WASHINGTON -- The glow from a health care triumph faded quickly for President Barack Obama on Sunday as Democrats realized the bill they fought so hard to pass in the House has nowhere to go in the Senate.
Speaking from the Rose Garden about 14 hours after the late Saturday vote, Obama urged senators to be like runners on a relay team and "take the baton and bring this effort to the finish line on behalf of the American people."
The problem is that the Senate won't run with it. The government health insurance plan included in the House bill is unacceptable to a few Democratic moderates who hold the balance of power in the Senate.
If a government plan is part of the deal, "as a matter of conscience, I will not allow this bill to come to a final vote," said Sen. Joe Lieberman, the Connecticut independent whose vote Democrats need to overcome GOP filibusters.
"The House bill is dead on arrival in the Senate," Sen. Lindsey Graham, R-S.C., said dismissively.
Democrats did not line up to challenge him. Senate Majority Leader Harry Reid, D-Nev., has yet to schedule floor debate and hinted last week that senators may not be able to finish health care this year.
Nonetheless, the House vote provided an important lesson in how to succeed with less-than-perfect party unity, and one that Senate Democrats may be able to adapt. House Democrats overcame their own divisions and broke an impasse that threatened the bill after liberals grudgingly accepted tougher restrictions on abortion funding, as abortion opponents demanded.
In Senate, the stumbling block is the idea of the government competing with private insurers. Liberals may have to swallow hard and accept a deal without a public plan in order to keep the legislation alive. As in the House, the compromise appears to be to the right of the political spectrum.
Republican Sen. Olympia Snowe of Maine, who voted for a version of the Senate bill in committee, has given the Democrats a possible way out. She's proposing to allow a government plan as a last resort, if after a few years premiums keep escalating and local health insurance markets remain in the grip of a few big companies. This is the "trigger" option.
That approach appeals to moderates such as Sen. Mary Landrieu, D-La. "If the private market fails to reform, there would be a fallback position," Landrieu said last week. "It should be triggered by choice and affordability, not by political whim."
Lieberman said he opposes the public plan because it could become a huge and costly entitlement program. "I believe the debt can break America and send us into a recession that's worse than the one we're fighting our way out of today," he said.
For now, Reid is trying to find the votes for a different approach: a government plan that states could opt out of.
The Senate is not likely to jump ahead this week on health care. Reid will keep meeting with senators to see if he can work out a political formula that will give him not only the 60 votes needed to begin debate, but the 60 needed to shut off discussion and bring the bill to a final vote.
Toward the end of the week, the Congressional Budget Office may report back with a costs and coverage estimate on Reid's bill, which he assembled from legislation passed by the Finance Committee and the Health, Education, Labor and Pensions Committee. The Finance Committee version does not include a government plan.
Reid has pledged to Obama that he will get the bill done by the end of the year and remains committed to doing that, according to a Senate leadership aide.
Both the House and Senate bills gradually would extend coverage to nearly all Americans by providing government subsidies to help pay premiums. The measures would bar insurers' practices such as charging more to those in poor health or denying them coverage altogether.
All Americans would be required to carry health insurance, either through an employer, a government plan or by purchasing it on their own.
To keep down costs, the government subsidies and consumer protections don't take effect until 2013. During the three-year transition, both bills would provide $5 billion in federal dollars to help get coverage for people with medical problems who are turned down by private insurers.
Both House and Senate would expand significantly the federal-state Medicaid health program for low-income people.
The majority of people with employer-provided health insurance would not see changes. The main beneficiaries would be some 30 million people who have no coverage at work or have to buy it on their own. The legislation would create a federally regulated marketplace where they could shop for coverage.
There are several major differences between the bills.
By defusing the abortion issue -- at least for now -- the House may have helped the long-term prospects for the bill. Catholic bishops also eager to expand society's safety net may yet endorse the final legislation.
Lieberman appeared on "Fox News Sunday," while Graham was CBS' "Face the Nation."
"The Oklahomans I represent oppose this bill because they know what it does and what it does not do," Congressman Cole said. "They understand that this bill will raise taxes, not lower them and that it will grow government, instead of shrinking it. They know that this legislation weakens Medicare, instead of strengthening it. And they understand that during a time when unemployment has reached 10.2%, we don't need a bill that destroys jobs. They understand that this bill will force state governments to cut services and raise taxes and it will put government bureaucrats rather than health care professionals in charge of their health care system."
"This bill does not include common sense health care reforms that Oklahomans do support - such as tort reform and the establishment of tax deductions for individual purchasers. My constituents want a plan that establishes national insurance markets and association health plans that would allow small businesses to provide affordable insurance to their employees. Oklahomans rightly believe the Pelosi health care bill is a giant step backwards and it's one that I don't support."
"I am very discouraged by the House of Representative’s passage of Speaker Pelosi’s government run health care legislation," Lucas stated. "Over the last several months, millions of Americans have expressed their strong opposition to this legislation. Yet Speaker Pelosi and her leadership team have once again ignored the will of the people and forced this trillion dollar government takeover of our health care system on them.
"With the passage of this bill, the federal government will become the dominant force behind our health care system, putting bureaucrats in Washington between patients and their doctors. I will continue to oppose any health care plan that includes a government takeover of our health care system, that burdens our states with additional fees and bureaucracy, and that saddles our future generations with trillions of dollars of debt," Lucas stated.
“I’m personally disgusted with this entire process. Speaker Pelosi and her left wing allies in Congress resorted to twisting arms and backroom tactics to sell out the American people and put the federal government in charge of their personal healthcare decisions. This bill is bad for patients, bad for doctors, bad for small businesses and couldn’t have come at a worse time for our economy - as our national unemployment rate has reached a staggering 10.2%.
“The American people need to understand what took place here in the people’s house tonight- Speaker Pelosi and every democrat who voted for this government run healthcare system in the dead of night, completely ignored their voices. My Republican colleagues and I heard you loud and voted overwhelmingly against this bill.
“Let’s be very clear about what this bill does – it writes the American people a prescription for disaster by spending more, taxing more, and letting Washington bureaucrats make healthcare decisions that are better left to you and your families. It’s simply the wrong approach. I urge my Republican colleagues, and common sense Democrats, in the Senate, to vote NO and derail this freight rain of government expansion before it can become law.”
“Last night, I voted ‘NO’ on the Obama/Pelosi health care bill.
"The plan is nothing less than a government takeover of the health care industry, complete with job-killing tax increases and the kind of budget-busting spending that will continue to heap debt onto generations of Americans to come. It is my sincere hope that continued activism by the American people and conservative, grass roots leaders will force the Democrat majorities in Washington to abandon their plan and start over.
"I am not opposed to all reform. In fact, should I have the honor of serving as your next governor, I am determined to pursue free market reforms that will reduce medical costs and improve access to quality, affordable care. However, a government-run health care system is not the answer. Speaker Pelosi and President Obama want to heap more bureaucracy onto the system, but the way to control costs and reduce price inflation is to peel back the layers of burdensome regulation and administrative overhead, not add more.
"What has been perhaps the most disturbing aspect of this health care debate is how out of touch it has revealed some of our political leaders to be. Oklahomans, and Americans everywhere, want the government to focus on job creation, growing our economy, and addressing the skyrocketing deficits that threaten this country's financial stability. Instead, Speaker Pelosi and President Obama have produced a 2,000 page bureaucratic nightmare that will increase taxes, spend more, and do nothing to alleviate the high cost of health care that is threatening family budgets and hurting small businesses.
"If the Speaker of the House and the President of the United States can't understand what Oklahomans want, we could sure use a governor that does. If I'm elected in 2010, we'll have that and more - because I will be the kind of leader who fights for our state, who fights for the cause of liberty and who pursues the kind of reforms that grow our economy, create more and better jobs and moves us towards a better, brighter future.”
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