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Politics & Government

Pelosi open to health bill without public option

David Lightman - McClatchy Newspapers

December 16, 2009 07:32 PM

WASHINGTON — Speaker Nancy Pelosi said Wednesday that she and the Democratic-controlled House of Representatives are open to a health care overhaul without a government-run public option, a strong signal that Congress could agree on a plan early next year.

The House last month passed a health care bill that included the kind of public option that President Barack Obama and party liberals have long sought, but the Senate has balked. A final Senate vote on the health care package could occur on Dec. 23 or 24.

The White House and Senate leaders continued to push Wednesday for the 60 votes needed to cut off debate, and were thought to be one short. The apparent holdout, Nebraska Sen. Ben Nelson, met privately with Obama in the Oval Office Tuesday for about half an hour.

Nelson, who wants more restrictive abortion language and has other concerns, still wouldn't commit to backing the bill.

Meanwhile, with the Senate mired in procedural knots, two developments behind the scenes were driving the process:

  • One was spreading the message that "bare bones" legislation could be passed, as Senate Finance Committee Chairman Max Baucus, D-Mont., put it, and improved in future years.
  • The other sticking point remains abortion, the focus of private conversations throughout the Capitol.
  • If the Senate measure eventually passes, Senate and House leaders would negotiate a compromise, which then would be subject to votes in both chambers.

    While the closed-door negotiations, which are expected to involve top White House officials, are still expected to be tense — several key points of disagreement remain — Pelosi told reporters Wednesday she was confident that those obstacles could be overcome.

    Asked if she could support a bill that didn't have the public option, Pelosi said, "It depends on what else is in the bill."

    Her attitude is similar to that of many others who've pushed a public option. The mantra now among top Democrats is to find areas of agreement on health care, put them in the bill, declare victory and work in the months and years ahead to fashion something broader.

    "This is about a framework," added Sen. Debbie Stabenow, D-Mich., "a fundamental framework that will drive the debate.

    "This reform effort will never really end," said Sen. Mary Landrieu, D-La.

    Pelosi urged looking at the areas of House-Senate agreement, such as barring insurers from charging consumers more or cutting off coverage because of pre-existing conditions, or requiring nearly everyone to obtain coverage.

    "It isn't just about health care. It's about a healthier America," Pelosi said.

    After Obama met with Senate Democrats Tuesday, Nelson stuck around and met privately with the president, their third such session in about a week. They reportedly didn't engage in negotiations, but Nelson said Obama talked about "the consequences of not taking action."

    Talk was that most of the seven Senate Democrats who last week voted for tough restrictions on federal abortion funding wanted similar language in the health care bill.

    Nelson has been in close touch with Nebraska anti-abortion groups about the issue, and was in contact with several moderate senators Wednesday, notably Sen. Robert Casey, D-Pa., who's trying to iron out abortion language the seven Democrats can accept.

    Nelson also had other concerns, notably about the bill's excise tax on more expensive policies, Medicare reimbursement to nursing homes and other issues.

    An abortion compromise probably would be part of a huge amendment to the bill that included not only abortion, but also other changes.

    Among them: Having the federal Office of Personnel Management oversee national health care plans that would compete with the private sector. No details were yet available.

    In the House, Pelosi couldn't say if she supported the idea. But she seemed open, saying, "The emphasis was not on public. The emphasis was on option."

    ON THE WEB:

    Congressional Budget Office analysis of Senate Democrats' health care bill

    Text of Senate Democratic health care bill

    Congressional Budget Office analysis of House health bill

    Sen. Lieberman's health care statement

    Sen. Bernie Sanders on health care

    MORE FROM MCCLATCHY:

    Obama might not get health care for Christmas

    Health care bills would engender differences, keep age discrepancies

    No easy answers on proposals to expand Medicare coverage

    Senate Democrats reach tentative deal on public option

    Health bills would raise taxes well before changes roll out

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