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By CARRIE BUDOFF BROWN & CHRIS FRATES | 12/19/09 9:34 AM EST
POLITICO
Sen. Chuck Schumer told reporters in the Capitol that the deal was finalized late Friday night, with a handshake at 10:30 p.m.
Senate Democrats announced a deal Saturday morning on a wide-ranging overhaul of the nation’s health care system, setting a course for a vote by Christmas and delivering President Barack Obama a badly needed victory on his top legislative priority.
A 13-hour negotiating session that stretched into the night Friday finally clinched the support of the last Democratic holdout, moderate Sen. Ben Nelson (D-Neb.) The handshake deal cleared the way for a series of votes that could stretch until 7 p.m. Christmas Eve.
“Change is never easy,” Nelson told reporters. “I truly believe this legislation will stand the test of time. The lives of millions Americans will be improved.”
Nelson agreed to support the bill after Democrats strengthened restrictions on federal funding of abortion, by allowing states to opt out from allowing plans to cover abortion in a new insurance marketplace. Also, enrollees in plans covering abortion must pay separate checks – one for abortion, one for the rest of services.
Similar proposals have come under fire from pro-life groups who call the maneuver a shell game. They argue that because the insurance plans offered through the exchange are eligible for federal subsidies, taxpayer money is still paying for the coverage of abortion.
Nelson also won his own version of Sen. Mary Landrieu's much-derided "Louisiana Purchase." In Nelson's case, the federal government will permanently pick up all the cost of new Medicaid enrollees in Nebraska, rather than splitting the tab with the state, as is usually done. Nelson’s Nebraska is the only state singled out for such treatment – a $45 million cost to federal taxpayers that shows the power of a single senator in this debate.
The federal government will also pick up the tab for all new Medicaid enrollees in the other 49 states through 2017.
Sen. Tom Harkin (D-Iowa) said the move may prove permanent.
"In 2017, as you know, when we have to start phasing back from 100 percent, and going down to 98 percent, they are going to say, 'Wait, there is one state that stays at 100?' And every governor in the country is going to say, 'Why doesn’t our state stay there?'" said Harkin.
"When you look at it, I thought well, God, good, it is going to be the impetus for all the states to stay at 100 percent. So he might have done all of us a favor."
Nelson, however, made clear that if the compromise on restricting federal funding of abortion and Medicaid funding don’t survive in the final House-Senate compromise, he will not support the final bill.
If there are material changes in that conference report that are different from this bill, I reserve the right to vote against" the bill, Nelson said. He also said he was assured there would be a “limited” House-Senate conference that wouldn’t make big changes to the bill.
Republicans instantly blasted the bill as secretly crafted, hastily decided and bad for the American people. “This bill is a legislative train wreck of historic proportions,” said Senate Republican leader Mitch McConnell (R-Ky.) "If they were proud of this bill they wouldn't be doing it this way."
Sen. Tom Coburn (R-Okla.) sharply criticized Nelson’s abortion compromise, saying whoever negotiated the abortion provisions “threw unborn babies under the bus."
But for one snowy Saturday at the Capitol, Nelson’s assent was all Democratic leaders needed to send the bill to the Senate floor.
Senate Majority Leader Harry Reid (D-Nev.) and others spoke of being on the cusp of an historic achievement dreamed about by Democrats for decades – to provide near-universal coverage to the more than 30 million Americans who currently have no insurance. The bill accomplishes this though a complex web of federal subsidies, an expansion of Medicaid, a new nationally run health plan with private company policies and new rules that prevent insurance companies from rejecting coverage.
Sen. Chris Dodd (D-Conn.), chairman of the Senate Banking Committee, grew emotional as he recalled how the late Sen. Ted Kennedy had spent a career hoping to reach this moment.
Kennedy never stopped believing that “in the wealthiest country in history, everyone should be guaranteed access to health care, and he never stopped believing that in the freest country in history that it would come to pass,” Dodd said. “This moment and these moments do not come often. We will not and we must not let it slip through our hands.”
But what the Senate bill doesn’t include is a government-run health care option, after Nelson and other moderate Democrats called it a deal-killer. Already, that has drawn sharp criticism from liberal Democratic activists, such as former Democratic National Chairman Howard Dean, who said earlier this week Democrats should scrap this bill and start over.
Reid took on the criticism directly.
“Some who are progressives, they feel that this bill doesn’t go far enough... But this bill, this bill, will do so many good things for so many people,” Reid said. “This broken system cannot continue, and it will not continue. All Senate Democrats stand shoulder to shoulder with President Obama and the American people who know inaction is not an option.”
If the Senate passes the bill next week as expected, it will go into a conference with Democrat House leaders – whose bill is far more liberal than the Senate version. The House bill includes a government-run health care option and a different mechanism to pay the nearly $900 billion cost, and that could cause problems when the two houses try to merge their bills – forcing Obama ultimately into the role of conciliator between the two sets of Democrats.
The stakes for Obama in this debate are high, as Democrats worried that if the Senate fell short, the president would get criticized for spending nearly his whole first year trying to get a health bill through and coming up empty. In fact, many Democrats who don’t fully support the bill seemed to have become persuaded in recent weeks of the White House’s main argument – it’s far more politically damaging to pass nothing, than to pass something that polls show many American don’t support.
But even getting to this compromise wasn’t easy. Sen. Chuck Schumer (D-N.Y) told reporters in the Capitol that the deal was finalized late Friday night, with a handshake at 10:30 p.m. The negotiations, which included Reid, Schumer, Nelson and White House officials Pete Rouse and Jim Messina, ended after a marathon 13 hours of talks.
There were many times they thought they couldn't come to an agreement,” Schumer said. “We are now for the first time really feeling good. I think every Democrat realized whatever his or her views, we had to get this done.”
But Schumer made clear the negotiations, which centered on abortion funding and Medicaid expansion were touch and go. “There were several times in that room where we thought we wouldn't have a deal," he said.
And in fact, Nelson left the Capitol about 10 p.m. Friday telling reporters there wasn’t a deal – at least not a final one – and that all sides had to sleep on it.
The compromise gets Reid to the 60 votes he needs to move ahead with health reform, but it’s going to be a long weekend. The first vote right now is set for 1 a.m. Monday – after a reading of the so-called manager’s amendment released this morning. The final vote, under the current calendar, would take place at 7 p.m. on Christmas Eve.
The bill would call for the creation of national health insurance exchange that would allow people to shop for insurance, subsidies to help low-income people buy insurance and an expansion of Medicaid. It does not include the government-run health insurance option that Nelson and other moderates objected to – and its absence has drawn fire from liberal critics who say the bill doesn’t amount to true reform.
While the set up might not satisfy pro-life groups, the important point for Democrats today is that it wins Nelson's vote, which they need to pass a bill.
Reid needed to get a deal in place so he can begin the procedural steps necessary to pass the health care bill by his self-imposed Christmas Eve deadline. Senate Republicans have already asked for a full reading of the amendment, which could take several hours, depending on its length.
Reid needs the reading to end by 11:59 p.m. Saturday. This is because Reid needs at least one day, which would be Sunday, between when he moves to end the debate on the amendment and when the Senate votes early Monday morning.
Despite the ticking clock for the Democratic leadership, Nelson said Friday he wasn’t operating on a deadline.
"I'm not focused on that deadline. What will be will be when it comes to the deadlines. That's up the leader to establish,” Nelson said. “I've seen a proposed schedule, but I'm not going to predict whether or not we can meet that schedule. I'm focused on getting this right rather than according to a deadline."
Before Reid can set in motion the steps toward a vote on the bill, the Congressional Budget Office needs to return a cost estimate, which is expected later today.
The lack of details — less than 72 hours before senators are scheduled to cast the first key vote on Monday at 1 a.m. — came under attack Friday from Sen. John McCain (R-Ariz.) and Minority Leader Mitch McConnell (R-Ky.)
"The majority leader has signaled that he is going to unveil the most significant piece of domestic legislation in memory, and his goal after introducing that measure in the morning presumably would be, of course, to vote on it some 36 hours after that,” McConnell said. “What we know for sure at the moment, is that we've seen the Pelosi bill and we've seen the Reid bill, but none of us ... have seen the newest bill, which is a mystery to virtually everyone, including the Democratic leaders of the Senate."
At a morning press conference, the Republicans used visual aids to press their point. The health care bill from the House and Reid’s original legislation in the Senate were piled on a table — next to a skeleton of packing tape meant to represent the manager’s amendment that had at that point yet to emerge.
Jake Sherman contributed to this report.
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