Attention Shifts to Senate Reform Efforts After House Passes Bill

The focus of the health care reform debate this week is expected to shift back to the Senate, after the House on Saturday passed its reform bill (HR 3962), Politico reports.

Senate Majority Leader Harry Reid (D-Nev.) -- who is leading the effort to produce a final Senate bill -- is facing opposition from some Senate moderates over certain provisions in the bill (Budoff Brown/Raju, Politico, 11/8).

According to the Wall Street Journal, the slim margin by which the House bill passed -- 220-215 -- emphasizes the potential challenges ahead for Reid and other top Democrats. Senate lawmakers have yet to reach a consensus on the financing mechanisms of their bill and whether the package should include a government-run public insurance plan option.

In addition, the division in the House over abortion funding, which "almost derailed the House vote," also is expected to surface in the Senate (Adamy/Bendavid, Wall Street Journal, 11/9).

Jim Manley, a spokesperson for Reid, said that the Senate could use the House vote as a gauge on how to address the potential sticking points, such as the issue over abortion coverage (Politico, 11/8).

Public Option One Sticking Point

According to the AP/Atlanta Journal-Constitution, the public option has drawn criticism from some Senate Democrats, particularly a few moderates "who hold the balance of power" in the chamber.

Last month, Reid added a public option with a state "opt-out" clause into the bill as a compromise to a national public plan, in part to attract the 60 votes he needs to start a debate on the bill and to bring the measure to a final vote (Alonso-Zaldivar, AP/Atlanta Journal-Constitution, 11/9).

However, Sen. Joseph Lieberman (I-Conn.), during an appearance on "Fox News Sunday," reiterated his earlier stance that he would help block any legislation in the Senate that included a public option (Wall Street Journal, 11/9).

Abortion Still a Hot-Button Issue in Both Chambers

A provision to prohibit federal funds from being used to subsidize abortion coverage is expected to emerge as a central issue during the debate on the Senate's bill, the Washington Post reports.

The House on Saturday approved an amendment that would significantly curtail the availability of coverage for abortion services, which currently are covered by private insurers.

Abortion-rights supporters are committed to removing the amendment in the final bill, which will be developed in conference between the two chambers.

Manley acknowledged that the debate over the issue in the Senate would get more heated (MacGillis, Washington Post, 11/9).

Sanders Potentially 'Spoiler' for Reid

Although Lieberman emerged as a "headache" for Reid and other Democrats seeking to corral enough votes to proceed on the Senate bill, The Hill reports that the other independent senator Democrats are counting on for support actually might turn out to be a "spoiler."

During a recent interview, Sen. Bernie Sanders (I-Vt.) -- who, like Lieberman, usually caucuses with the Democrats -- declined to say he would vote with Democrats on the expected procedural votes and reiterated his support for a government-run public option.

Sanders said, "All I'll say for now is that I want the strongest public option possible in the bill," adding, "Beyond that, we're going to have to look at what develops" (Rushing, The Hill, 11/9).

Republicans Not Looking To Derail Legislation

Republican members of the Senate -- who have roundly opposed the Democrats' proposals -- are not looking to "derail the legislation entirely," according to the Chicago Tribune.

Still, the GOP has more clout in the Senate than in the House. GOP senators might introduce amendments to the bill, or at least raise political pressure on their moderate and conservative Democratic colleagues to push for changes to the measure, the Tribune reports (Hook, Chicago Tribune, 11/9).

Timeline

Reid is facing growing pressure from some Democrats and White House officials anxious about the lengthening timeline of the Senate's bill, Politico reports.

Last week, Reid suggested that floor debate on the Senate bill might not begin until after Thanksgiving and added that the Congressional Budget Office's delay in providing a score on the bill could push the debate into 2010 (Politico, 11/8).

CBO is expected to release its score by the end of this week, the AP/Journal-Constitution reports (AP/Atlanta Journal-Constitution, 11/9).

According to Politico, the House action on Saturday "elevated the stakes" for Reid to send a final bill to the floor (Politico, 11/8).