Pushback Grows as Senate Nears Passage of Health Reform Bill

With the Senate inching closer to final passage of its health care reform legislation (HR 3590), Republican lawmakers and other opponents of reforming the U.S. health care system have become more vocal in their criticism of the bill. However, no amount of grumbling can overcome the fact that Democrats now have the 60 votes they need. The last vote came in on Saturday when Sen. Ben Nelson (D-Neb.) announced that he would vote in favor of reform after winning concessions for stricter language on abortion coverage.

Senate Majority Leader Harry Reid (D-Nev.) unveiled a manager’s amendment — which made several key changes to the legislation, including replacing a public option with multi-state plans that would be run by the Office of Personnel Management — and Sen. Judd Gregg (R-N.H.) promptly attacked the legislation. In a statement, Gregg called the legislation “nothing more than a rehash of expensive and unpopular ideas.” Gregg added that the plan “represents a massive expansion of the federal government that will cost $2.3 trillion over 10 years when fully implemented.”

A Congressional Budget Office score released on the same day as Gregg’s statement said the bill would cost $871 billion and would reduce the federal deficit in the first 20 years after enactment. However, Gregg concluded, “The lesson to be learned here is that to secure 60 votes in the Senate, you have to produce legislation that spends more, taxes more, and borrows more.”

Prior to a 1 a.m. cloture vote on Monday, Sen. Mike Enzi (R- Wyo.) made his feelings known on the Senate’s reform vision. In a statement released via his Web site, Enzi said, “As families across the country look forward to the Christmas holiday, Senate Democrats are planning to deliver an early lump of coal in every American’s stocking.” Enzi criticized Democrats for “trying to pass a bill that would drive up costs, hike taxes by the New Year, slash Medicare benefits to create a new entitlement program, and explode the deficit.”

Sen. Orrin Hatch (R-Utah), speaking on the Senate floor, criticized the compromise on language on federal funding for abortion services that won over Nelson’s vote. He called the language “completely unacceptable,” adding, “The new abortion provisions are significantly weaker than the amendment I introduced with Sen. Ben Nelson to ensure that the Hyde Amendment, which prohibits federal dollars for paying for elective abortions, also applies to any new federal health programs created by Congress.”

Legislators were not the only ones who vocalized their opposition to health reform. Rick Scott, head of Conservatives for Patients’ Rights, in a post on CPR’s Web site, wrote that “it only takes one senator” to prevent a public option from being included in a final reform bill after the House and Senate reconcile their bills. Scott noted that if one senator objects to the naming of conferees to reconcile the two bills and maintains that objection throughout the debate, the only legislation that could be passed is the Senate bill, which does not contain a public option. Scott wrote, “It only takes one senator, but our hope is that as many senators as possible would move to ensure that America’s health care system would not suffer the government takeover that the liberal Democratic leadership thirsts for.”

Amid the chorus of criticism, California’s senatorial stable remained strongly in favor of the legislation. Sen. Dianne Feinstein (D) recently voted in favor of the bill, despite a provision that would greatly expand her state’s outlay for Medicaid. Feinstein said that the Medicaid expansion would be fully funded until 2016, giving the state time to find funding to offset the additional cost.

Meanwhile, Sen. Barbara Boxer (D), during the floor debate leading up to the chamber’s first vote on the reform bill, said, “You just heard our Republican friends say it’s very hard to defend our bill. Now maybe it’s hard for them, but it’s not hard for the American Medical Association … who have endorsed our bill. They not only defend our bill, they support our bill.” Boxer also noted that 14,000 U.S. residents lose health coverage daily and that U.S. families are expected to pay as much as 45% of their income on health premiums in 2016, adding that the current system is “not sustainable.”

Regardless of Republican reaction, Senate Democrats are on their way toward beginning the process of reconciling the House and Senate versions of an overhaul. The Senate has already cleared two procedural hurdles, with just one more to go before a final vote, scheduled for 8 a.m. on Christmas Eve. With Nelson on board, it appears at this point as if the votes are mere formality.

More news on the reform debate is provided below.

Administration Steps Up Defense of Health Reform

• With a number of liberal lawmakers and commentators criticizing the Senate’s health reform proposal for being too scaled back, the White House went into action attempting to quell the disapproval of the bill and ensure it continues toward passage, Politico reports (Allen, Politico, 12/17).
• President Obama over the weekend praised the Senate for scoring a “big victory for the American people” after their late-night “historic vote” to advance health reform, The Hill reports. Obama, speaking at the White House, said that the bill’s projected costs would be offset by Medicare cuts and new taxes and fees. Those who are “continually carping about how this is a big-government spending bill” are incorrect, Obama said (Youngman, The Hill, 12/21).
• In a New York Times opinion piece, Vice President Biden wrote, “While it is not perfect, the bill pending in the Senate today is not just good enough — it is very good.” He added, “I share the frustration of other progressives that the Senate bill does not include a public option. But I’ve been around a long time, and I know that in Washington big changes never emerge in perfect form” (Khan/Wolf, ABC News, 12/21).

Democrat, Republican Reaction

• Many liberals are suggesting that the Senate’s bill is watered down because it lacks the public health insurance option they supported (Youngman [2], The Hill, 12/21).  Although all 60 senators who caucus with Democrats supported the bill, some apparently did so grudgingly. Sen. Russ Feingold (D-Wis.) criticized the Obama administration for not pushing harder for a public option (ABC News, 12/21).
• Republican senators quickly launched their criticisms of the bill after the Monday morning vote, highlighting the concessions made to Democratic holdouts. The compromises — hashed out late at night after behind-closed-doors negotiations — reek of “Bernie Madoff gimmicks,” Sen. John McCain (R-Ariz.) said (ABC News, 12/21).

Abortion Compromise

• Groups both supporting and opposing abortion rights are criticizing a Democratic compromise on abortion coverage that cleared the way for the Senate health reform bill (HR 3590) to advance through its first procedural hurdles over the weekend, the New York Times reports (Pear, New York Times, 12/20). The abortion concessions were made to appease Sen. Ben Nelson (D-Neb.), an abortion-rights opponent who said he would oppose the bill without more stringent limitations on federal coverage of abortion services. Nelson and Senate Democratic leaders reached an agreement that would allow individual states to decide whether to bar insurance plans participating in the exchange in their state from offering abortion coverage (MacGillis, Washington Post, 12/22).