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White House Weighs Idea of Splitting Health Bill

By Adriel Bettelheim, CQ Staff

August 20, 2009 – With prospects for a bipartisan agreement increasingly slim, the Obama administration is weighing the merits of splitting a health care overhaul into two pieces.

Under such an approach, the most contentious provisions—including those creating a government-run health plan—would advance under the budget reconciliation procedure, making that bill immune to filibuster in the Senate.

White House Press Secretary Robert Gibbs declined to comment on the possibility on Thursday, saying President Obama remains committed to working with Republicans and Democrats on a comprehensive plan. A bipartisan group of six Senate Finance Committee members involved in ongoing talks is scheduled to hold a conference call Thursday night to evaluate their next steps.

However, individuals familiar with the administration's thinking say the White House is increasingly comfortable with a strategy that could push part of the health care legislation through the Senate without Republican votes.

Under one scenario, Senate Democratic leaders could break off provisions that enjoy significant bipartisan support, including new regulations barring insurers from denying coverage based on pre-existing medical conditions and placing caps on some out-of-pocket expenses. These provisions, which wouldn't require new spending, are believed to be capable of garnering the 60 votes necessary to overcome a filibuster.

Senate leaders could then package more contentious provisions, including those dealing with a public plan to compete with private insurers and tax increases to finance an overhaul, into a separate measure they would try to pass using the reconciliation process. Reconciliation bills can pass the Senate with a simple majority instead of the 60 votes needed to thwart blocking tactics by the opposition.

Splitting the bill probably would be necessary if Democrats opt to use reconciliation in any manner, because under Senate rules, the reconciliation process cannot be used for provisions that don't affect income or spending.

Democrats theoretically control 60 votes in the Senate. But the absence of Edward M. Kennedy, D-Mass., who is battling brain cancer, and the frail health of 91-year-old Robert C. Byrd, D-W.Va., leaves them short of that number as a practical matter. 

A House health care bill (HR 3200) contains a public plan. But centrist party members in both chambers have become increasingly skittish about details of the health care bill and its price tag over the August recess, influenced by sometimes fiery confrontations at town hall meetings and withering attacks from the political right.

Gibbs said it was unlikely Obama would be discussing a split-bill strategy with aides next week while he vacations in Martha's Vineyard, Mass. He said Obama will not participate in Thursday night's conference call among the Senate negotiators.

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