Democrats agree to drop government run insurance option

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Post by racehorse » 12-20-2009 08:23 PM

http://www.kentucky.com/473/v-print/story/1067301.html

Posted on Sun, Dec. 20, 2009

Comparison of Senate, House health care bills

By RICARDO ALONSO-ZALDIVAR and ERICA WERNER
Associated Press Writers

A comparison of the health care bills before Congress:

---

The Senate Democratic bill (Patient Protection and Affordable Care Act):

WHO'S COVERED: About 94 percent of legal residents under age 65 - compared with 83 percent now. Government subsidies to help buy coverage start in 2014. About one-third of the remaining 24 million people under age 65 left uninsured would be illegal immigrants.

COST: Coverage provisions cost $871 billion over 10 years.

HOW IT'S PAID FOR: Fees on insurance companies, drugmakers, medical device manufacturers. Medicare payroll tax increased to 2.35 percent on income over $200,000 a year for individuals; $250,000 for couples. A 10 percent sales tax on tanning salons, to be paid by the person soaking up the rays. Cuts to Medicare and Medicaid. Forty percent excise tax on insurance companies, keyed to premiums paid on health care plans costing more than $8,500 annually for individuals and $23,000 for families. Fees for employers whose workers receive government subsidies to help them pay premiums. Fines on people who fail to purchase coverage.

REQUIREMENTS FOR INDIVIDUALS: Almost everyone must get coverage through an employer, on their own or through a government plan. Exemptions for economic hardship. Those who are obligated to buy coverage and refuse to do so would pay a fine starting at $95 in 2014 and rising to $750.

REQUIREMENTS FOR EMPLOYERS: Not required to offer coverage, but companies with more than 50 employees would pay a fee of $750 per employee if the government ends up subsidizing employees' coverage.

SUBSIDIES: Tax credits for individuals and families likely making up to 400 percent of the federal poverty level, which computes to $88,200 for a family of four. Tax credits for small employers.

BENEFITS PACKAGE: All plans sold to individuals and small businesses would have to cover basic benefits. The government would set four levels of coverage. The least generous would pay an estimated 60 percent of health care costs per year; the most generous would cover an estimated 90 percent.

INSURANCE INDUSTRY RESTRICTIONS: Starting in 2014: no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age and family size. Starting upon enactment of legislation: children up to age 26 can stay on parents insurance; no lifetime limits on coverage.

GOVERNMENT-RUN PLAN: In place of a government-run insurance option, the estimated 26 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for national plans overseen by the same office that manages health coverage for federal employees and members of Congress. Those plans would be privately owned, but one of them would have to be operated on a nonprofit basis, as many Blue Cross Blue Shield plans are now.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Self-employed people, uninsured individuals and small businesses could pick a plan offered through new state-based purchasing pools. Would generally encourage employees to keep work-provided coverage.

DRUGS: Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases. Drug companies contribute $80 billion over 10 years with the majority of the money used to limit the prescription coverage gap in Medicare.

CHANGES TO MEDICAID: Income eligibility levels likely to be standardized to 133 percent of poverty - $29,327 a year for a family of four - for parents, children and pregnant women. Federal government would pick up the full cost of the expansion during the first three years. States could negotiate with insurers to arrange coverage for people with incomes slightly higher than the cutoff for Medicaid.

LONG-TERM CARE: New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.

ANTITRUST: Maintains the industry's decades-old antitrust exemption.

ILLEGAL IMMIGRANTS: Would be barred from receiving government subsidies or using their own money to buy coverage offered by private companies in the exchanges.

ABORTION: The bill tries to maintain a strict separation between taxpayer funds and private premiums that would pay for abortion coverage. No health plan would be required to offer coverage for the procedure. In plans that do cover abortion, beneficiaries would have to pay for it separately, and those funds would have to be kept in a separate account from taxpayer money. Moreover, individual states would be able to prohibit abortion coverage in plans offered through the exchange, after passing specific legislation to that effect. Exceptions would be made for cases of rape, incest and danger to the life of the mother.

----

The House bill (Affordable Health Care for America Act):

WHO'S COVERED: About 96 percent of legal residents under age 65 - compared with 83 percent now. Government subsidies to help buy coverage start in 2013. About one-third of the remaining 18 million people under age 65 left uninsured would be illegal immigrants.

COST: The Congressional Budget Office says the bill's cost of expanding insurance coverage over 10 years is $1.055 trillion. The net cost is $894 billion, factoring in penalties on individuals and employers who don't comply with new requirements. That's under President Barack Obama's $900 billion goal. However, those figures leave out a variety of new costs in the bill, including increased prescription drug coverage for seniors under Medicare, so the measure may be around $1.2 trillion.

HOW IT'S PAID FOR: $460 billion over the next decade from new income taxes on single people making more than $500,000 a year and couples making more than $1 million. The original House bill taxed individuals making $280,000 a year and couples making more than $350,000, but the threshold was increased in response to lawmakers' concerns that the taxes would hit too many people and small businesses.

There are also more than $400 billion in cuts to Medicare and Medicaid; a new $20 billion fee on medical device makers; $13 billion from limiting contributions to flexible spending accounts; sizable penalties paid by individuals and employers who don't obtain coverage; and a mix of other corporate taxes and fees.

REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through a tax penalty of 2.5 percent of income. People can apply for hardship waivers if coverage is unaffordable.

REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payrolls under $500,000 annually are exempt - a change from the original $250,000 level to accommodate concerns of moderate Democrats - and the penalty is phased in for companies with payrolls between $500,000 and $750,000.

Small businesses - those with 10 or fewer workers - get tax credits to help them provide coverage.

SUBSIDIES: Individuals and families with annual income up to 400 percent of poverty level, or $88,000 for a family of four, would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Beginning in 2013, through a new Health Insurance Exchange open to individuals and, initially, small employers. It could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.

BENEFITS PACKAGE: A committee would recommend a so-called essential benefits package including preventive services. Out-of-pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange.

INSURANCE INDUSTRY RESTRICTIONS: Starting in 2013, no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age.

GOVERNMENT-RUN PLAN: A new public plan available through the insurance exchanges would be set up and run by the health and human services secretary. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors. But the final version - preferred by moderate lawmakers - would let the HHS secretary negotiate rates with providers.

CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded to cover all individuals under age 65 with incomes up to 150 percent of the federal poverty level, which is $33,075 per year for a family of four. The federal government would pick up the full cost of the expansion in 2013 and 2014; thereafter the federal government would pay 91 percent and states would pay 9 percent.

DRUGS: Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases. Phases out the gap in Medicare prescription drug coverage by 2019. Requires the HHS secretary to negotiate drug prices on behalf of Medicare beneficiaries.

LONG-TERM CARE: New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.

ANTITRUST: Would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price-fixing and bid rigging. The bill also would give the Federal Trade Commission authority to look into the health insurance industry at its own initiative.

ILLEGAL IMMIGRANTS: Would be barred from receiving government subsidies but permitted to use their own money to buy coverage offered by private companies in the exchange.

ABORTION: Private companies in the exchange could not offer plans covering abortion if those plans received federal subsidy money. Most plans in the exchange would be affected, because most consumers in the exchange would be using federal subsidy money to buy coverage. The new government plan could not offer abortion coverage. Insurance companies would be permitted to offer supplemental abortion coverage in separate plans that people could buy with their own money. Use of federal money for abortion coverage would be limited to cases of rape, incest or danger to the woman's life.
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Post by racehorse » 12-20-2009 11:14 PM

http://snowe.senate.gov/public/index.cf ... 0f85c61537

SNOWE STATEMENT ON SENATE HEALTH REFORM DEBATE VOTE

December 20, 2009

Washington, D.C. -

U.S. Senator Olympia J. Snowe (R-Maine) released the following statement today on the status of the health reform legislation currently pending before the United States Senate:

“Having been fully immersed in this issue for this entire year and as the only Republican to vote for health reform in the Finance Committee, I deeply regret that I cannot support the pending Senate legislation as it currently stands, given my continued concerns with the measure and an artificial and arbitrary deadline of completing the bill before Christmas that is shortchanging the process on this monumental and trans-generational effort.

“Only three weeks ago the Senate received a more than 2,000 page bill on one of the most complex issues in our history, and we have since considered fewer than two dozen amendments out of more than 450 filed. A little over 24 hours ago, the Senate received a final, nearly 400 page manager’s amendment that cannot be changed or altered, with more than 500 cross references including to other statutes and will be voted on at 1 am Monday morning. It defies logic that we are now expected to vote on the overall, final package before Christmas with no opportunity to amend it so we can adjourn for a three week recess even as the legislation will not fully go into effect until 2014, four years from now.

“I remain convinced we must work toward a responsible, common sense solution to reverse the trend of spiraling health care costs -- that will cause one-in-four Americans this year to have either inadequate coverage or none at all, and threatens affordable coverage for millions more Americans in the future. As I pledged to the President in an Oval Office meeting Saturday afternoon, I couldn’t agree more that reform is an imperative, and I will continue my constructive efforts to forge effective, common sense health care reform as the process moves into a House-Senate conference.

“The reality that the status quo is unacceptable is what originally brought six of us together on the Senate Finance Committee this summer in the only bipartisan effort in any committee of the House or Senate in the so-called Group of Six, convened by Chairman Max Baucus. We met 31 times, week after week for over four months, to debate policy and not politics.

“Two months ago, when I voted for the Finance Committee bill, I said that the process moving forward shouldn’t be about vote counting, but rather crafting the right policy and that the credibility of the process would determine the credibility of the outcome. So I was troubled that when the Finance bill was melded with the measure reported by the Senate HELP committee it was without the more inclusive, collaborative process I’d participated in up to that point and instead it was done in the shadows, without transparency, just to garner the necessary 60 votes and nothing more.
“This bill has taken a dramatically different direction since the Finance Committee bill – it is now 1,200 pages longer and includes a new employer mandate that could annihilate the job growth potential that is so vital to our economic recovery. As the Small Business & Entrepreneurship Council has stated, this mandate “will only burden firms with more costs and red tape which means they will not grow, invest, or create jobs.”

“This bill also creates the CLASS Act on long term care insurance, a brand new program which the Medicare Actuary has said is projected to go into the red just five years after it begins paying out benefits. And the legislation requires a $90 billion increase in Medicare payroll taxes – a provision that was not part of the bill I voted for in Finance Committee – that predominately affects the self-employed and the very same small business owners we are counting on to create new jobs and lead us out of this recession. And that’s just to name a few of the vital issues.

“Furthermore, we still don’t have answers to some of the most fundamental questions that people will be asking at their kitchen tables. These are the critical questions relevant to peoples’ daily lives, such as, what does this mean for me? How much will my health insurance plan cost? How much will my deductible or my co-pay be? How much am I going to have to pay out of pocket? Not one single member in Congress – Republican or Democrat – can answer those questions, and that is why I wrote to the Congressional Budget Office on December 3rd requesting a complete analysis of these and other key issues as it is imperative that we have those answers before proceeding.

“Ultimately, there is absolutely no reason to be hurtling headlong to a Christmas deadline on monumental legislation affecting every American, when it doesn’t even fully go into effect until 2014. When 51 percent of the American people in a recent survey have said they do not approve of what we are doing, they understand what Congress does not -- and that is, that time is not our enemy, it is our friend. Therefore, we must take a time out from this legislative game of “beat the clock”, reconvene in January – instead of taking a three week recess – and spend the time necessary to get this right. Legislation affecting more than 300 million Americans deserves better than midnight votes on a bill that cannot be further amended and that no one has had the opportunity to fully consider – and the Senate must step up to its responsibility as the world’s greatest deliberative body on behalf of the American people.”

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Post by racehorse » 12-21-2009 12:59 AM

http://www.foxnews.com/politics/senate/ ... inionPrint

December 20, 2009

Senate Democrats Warn House Not to Toy With Health Bill

Senate Democrats are warning the House not to make any significant changes to the health care package heading toward a vote in their chamber if they want the bill to survive past Christmas.

Do not mess with this bill.

That was the message Senate Democrats sent to their colleagues on the House side over the weekend, warning them not to make any significant changes to the health care package heading toward a vote in their chamber if they want the bill to survive past Christmas.

Senate Majority Leader Harry Reid on Saturday won the support of the last known Democratic holdout, Sen. Ben Nelson, D-Neb., giving him the 60 votes necessary to pass the bill out of the Senate. But assuming the bill clears the Senate, negotiators from both sides will still have to work out vast differences between the House and Senate versions in what's known as a conference committee.

Liberal Democrats are eager to negotiate and try to win back items that were stripped from the Senate bill like a government-run insurance plan. But the final version would again need 60 votes to overcome a Senate filibuster, and Senate moderates warn that any big changes in conference could erode that bloc.

"Anybody who's watched this process can see how challenging it has been to get 60 votes," Sen. Kent Conrad, D-N.D., said on "Fox News Sunday." "It is very clear that the bill, the final bill, to pass in the United States Senate is going to ... have to be very close to the bill that has been negotiated here. Otherwise you will not get 60 votes in the United States Senate."

The Senate bill was heading toward a critical test vote set for after midnight early Monday.

Nelson bluntly warned Saturday that even though he planned to vote for the Senate bill this coming week, that pledge might not apply to the version that emerges from the House and Senate negotiations.

"If there are material changes in that conference report different from this bill that adversely affect the agreement, I reserve the right to vote against the next cloture vote," he said. "Let me repeat it, I reserve the right to vote against the next cloture vote, if there are material changes to this agreement in the conference report. And I will vote against it if that is the case."

Cloture is the process of cutting off debate that requires 60 votes. Because the Democrats have exactly a 60-vote majority in the Senate, party leaders had to individually accommodate every holdout in their party to move the bill forward -- particularly since no Republicans are on board.

This resulted in a bill that looks very different from the House version.

But despite the tenuous support on the Senate side, liberal Democrats continue to call for major revisions in the conference committee.

Former Democratic National Committee Chairman Howard Dean, who has led the fight against the Senate version, said Sunday that "we really do need some kind of a public option" in the bill.

"Let's see if we can fix it some more," Dean said on NBC's "Meet the Press." "This can't be the final version of this bill."

Dean complained that President Obama did not end up fighting for the so-called public option in the Senate version.

"We've been very disappointed by that. We don't think that there has been much fight in the White House for that," he said.

The White House has made clear that passage of a health care reform bill is far more important than the survival of any one provision in it.

Senior Adviser David Axelrod expressed confidence Sunday that the intra-party disputes over the contents of the bill will ultimately be resolved.

"I think we're going to get it done," he said on "Meet the Press," disputing Dean's characterizations of the bill. "I think that people understand that this is a historic crossroads."
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Post by racehorse » 12-21-2009 01:32 AM

http://cnn.site.printthis.clickability. ... rID=211911

Senate votes to give green light to health care bill

STORY HIGHLIGHTS

* NEW: Key vote on health bill early Monday splits along party lines
* Majority Leader Harry Reid needs every vote of the Democratic caucus to pass bill
* The U.S. House has already passed its version of the health care bill

(CNN) -- Senate Democrats took a critical step towards passing their health care bill early Monday morning, voting to end debate on a package of controversial proposals negotiated by Majority Leader Harry Reid, D-Nevada.

The vote split on partisan lines in the 60 to 40 vote. With Republicans unanimously opposed, Democrats needed the support of their entire caucus to overcome a filibuster and move to a final vote on the bill later this week.

Senate Democrats braved the aftermath of a blizzard to continue their push to pass a sweeping health care bill before Christmas.

A vote invoked cloture on changes crafted by Majority Leader Harry Reid of Nevada.

While the House and Senate bills agree on most issues, there are significant differences over how to pay for them and how they will expand health coverage to more than 30 million uninsured Americans.

The House bill calls for an income tax surcharge on the wealthy, while the Senate version would increase the Medicare payroll tax for those earning more than $200,000 and levy a tax on insurance companies that provide expensive health plans.

With Republicans unanimously opposed, Democrats need the support of their entire caucus to overcome a filibuster and move to a final vote on the bill later this week.

"We have had a long, arduous and I think sometimes taxing debate to reach this moment," said Illinois Sen. Dick Durbin, the chamber's second-ranking Democrat, to open the session. "I think it's time for a vote."

A key hurdle was cleared Saturday when the last Democratic holdout, Sen. Ben Nelson of Nebraska, agreed to support the bill in return for compromise language on federal funding for abortion and more money for his state. It was the latest in a series of deals with Senate Democrats to hold together caucus support for the bill.

The House of Representatives already has passed its health care bill, and if the Senate also passes a bill, the two versions would be merged by a conference committee. Both chambers would then have to approve a final version before it goes to President Obama to be signed into law, though a House Democratic leadership source indicated Saturday that won't happen by the new year as the president had hoped.

In a New York Times op-ed published Sunday, Vice President Joe Biden said the bill was "not perfect," but called it "very good" because it expands coverage to those currently unable to afford or obtain health insurance while holding down the nation's spiraling health care costs.

Republicans, however, accused the Senate's Democratic majority of working secretly to force through a poorly conceived bill that required special deals with recalcitrant caucus members.

Sen. Lindsey Graham, R-South Carolina, said on CNN's "State of the Union" that the wheeling and dealing "personifies the worst" in how Washington operates, while Sen. Tom Coburn, R-Oklahoma, accused the Democrats of buying support.

According to the Congressional Budget Office, the legislation could decrease the deficit by $132 billion over the first decade, and more than $1 trillion in the 10 years afterward, Obama said at a brief news conference.

While the House and Senate bills agree on most issues, there are significant differences over how to pay for them and how they will expand health coverage to more than 30 million uninsured Americans.

The House bill calls for an income tax surcharge on the wealthy, while the Senate version would increase the Medicare payroll tax for those earning more than $200,000 and levy a tax on insurance companies that provide expensive health plans.
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Post by racehorse » 12-21-2009 06:39 PM

http://article.nationalreview.com/print ... lhYmNhODU=

December 21, 2009, 4:00 a.m.

Five Reasons It Might Not Pass

Obamacare still may not be inevitable.


By Rich Lowry & Robert Costa

Harry Reid got his 60. Ben Nelson resorted to the typical Washington expedient in such situations and bought into a few window-dressing compromises, in exchange for an enormous Medicaid benefit to his state. The Cornhusker Kickback joins the Louisiana Purchase as the latest evidence that there’s nothing like a hundred million or so in federal dollars to alleviate a senator’s deeply held concerns about the substance of Obamacare. Nelson’s sellout is a gigantic step toward the passage of the bill, but it’s not over yet. Here are five obstacles that still stand between Reid-Pelosi and a White House signing ceremony:

1. Public Revulsion. The bill was already under water in every major public-opinion poll, and opposed by a margin of almost 2 to 1 in the latest CNN poll. The latest NBC News/Wall Street Journal poll put its support at freezing, 32 percent. A few ticks downward and the bill will be in the 20s.

Is anything that has happened recently likely to change the trajectory? The Reid bill just got even longer, and the new version includes more tax increases. Even by the standards of the United States Congress, the process has been hide-the-children ugly: massive payoffs to the on-the-fence senators and a heedless, late-night rush to pass something, anything. The Democrats have shown no inclination to let public opinion hold them back, but the stiff headwind makes everything a little harder and reduces an already-small margin for error.

One subset of public opinion will be particularly important: Nebraska. If Nelson is perceived to have made a career-defining choice that will end his designation as a conservative Democrat and a pro-lifer, and if he takes an immediate dive in the polls, it will cast a pall over other Blue Dogs inclined to play ball. In that case, the various payoffs on offer won’t seem worth the larger cost of supporting the bill. It’s too early to tell exactly how it’s going to play in Nebraska, but Nebraska Right to Life has been appropriately excoriating about Nelson’s betrayal.

Democrats have set out to disprove Lincoln’s adage that without public sentiment nothing can succeed. They may yet succeed, but sailing into the teeth of such a howling headwind of public opinion won’t be easy.

2. The Stupak Dozen. Nelson cut a deal so far short of the Stupak language in the House that the National Right to Life Committee is going to score the cloture vote on the bill as a vote to subsidize abortion on demand. That won’t matter to anyone in the Senate, but it could have a major effect in the House. After her initial 220–215 victory, Pelosi can afford to lose only two net votes. Bart Stupak has declared the Nelson language unacceptable and vows to oppose the final bill if it doesn’t include the restrictions contained in his amendment. As John McCormack points out, earlier in the year Stupak was part of a bloc of Democrats who wrote a letter to Pelosi saying they’d stand against “any health-care-reform proposal unless it explicitly excludes abortion from the scope of any government-defined or -subsidized health-insurance plan.” Eleven of those signatories voted for the House bill.

Then there’s Joseph Cao, the Louisiana Republican who voted for the bill at the last moment during the first House vote but has said he would vote against the bill — even if doing so might cost him his seat — if it funds abortion. Surely, not all of the Stupak Dozen have that level of commitment. The full weight of the Democratic establishment will come crashing down on them if they threaten the bill. Still, it would take only two or three of them to upset the entire effort. One option would be simply to give them what they want. But will Barbara Boxer stand for the Stupak language in the Senate? This has been a devilish dilemma for the Democrats from the beginning, and it hasn’t gotten any easier as the stakes have gotten higher.

3. Who Pays? As a practical matter, it should be relatively easy to find a compromise on revenue sources. That doesn’t involve a hot-button cultural issue or a matter of deep principle like abortion. But the differences in financing between the Senate and the House bills are vast. The Senate relies on a so-called Cadillac tax on pricey insurance plans, the House on a surtax on the wealthy. The Senate long ago declared the surtax anathema, and the House is just as dismissive of the Cadillac tax. The unions hate the Cadillac tax, since they enjoy such plans themselves, the fruit of collective bargaining. If the House gives in, it will create even more unrest on the Left. If the Senate gives in, it could upset the fragile deal for 60. If this disagreement over financing doesn’t represent as dire a threat to the future of the bill as the other factors we are cataloguing, it’s still a stumbling block.


4. Feeling Blue. “Blue Dog Democrat” is understandably becoming a term of derision, denoting a willingness to object only enough to be noticed before caving in to the Democratic leadership. Yet the Blue Dogs still have to be a worry for supporters of the bill. When Obamacare first passed the House, 28 Blue Dog Democrats, more than half of their 52-member coalition, were on board. This is a pool that surely includes some very nervous votes. As Michael Barone points out, nearly 70 percent of the Blue Dogs represent districts that voted for John McCain. A vote for this bill must look even more like a potentially career-ending decision now than it did the first time around.

Keep an eye especially on the Pennsylvanians. Rep. Patrick Murphy already has four GOP opponents in his suburban Philadelphia district. After supporting round one of Obamacare, the auto bailouts, TARP, and the stimulus, Murphy may be looking for a way back toward the center. Reps. Kathy Dahlkemper and Christopher Carney, both elected in the 2006 anti-Bush sweep, represent blue-collar districts in the Keystone State in which Obama failed to reach 50 percent last year. You can bet that trio is watching the polls. Other Blue Dogs are simply getting out. In the past month, Reps. Bart Gordon (D., Tenn.), Dennis Moore (D., Kan.), and John Tanner (D., Tenn.) have all announced their retirements.

Don’t count on the Blue Dogs, though, since most of them are experts at folding under pressure.

5. The Left. Progressives are pained, at what should be their very moment of triumph. The Senate dashed their dreams of the public option. Without it, many on the left are abandoning ship. “This is the real sticking point,” said Howard Dean last Sunday. “There hasn’t been much fight from the White House on that.” It was always unlikely, no matter how much Bernie Sanders grumbled, that left-wing senators would block the deal. It’s easier to imagine a firebrand or two in the House doing it. No fewer than 60 liberals in the House imprudently made a pledge to oppose a bill without a public option. Almost all of them can be expected to eat it. But what if one or two don’t? Public-option scold Rep. Anthony Weiner (D., N.Y.) is continuing to pressure Obama to move further left. “What we’re saying is now’s your moment, big guy, you’re the Mariano Rivera of this situation,” he said to MSNBC last week. “You’re going to come in at the end, and there’s still a chance to do it.” That’s not going to happen, but perhaps a few of Weiner’s colleagues are ideologically besotted enough to lash out at the president’s “betrayal” when he doesn’t “come in” the way they hope he will.

All of this means that Democrats shouldn’t be celebrating until they have the bill on Obama’s desk. But make no mistake: The momentum for the bill that Reid had to fake a week or so ago is now real, at least within Congress. Early next year, the question may shift from whether Democrats can pass the bill, to whether Republican can make the sort of gains in 2010 and 2012 necessary to repeal it.

— Rich Lowry is the editor of National Review. Robert Costa is the William F. Buckley Jr. Fellow at the National Review Institute.
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Post by racehorse » 12-22-2009 01:04 AM

http://www.washingtonpost.com/wp-dyn/co ... 24_pf.html

Both sides question health bill's abortion compromise

By Alec MacGillis
Washington Post Staff Writer

Tuesday, December 22, 2009; A08

The abortion language that was added to the Senate's health-care bill to win the vote of Sen. Ben Nelson (D-Neb.) has achieved a rare feat: It is drawing contempt from both sides.

That could be taken as a sign that senators finally found an elusive compromise on a thorny issue. But serious questions are already being raised about how the new language would work in practice and whether it would even be feasible to implement.

"This is why it's being attacked by both sides -- not because it's so moderate but because it's crazy," said Richard Doerflinger, a spokesman for the U.S. Conference of Catholic Bishops.

Sara Rosenbaum, a George Washington University professor of public health and law who criticizes the language as too restrictive, echoes that conclusion: "None of how this is supposed to work is even remotely in the bill, so I don't know what people are thinking about it."

The long-standing ban on federal funding for abortion has complicated congressional Democrats' health-care legislation. Medicaid bars federal funding for abortion, but 17 states and the District allow the procedure for female Medicaid enrollees paid out of their own funds. It is harder to reach middle ground in the bill before Congress, which would provide federal subsidies to millions of people to buy private health insurance plans on a new marketplace, or "exchange." The deal reached by Nelson and other Democrats over the weekend would allow those people to purchase insurance plans with abortion coverage. But they would have to write two separate premium checks -- one to cover the bulk of their plan and the other to cover the sliver for abortion coverage, probably a dollar or so per month.

States could also decree that no plans including abortion coverage be provided on the exchange in their state. As it stands, five states already have some sort of ban on abortion coverage.

By contrast, an amendment that passed the House would prohibit insurers from selling plans with abortion coverage to anyone buying coverage with the help of subsidies -- excluding 85 percent of customers on the exchange. The amendment, sponsored by Reps. Bart Stupak (D-Mich.) and Joe Pitts (R-Pa.), would permit the sale of "riders" for abortion coverage, but abortion rights groups say it is offensive to expect women to buy separate coverage for a procedure that most do not plan on needing.

Neither the House language nor the Senate language would affect women who have employer-provided plans, many of which cover abortion. But it is expected that more people would go into the exchange over time for coverage, broadening the impact of its rules.

An amendment by Nelson that mirrored the Stupak-Pitts language failed in the Senate. Senators supporting the new language say it is preferable to Stupak-Pitts because it would allow all women, subsidized or not, to buy plans with abortion coverage, assuming their state allows it.

"Is this the language we wanted? No. But it stopped Stupak and kept health reform moving forward without rolling back women's health-care options," said Alex Glass, a spokeswoman for Sen. Patty Murray (D-Wash.).

Others outside the Senate, though, say the language could limit abortion coverage as much as Stupak-Pitts. Anyone who selects a plan that includes abortion coverage would have to pay two separate premiums -- even single men or older women, who would not need abortion coverage. Abortion rights supporters suggest that would prompt frustration and, in turn, reduce demand for such plans. Eventually, they argue, insurers may decide not to offer abortion coverage at all.

"The absurdity of requiring these two separate checks doesn't accomplish anything toward the supposed goal of segregating federal funds," said Cecile Richards, president of the Planned Parenthood Federation of America. "It just creates additional hoops for insurance companies . . . and more administrative burdens and obstacles for women to get the coverage they need."

Jake Thompson, a spokesman for Nelson, said the senators crafting the compromise had not consulted with insurers. "As far as what insurers might do, that's hypothetical," he said.

Insurance representatives said it is too soon to say how the language would shape their offerings. But Wellpoint spokeswoman Kristin Binns noted that the insurer already navigates different rules in offering products in 14 states. "We comply with all the regulations, so however they pan out, we'll comply accordingly," she said.

To abortion opponents, the new language is objectionable simply because it would permit federal subsidies for people who buy plans with abortion coverage. They are not reassured by the prospect that insurers may find the language so unwieldy that they would stop offering such coverage.

"This is so murky that it's difficult to predict how it would be implemented," said Douglas Johnson, legislative affairs director for the National Right to Life Committee.

If the Senate bill passes, it will be up to a conference committee to come up with a solution. Stupak, who got 64 Democrats to vote for his amendment, has already declared the Senate language "unacceptable."
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Post by racehorse » 12-22-2009 10:22 AM

http://www.kentucky.com/963/v-print/story/1069278.html

Posted on Tue, Dec. 22, 2009

Senate closer to passing health care after early morning vote

David Lightman
McClatchy Newspapers

WASHINGTON — The Senate Tuesday morning voted to approve a Democratic-authored package of compromises and cut off another Republican effort to engage in extended debate, inching the historic health care plan closer to final passage later this week.

The Senate first voted 60 to 39 — no Republicans were in the majority — on a plan that includes strict standards on federal abortion funding and creation of a federally-supervised series of national health care plans that would compete with private firms.

The second vote, 60 to 39, formally allows the Senate to move forward with the entire $871 billion health care bill. The early morning votes, completed at 8:12 a.m., were scheduled so senators could take a final vote on the bill before Christmas; that vote is now planned for Thursday night, Christmas eve.

Republicans have one more shot at continuing the debate, and a vote to cut off that effort is scheduled Wednesday afternoon. If Democrats again muster 60 votes, the minimum needed to limit the talking, the schedule remains intact. If the Senate passes the bill, as expected, conferees, or negotiators, from both houses of Congress will begin trying to reconcile differences between the Senate measure and one passed last month by the House of Representatives.

A key threat to eventual passage is the public's view of the legislation, said Paul Ginsburg, president of the Center for Studying Health System Change, a nonpartisan Washington research group.

It could take several weeks for the conference to produce a bill, and "that's a long time for public opinion to shift," he said, and its success, particularly in an election year, will depend on "how this plays out with the public over the next few months."

Signs of what could happen next are mixed.

"There's pretty broad agreement on a lot," said Elizabeth Carpenter, a health policy analyst at the New America Foundation, a center-left Washington research group.

Under both bills, insurers would be barred from rejecting anyone because of pre-existing conditions. Gone, too, would be the practice in many states of charging women more than men, and insurers would be limited in how much they could increase rates on older people.

Consumers would be able to shop for coverage through exchanges, much as they now scan the Internet for the best airline fares. Most people would have to obtain a certain level of coverage, and pay penalties if they failed to do so. Both houses agree on financial help for people having trouble affording coverage: They both would provide aid to families earning up to about $88,000 per year.

What could derail the entire effort are areas in which Democratic leaders have struggled for months to find common ground: abortion, taxes and the public option.

Ultimately, Democrats will write the final bill, because they control 60 Senate seats_ enough to cut off extended debate_ and 258 of the House's 435 seats. However, that means appealing to the approximately 52 moderate-to-conservative Blue Dogs in the House, as well as to the eight to 12 centrist Democrats in the Senate. That's likely to mean important concessions on the three big controversies.

Already, liberals' yen for a government-run insurance alternative and giving women more access to elective abortions faded when moderate senators balked.

Sen. Ben Nelson, D-Neb., who over the weekend provided the crucial 60th vote to cut off debate, explained a big reason he went along: "The Senate health-care bill is not perfect. Yet it doesn't include a public option or taxpayer funding of abortion I worked to exclude."

One of the public option's biggest boosters, Sen. Russell Feingold, D-Wis., realized that without the moderates, the entire health-care bill could be defeated.

"While the loss of the public option is bitter pill to swallow, on balance the bill still delivers meaningful reform, and the cost of inaction is simply too high," he said.

What all this means, said Barbara Kennelly, the president of the Committee to Preserve Social Security and Medicare, is that bill supporters need to be reminded, "This is truly an opportunity to begin health-care reform."

That desire to at least provide a foundation for future action is what worries skeptics.

Abortion rights supporters worry that the Senate bill doesn't go much further than the House version, which restricts federal funding to instances in which a woman's life is in danger or she's a victim of rape or incest. Abortion opponents think the Senate bill, which has somewhat less restrictive requirements, goes too far.

Taxpayer groups see too many taxes going up, since the House version imposes a 5.4 percent surcharge on individuals with adjusted gross incomes of more than $500,000 and couples making more than $1 million.

The Senate version includes a 40 percent excise tax on more expensive insurance policies and a 0.9 percentage point increase in the 1.45 percent Medicare tax for individuals with wages of more than $200,000 and couples earning more than $250,000.

"Democratic leaders put together a bill so heavy with tax hikes, Medicare cuts and government intrusion that in the end their biggest problem wasn't convincing Republicans to support it, it was convincing Democrats," scoffed Senate Republican leader Mitch McConnell, R-Ky.

However, Senate Majority Leader Harry Reid, D-Nev., was cheered Monday by a new CNN/Opinion Research Corp. poll, which found that support for the Democrats' health-care bill was up 6 percentage points over the last two weeks.

That poll, though, also showed Democrats have a long way to go, as 56 percent still oppose the bill, while 42 percent support it.
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Post by racehorse » 12-22-2009 10:31 AM

http://politicalwire.com/archives/2009/ ... argin.html

December 22, 2009

Voters Oppose Health Care Plan By Wide Margin

As the Senate prepares to vote on health care reform, American voters "mostly disapprove" of the plan 53% to 36% and disapprove 56% to 38% of President Obama's handling of the health care issue, according to a new Quinnipiac poll ( http://www.quinnipiac.edu/x1295.xml?ReleaseID=1408 ).
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Post by racehorse » 12-22-2009 09:12 PM

http://www.latimes.com/news/nation-and- ... rint.story

latimes.com

Senate healthcare bill may be hard to reconcile with House's

With passage of the Senate version expected early Christmas Eve, the reality of the differences between the bills looms in the New Year.


By Janet Hook

5:32 PM PST, December 22, 2009

Reporting from Washington

As the Senate lumbers toward passage of its healthcare bill, Democrats are looking ahead to the potentially difficult process of reconciling its substantial differences with the more-liberal House version -- the last major obstacle before President Obama can sign landmark legislation into law.

The final Senate vote on the healthcare bill was set for 8 a.m. Thursday, Christmas Eve, as Republicans held the floor today to criticize the measure and delay its enactment. Democrats are hopeful that the momentum generated by the long-awaited Senate vote -- and the high political stakes involved in finishing the job -- will grease the wheels of negotiations with the House.

"Each side knows we cannot fail," said Sen. Charles E. Schumer (D-N.Y.). "Each side knows they have to give."

But after lawmakers enjoy what is left of the holiday season in their home states, they will return to wide and deeply held differences between the House and Senate bills on federal funding for abortion and the liberals' dream of establishing a "public option" -- a government plan that would compete with private insurers -- to guarantee access to affordable insurance.

Negotiators also will have to hammer out disagreements that will determine how quickly the bill takes effect, what taxes will be raised, and other items that reach deeply into every hospital, doctor's office and home medicine cabinet.

Nancy Anne DeParle, Obama's health advisor, acknowledged that many liberal House Democrats feel they already have compromised too much on the public option. But, she added, she was encouraged by signs that they do not see the matter as nonnegotiable.

Moreover, DeParle said as she shuttled between meetings in the Capitol today, some of the conservative Democrats who voted against the House bill have told her that they might be open to the final version of the legislation if it included more cost-containment provisions, as the Senate bill does.

In a gesture to underscore his commitment to seeing the fight through, Obama said today that he would delay his planned Christmas trip to Hawaii -- which was scheduled to start today -- until after the bill passed.

"If they're making these sacrifices to provide healthcare to all Americans, then the least I can do is to be around and to provide them any encouragement and last-minute help if necessary," Obama told reporters.

The outcome of Senate debate has been a settled matter since early Monday morning, when the chamber took the first of a series of procedural votes after Majority Leader Harry Reid (D-Nev.) crafted a compromise that garnered support from all 60 members of the Democratic caucus.

The Senate voted 60 to 39 today to clear the next procedural hurdle. (GOP Sen. James M. Inhofe of Oklahoma was absent from the party-line roll call.) After another procedural vote Wednesday, the bill will come up for final passage at an unusually early hour Thursday to give senators time to get home for Christmas.

"The finish line is in sight," Finance Committee Chairman Max Baucus ( D-Mont.) said at a news conference. "We're not the first to attempt such reforms, but we will be the first to succeed."

Senate debate stretched into its 23rd day today as Republicans continued to demand time to highlight their opposition to a bill they see as a costly, dangerous expansion of government power. And they delighted in turning a spotlight on the backroom deals that went into building Democratic support.

Among the agreements was a federal government commitment to pick up the full cost of expanding Medicaid in Nebraska, to cover all people making less than 133% of the federal poverty level. Other states must split the cost of the expansion with Washington.

The Nebraska exception was made to win the vote of that state's Sen. Ben Nelson, who on Saturday became the last Democrat to line up behind the bill. Another Medicaid exception was made for Louisiana some time ago as an enticement to Sen. Mary L. Landrieu (D-La.). Vermont and Massachusetts also get special treatment.

"This bill is a mess, and so was the process that was used to get it over the finish line," said Senate Minority Leader Mitch McConnell (R-Ky.). "Americans are outraged by the last-minute, closed-door, sweetheart deals that were made to gain the slimmest margin for passage."

As Democrats began to contemplate what compromises will be needed between the House and Senate, Obama responded to criticism -- mostly from liberals -- that he had given away too much in order to get a bill passed.

"Nowhere has there been a bigger gap between the perceptions of compromise and the realities of compromise than in the healthcare bill," Obama said in an interview with the Washington Post . "Every single criteria for reform I put forward is in this bill."

Liberals' central bone of contention is that Obama did not push harder for the public option. But even in the more-liberal House, it was impossible to pass the public option without watering down the government's role in setting reimbursement rates.

For some time, Speaker Nancy Pelosi (D- San Francisco) has said that the House could not pass a bill without a public option. And some liberals have threatened to vote against the entire bill if the provision is dropped.

Rep. Raul M. Grijalva (D-Ariz.), co-chairman of the Congressional Progressive Caucus, criticized the Senate and the White House, saying: "We need strong leadership so close to the finish line, not efforts to water down a bill to the breaking point."

It may be even harder to resolve differences between the House and Senate provisions on abortion. Leading opponents of abortion favor the House's stricter language banning federal funding for the procedure. A key question is whether the House's sizable faction of antiabortion Democrats will vote against the bill if the provisions are not to their liking.

Noam N. Levey in the Washington Bureau contributed to this report.
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Post by racehorse » 12-22-2009 10:50 PM

http://online.wsj.com/article/SB1261482 ... #printMode

* DECEMBER 22, 2009, 9:38 P.M. ET

One Hurdle Remains in Senate

By GREG HITT and NAFTALI BENDAVID

WASHINGTON -- Democrats approved the second of three motions to close off debate on their health bill Tuesday and moved closer to passage on Christmas Eve, while Republicans highlighted their contention that the bill's requirement for buying insurance is unconstitutional.

All 58 Democrats and two independents supported the motion to limit the debate, which is now in its fourth week, while 39 Republicans were against it.

The final motion to end debate is expected to win approval Wednesday, clearing the way for senators to vote on the bill itself at 8 a.m. Thursday, which is Christmas Eve. Immediately after that, the Senate is also planning to vote on House-passed legislation increasing the government's borrowing authority.

Convening on Christmas Eve would mark the 25th straight day of debate, bringing the Senate just short of the record for most consecutive days in session. That was set in the winter of 1917 in the run-up to U.S. entry into World War I, when the chamber met for 26 consecutive days.

"The finish line is in sight, said Senate Finance Committee Chairman Max Baucus, the Montana Democrat who is a chief architect of the Senate bill. "Now we know with certainty that we have the will to cross it."

To meet a pre-Christmas deadline for action set by President Barack Obama, Senate Majority Leader Harry Reid (D., Nev.) has pushed his colleagues -- even 92-year-old Sen. Robert Byrd, the West Virgina Democrat -- through a grueling schedule this week, including votes at 1 a.m. Monday and 7 a.m. Tuesday.

With Senate Democrats showing their determination to move in lockstep, Republicans -- who contend that the sweeping bill would impose unreasonable burdens on taxpayers and businesses -- said they would continue fighting even after the House and Senate begin negotiations on a compromise version in January.

"This debate is not over," said Senate Minority Leader Mitch McConnell (R., Ky.). "The American people are still going to have another month to weigh in."

Republicans are forcing the Senate to vote Wednesday on whether the Democrat-backed bill is unconstitutional. Sen. John Ensign (R., Nev.) raised a point of order Tuesday against the bill, arguing that the Constitution doesn't give Congress latitude to force Americans to buy health coverage, as both the House and Senate bills do.

"What's next?" Mr. Ensign said. "Will we consider legislation in the future requiring every American to buy a car? Will we consider legislation in the future requiring every American to buy a house?"

Mr. Ensign isn't expected to succeed. But the effort dramatizes a criticism raised by Republicans and conservative activists. Under the Senate and House bills, Americans who don't receive health coverage through their employers must buy insurance if they can afford it.

The "individual mandate" is part of broader legislation designed to expand health-insurance coverage to tens of millions of Americans. The bill offers tax subsidies to purchase insurance and widens eligibility for Medicaid, the federal-state program that provides health insurance to the poor.

Conservative critics contend that the provision violates the Constitution's "takings clause," which says "private property [cannot] be taken for public use, without just compensation."

Democrats counter that the mandate is necessary to make the planned overhaul of the health-care system work, and ensure that as many people as possible participate in the system. Under the Senate bill, individuals who don't purchase coverage would face a financial penalty up to $750.

Democrats say the courts have given Congress wide authority to impose rules under its powers to regulate interstate commerce.

"We feel very sound in our position," Mr. Reid said.
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Post by Psychicwolf » 12-22-2009 11:23 PM

Outstanding Bill Moyers on the "Reform"

BILL MOYERS: Welcome to the Journal.

Something’s not right here. One year after the great collapse of our financial system, Wall Street is back on top while our politicians dither. As for health care reform, you’re about to be forced to buy insurance from companies whose stock is soaring, and that’s just dandy with the White House.

Truth is, our capitol’s being looted, republicans are acting like the town rowdies, the sheriff is firing blanks, and powerful Democrats in Congress are in cahoots with the gang that’s pulling the heist. This is not capitalism at work. It’s capital. Raw money, mounds of it, buying politicians and policy as if they were futures on the hog market.

Here to talk about all this are two journalists who don’t pull their punches. Robert Kuttner is an economist who helped create and now co-edits the progressive magazine THE AMERICAN PROSPECT, and the author of the book OBAMA’S CHALLENGE, among others.

Also with me is Matt Taibbi, who covers politics for ROLLING STONE magazine where he is a contributing editor. He’s made a name for himself writing in a no-holds-barred, often profane, but always informative and stimulating style that gets under the skin of the powerful. His most recent article is “Obama’s Big Sellout,” about the President’s team of economic advisers and their Wall Street connections. It’s been burning up the blogosphere. Welcome to both of you.


http://www.ritholtz.com/blog/2009/12/bi ... re-reform/
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Post by racehorse » 12-23-2009 03:58 PM

http://thehill.com/blogs/blog-briefing- ... ails-39-60

Challenge to health bill's constitutionality fails, 39-60

By Michael O'Brien - 12/23/09 02:46 PM ET

A challenge to the Senate health bill's constitutionality failed on Wednesday afternoon in a party-line vote.

Sens. John Ensign (R-Nev.) and Orrin Hatch's (R-Utah) point of order arguing that the Senate bill is unconstitutional under the Interstate Commerce Clause and Fifth Amendment of the U.S. Constitution failed in a 39-60 vote.

The vote was the first in a series Wednesday afternoon as senators prepared to invoke cloture for final passage of the Senate's health bill.

Conservatives have alleged for some time that elements of the health bill, most particularly the mandate that individuals buy some sort of health coverage, violate the Constitution.

It wasn't immediately clear which GOP senator missed the vote, though Sen. James Inhofe (R-Okla.) has been absent from Washington this week due to family issues.
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Senate Health Care Bill Passes 60 to 39!

Post by racehorse » 12-24-2009 07:26 AM

The United States Senate, as expected has just passed the Senate Health Care Bill. The vote was 60 to 39 with all Democrats voting for it and all Republicans who voted voting against it.
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Post by racehorse » 12-24-2009 07:50 AM

For whatever reason, my United States Senator, Jim Bunning did not vote on this bill. :(

He has spoken out strongly against the legislation, however.
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Post by racehorse » 12-24-2009 07:51 AM

http://www.kentucky.com/1084/v-print/story/1071932.html

Posted on Thu, Dec. 24, 2009

It's done: Senate approves health care overhaul, 60-39

David Lightman
McClatchy Newspapers

WASHINGTO — The Senate Thursday voted 60 to 39 to overhaul the nation's health care system — President Barack Obama's top 2009 domestic priority — moving he nation closer to near-universal health care coverage early in the next decade.

It was a vote, said Senate Majority Leader Harry Reid, D-Nevada, “to live a healthylife.”

Fifty-eight Democrats and two independents — and no Republicans — voted to approve an $871 billion bill would require most Americans to obtain health care coverage, and would provide federal aid for those having difficulty affording it.

The bill, passed during the Senate's first Christmas Eve session in 46 years, now has to be merged with a version passed last month by the House of Representatives.

Lacking the votes to stop the bill in the chamber, Senate Republicans vowed to continue their fight in the public arena and encouraged angry voters to let Congress know what they think of the health care bill.

“We must take this chance and deliver on a promise the American people hae deserved for six and half decades,” said Majority Leader Harry Reid, D-Nevada, a reference to President Harry Truman’s initial bid to overhaul health care in the 190s.

But Republicans would not relent.

“I guarantee you the people who voted for this bill are going to get an earful when they finally get home for the first time since Thanksgiving,” said Senate Minority Leader Mitch McConnell, (R-Ky.) “This fight isn’t over…My colleagues and I will work to stop this bill from becoming law.”

Negotiators are likely to begin closed-door talks next month, aiming to have a final compromise bill finished in time for Obama’s 2010 State of the Union address, probably in late January.

Democratic leaders and the White House are confident they can find common ground, and see plenty already. Insurers would be barred from denying coverage because of pre-existing conditions. Insurance exchanges, or marketplaces, would be created where consumers could easily shop for policies. And companies could no longer charge separate rates because of gender and would be limited to how much more they could charge older consumers.

But reaching agreement on contentious areas could be difficult, because the bills have stark differences on some of the major political flashpoints.

The House bill puts strict limits on federal funding of abortion. The Senate is less restrictive.

The House wants a government-run insurance plan, or public option. The Senate does not, opting to push a federally-supervised system of multistate, private run insurance plans..

The House wants to impose a 5.4 percent income tax surcharge on individuals earning $500,000 and couples making more than $1 million, starting in 2011, a change that would begin to restore some of the Bush era tax cuts.

But the Senate has other ideas, preferring a 40 percent excise tax on more expensive employer-sponsored insurance plans and a 0.9 percentage point increase in the 1.45 percent Medicare tax on the wealthy.

And there are less discussed differences, such as effective dates — the House wants to start major changes in 2013, the Senate, a year later.
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