Healthcare reform draws nearer
By Edward Luce in Washington
Published: December 10 2009 23:26 | Last updated: December 10 2009 23:26
Barack Obama’s healthcare reform, the signature policy of his presidency, looks likely to clear its most formidable obstacle by Christmas.
Within the next few days, the non-partisan Congressional Budget Office will give its fiscal “scoring” of the compromise reached on Tuesday between five moderate and five liberal Democratic senators.
If the CBO were to pronounce the package at least deficit-neutral – a big if, given the body’s Jesuitical approach to budget accounting – the way would probably be cleared for a rapid vote in the Senate. Since the House of Representatives has already passed its own 1,990-page bill, only a seismic intervention could stop it from reaching Mr Obama’s desk within the ensuing weeks.
On Thursday, aides to Harry Reid, the Senate majority leader, said they believed the latest formulation would attract the 60 votes needed to prevent Republicans from being able to block it.
In addition, the fact Mr Reid is engaging the interest of two Republicans, Olympia Snowe and Susan Collins, both senators for Maine, has provided added confidence that they may be able to afford to lose one Democratic vote in the upper chamber.
“We put together a bill that we believe has the best chance to overcome a Republican filibuster,” said Jim Manley, an aide to the Senate majority leader.
But he added: “Mary Landrieu and Blanche Lincoln [centrist Democratic senators from Louisiana and Arkansas] are saying they’re not going to agree to anything until we hear back from the CBO.”
The smart money in Washington is now betting that the arduous and often unseemly legislative process is within spitting distance of a conclusion.
Len Nichols, a fellow at the centrist New America Foundation and probably one of the most experienced analysts of the Byzantine process, said: “In my judgment, the co-operation of the moderate and liberal Democrats and the fact that Snowe and Collins are in the conversation signals a real likelihood this will get through the Senate by Christmas and be on the president’s desk before his State of the Union address [in late January].”
Should the bill get the go-ahead from the CBO, Mr Reid is likely to push for a Senate vote as rapidly as possible, assuming he has garnered the 60 votes by then. After that, the bill would either have to be merged with the House version or else could even bypass the bicameral reconciliation process and go for a direct vote in the lower chamber – an unusual route but one that could circumvent the process.
Nancy Pelosi, the House speaker, who has insisted on a public insurance option, the measure that has attracted the most argument, on Thursday played down the differences between the two bills.
“We are waiting on the actions of the US Senate and hopefully we will be able to send it very, very soon to the president’s desk,” she said on Thursday.
The latest Senate compromise formed a new “Medicare buy-in” to allow people aged 55-64 to buy the healthcare coverage currently available only to senior citizens. It came at the expense of the public option.
Some liberals would fight to the finish to retain the public option, a watered-down version of which was passed in the House bill. But most Democrats are falling in line with the thinking of Rahm Emanuel, Mr Obama’s pugilistic chief-of-staff, who said: “The only non-negotiable principle here is success.”
Washington insiders believe a historic healthcare act would give Mr Obama and the Democratic party a boost ahead of next year’s mid-term elections. But polls, which show mixed support for healthcare reform, suggest the reality may not be so simple.
“All the revenue-raising measures – the taxes and fees – come up-front, while the benefits don’t kick in until 2013 and 2014,” says Robert Blendon, the leading healthcare pollster. “There would be an initial surge in support for this historic achievement, followed by quite a big backlash as the costs seep through.”