said a pared-down bill "is a possibility."

Democrats emphasized that they are weighing options on health care, however, and that a period of time is needed to let the dust settle.

Obama urged a more reflective approach. "It is very important to look at the substance of this package and for the American people to understand that a lot of the fear mongering around this bill isn't true," he said.

But the idea of jamming a House-Senate compromise before Brown is seated appears to be dead, and the notion of having the House vote on the Senate bill is drawing a negative early reaction.

Obama said the Senate should not act on an overhaul until Brown is seated. "I think it is very important for the House to make its determinations," he added. "I think, right now, they're feeling obviously unsettled and there were a bunch of provisions in the Senate bill that they didn't like, and so I can't force them to do that."

Asked if he would vote for the Senate bill, House Ways and Means Committee Chairman Charles B. Rangel, D-N.Y., said "I don't think we're going there."

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