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Democrats temper public option

Reid suggests accord clears way to pass health bill

By Lisa Wangsness
Globe Staff / December 9, 2009

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WASHINGTON - Senate negotiators reached a tentative deal last night to drop a full-fledged government-run insurance plan from the health care overhaul bill and replace it with a patchwork of new ideas to help people get coverage, according to a Democratic Senate staffer.

The deal might remove one of the biggest stumbling blocks to passage.

Senate majority leader Harry Reid announced that a team of 10 liberal and moderate Democrats had reached “broad agreement’’ on a compromise that would allow Senate Democrats to move the bill forward.

Reid did not provide details, saying he wants congressional budget analysts to determine its cost. But he implied it could garner the 60 votes required to clear the way for passage.

“The question is . . . is the end in sight?’’ Reid said, responding to a reporter at a brief press conference. “The answer is yes.’’

The agreement would replace the government-run insurance plan in the bill, which several crucial moderate Democrats had steadfastly opposed, with new provisions designed to provide a wider selection of insurance options, according to the staffer.

One new provision would require the US Office of Personnel Management, which oversees the Federal Employees Health Benefits Program, to negotiate with private insurers to offer national nonprofit plans in each state.

The plan would also let middle-aged people who cannot get affordable coverage through work buy into Medicare, the staffer said. Liberals senators said yesterday that they had pushed the Medicare buy-in as one way to achieve some of the goals the government run plan would have.

The House approved a health care bill with a government run health plan to compete with private insurers; the two versions would have to be reconciled by House and Senate negotiators.

In other action on the bill yesterday, the Senate defeated an amendment that would prohibit the sale of insurance plans that cover elective abortions to women who receive premium subsidies, much like an amendment the House approved. One of its cosponsors, Senator Ben Nelson, Democrat of Nebraska, has said he would not support a bill without that language.

Senator Dick Durbin, Democrat of Illinois, said he was not certain how the vote would affect the prospects of the overall health care bill.

“It depends on Ben Nelson,’’ Durbin said. “We all knew what the outcome would be, but he wanted his chance to call the amendment and he was given that chance. And now we hope that we could work with him to get a provision in the bill that he would accept.’’

Nelson might not be essential, though, if the Democrats recruit one or both of the Republican senators from Maine, Olympia Snowe and Susan Collins. Both have expressed a litany of concerns and sounded increasingly pessimistic about its direction in recent weeks. But Democrats are still courting them, particularly Snowe, who met with President Obama in the Oval Office Saturday to discuss health care and who has proposed a limited public option in states where private insurers did not offer affordable options. Both Snowe and Collins voted against Nelson’s abortion amendment yesterday.

Reid spoke forcefully against the amendment, contending it would venture far beyond the status quo and threaten to scuttle a bill that would provide millions affordable insurance.

“The issue in this amendment is not the only so-called moral issue in this debate,’’ Reid said. “The ability of all Americans to get access to the care they need to stay healthy is also a question of morality.’’

The Senate bill requires insurance plans to separate federal subsidies from individuals’ premiums and use only private money to pay for abortion procedures. Such funding separation is also used by states to cover abortion procedures for Medicaid enrollees, as well as by religious organizations that are required to keep US funding for social programs separate from religious activities.

Nelson, speaking before Reid, said: “Taxpayers should not be required to pay for other people’s abortions, it’s just that simple.’’

It is not clear how long it would take for the nonpartisan congressional budget office to analyze the bill, but aides have previously said it could take a week.

Earlier yesterday, Senator Jay Rockefeller, Democrat of West Virginia and one of the 10 senators negotiating on the public option, said he had proposed expanding Medicaid, the government insurance program for the poor. It would be, he said, another way to achieve some of the goals of a true public option. But he said he was having difficulty persuading others.

Several senators said they are concerned that opening Medicaid to too many people would place a heavy burden on states, which share some of the cost.

“We spent weeks and weeks and weeks negotiating with the nation’s governors,’’ said Senator Kent Conrad, Democrat of North Dakota and chairman of the Budget Committee. “The reason we arrived at the position we did was because we felt we could command the support of many of the governors.’’

Conrad said he is concerned about expanding Medicare because medical providers in his state are reimbursed at one of the lowest rates in the country.

Material from the Associated Press was used in this report.

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