Democrats agree to drop government run insurance option

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Post by racehorse » 12-18-2009 09:59 PM

http://www.kentucky.com/522/v-print/story/1065400.html

Posted on Fri, Dec. 18, 2009

Nelson signals progress on health care in talks

By DAVID ESPO
The Associated Press

Democratic leaders appeared to make progress Friday night in winning over Sen. Ben Nelson to be their 60th vote to pass a sweeping health care bill by Christmas. Nelson, a moderate Nebraska Democrat, is seeking stricter abortion curbs and said he's been offered ideas that may answer his concerns.

He declined to disclose details but said the proposed approach "would exclude any kind of federal funds directly or indirectly being used to fund elective abortions, and the question is always how you get them as tight as you can and still be able to get a common understanding and something that you could all agree to."

"We're looking at that to see if it does it sufficiently. That's the key - sufficiently," Nelson said during a break in closed-door talks in the Capitol with Senate Majority Leader Harry Reid, senior White House officials and others. The discussions were expected to continue into the night as Reid rushes to finalize the legislation in time for a first vote likely within days. Nelson is the lone holdout in the 60-member Democratic caucus - exactly the number Reid needs to overcome Republican opposition and pass the legislation.

Several officials said Nelson was seeking to ease the impact of a proposed insurance industry tax on nonprofit companies, as well as win more federal funds to cover Nebraska's cost of treating patients in Medicaid, the state-federal health care program for the poor. These officials, speaking on condition of anonymity because of the sensitivity of the talks, said the administration and Democratic leaders had offered concessions on those points.

In another sign of progress, Nelson said legislative language on Medicaid might be drafted in anticipation of agreement.

Nelson has spoken openly of seeking stricter abortion curbs, except in cases of rape, incest or when the life of a mother is in danger. An earlier proposed compromise on that issue - which attempted to separate public from private funds for abortion coverage - won the tentative support of Catholic hospitals. But the National Right to Life Committee objected, dismissing it as an accounting gimmick.

Later Friday, Cardinal Daniel DiNardo of the U.S. Conference of Catholic Bishops also rejected to the proposal. He said it "does not comply with long-standing ... restrictions on federal funding of elective abortions" that govern other government programs. The bishops played a significant role in drafting an abortion-related provision in the House bill.

If Republicans cared much about the outcome of negotiations, it wasn't apparent.

"This massive piece of legislation that seeks to restructure one-sixth of our economy is being written behind closed doors without input from anyone in an effort to jam it past not only the Senate but the American people before Christmas," said Sen. Mitch McConnell of Kentucky, the Republican leader.

"They are virtually thumbing their nose at the American people who are virtually screaming at us, don't pass this bill," he added.

Public opinion polls show lagging support for the measure, although Democrats argue that will change once legislation passes and consumers see benefits.

Not all liberals saw it that way.

MoveOn.org, which helped fuel Obama's election last year, announced its opposition to the measure, citing its lack of a government-run insurance option. It urged its members to sign a petition saying, "America needs real health care reform - not a massive giveaway to the insurance companies."

The bill is designed to extend coverage to millions who lack it, prohibit the industry from denying insurance on the basis of pre-existing medical conditions and generally slow the rate of growth of medical spending nationwide.

At a cost of nearly $1 trillion over a decade, it includes hundreds of billions of dollars to defray the cost of coverage to individuals and families at lower and middle incomes.

Reid, D-Nev., has been preparing a final series of revisions to the 2,074-page bill, with Senate debate expected to begin on them shortly after they are made public sometime early Saturday.

In addition to the negotiations with Nelson, there were talks with Sen. Olympia Snowe, R-Maine, who voted for an earlier version of the legislation when it cleared the Senate Finance Committee.

Republicans, who have been accused by Rush Limbaugh and others for failing to oppose the legislation vigorously enough, have threatened to force Senate clerks to read the entire text of the proposed changes aloud, a process that could consume eight hours or so.
-
Associated Press writers Ricardo Alonso-Zaldivar and Erica Werner contributed to this report.
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Post by racehorse » 12-19-2009 01:56 AM

http://abcnews.go.com/Politics/HealthCa ... 337&page=1

Does Sen. Ben Nelson Stand in the Way of Health Care Victory for Democrats?

Conservative Democrat Stands Tough on Abortion Issue, Threatens to Filibuster with Republicans


By HUMA KHAN

Dec. 18, 2009—

It is an age-old issue that has caused many a conflict.

For 36 years, the controversial Roe v. Wade decision set the ground rules for abortion law in the United States, but the issue has continued to simmer beneath the political surface. With the momentum to get a health care bill passed by the end of the year, it is now threatening to boil over and derail the health care legislation, and one senator is leading the helm -- Ben Nelson of Nebraska.

Nelson, 68, is a longtime abortion opponent. His amendment to tighten restrictions on federal funding for abortion was struck down in the Senate on Dec. 8, even though a similar measure passed in the House.

Since then, Nelson has ratcheted up the heat and is threatening to filibuster with Republicans if language similar to what he proposed is not included in the health care bill.

"The compromise adds important new initiatives addressing teen pregnancy and tax credits to help with adoptions," Nelson said Thursday in a written statement, referring to a compromise offered by a fellow anti-abortion Democrat, Sen. Bob Casey of Pennsylvania. "These are valuable improvements that will make a positive difference and promote life. But as it is, without modifications, the language concerning abortion is not sufficient."

Nelson is considered to be one of the most conservative Democrats in the Senate and his staunch stance is making some wonder whether he is the lone Democrat standing in the way of health care victory.

Senate Democratic leaders are in a tough spot. They need 60 votes to avoid a Republican filibuster of their health care bill, but there is little political capital left to spare between courting Sen. Joe Lieberman, I-Conn., who objects to a government-run insurance option and liberal Democrats, who want the opposite.

Nelson, however, is not a definite "no." In fact, he says, he "is open to looking at additional attempts to maintain the federal restriction on public funding of abortion."

But the question of whether his fellow party members will take the language as far as he wants is another issue. The current law restricts federal funding for abortion, but opponents argue that the new health care system contains loopholes that won't be able to stop federal dollars from going toward abortion services.

And it's not just abortion that the Nebraska native is taking issue with. In an interview with KLIN in Lincoln, Nebraska Thursday, Nelson said he has additional concerns about other proposals in the health care bill -- namely Medicare costs and new taxes and fees -- and that Senate Majority Leader Harry Reid's deadline of Christmas was unattainable.

Nelson Widely Courted

Lawmakers and the White House both have tried to woo Nelson, who has famously declared his vote is not for sale. He has met with President Obama three times in eight days, and has been scoffed at by some liberal groups for not siding with his caucus. Nelson, for his part, is standing by his arguments.

"I am not feeling any pressure from the party," he said. "I know what they would like me to do."

Sen. Casey's compromise included an increase in a tax credit for people who adopt a child, funding to help pregnant teens and others with alternatives to abortion and stronger language to protect health care providers who don't want to perform abortions. But it is unclear whether it went as far as the Stupak-Pitts amendment in the House bill, which would not only cut federal funding for abortion-related services, but would also limit access to abortions for people who receive federal subsidies and those who purchase insurance through a health insurance exchange, a marketplace where people would be able to shop for and compare insurance plans.

Rep. Bart Stupak, D-Mich., rejected the Casey proposal as a "non-starter," and expressed confidence that his language will be included in the final bill. Stupak told ABC News he has been in touch with Sen. Nelson.

"They are holding tough and they are asking me, 'Is the House holding tough?'" Stupak said, referring to his Senate counterparts like Nelson and Sen. Orrin Hatch, R-Utah, who crafted the abortion amendment in the Senate health care bill. "Our members are holding, so we will not pass if they are putting anything but a version of our language."

Ben Nelson Opposes Abortion Language in Senate Health Care Bill

Nelson, a former insurance industry executive, has been something of a star in Nebraska's Democratic party. Hailing from a relatively conservative state, he has enjoyed a long public service career and is currently the only Democratic candidate from the state in Congress.

But while he enjoys local success, he has butted heads with fellow Democrats in Nebraska several times, especially on the issue of abortion.

As governor, Nelson signed a ban on so-called partial-birth abortion that was overturned by Nebraska's Supreme Court in 2000.

He also backed the nomination of Supreme Court nominee Samuel A. Alito Jr. despite Democrats' objections to the judge's anti-abortion position.

Nelson, who was born in Nebraska and has lived all his life there, is also a member of anti-abortion organizations and, during his campaign, was endorsed by several of them.

Nelson sees a tough battle in 2012, when his term expires. The Nebraska senate race is expected to be a competitive one as Republicans step up efforts to reclaim Nelson's seat, which has been occupied by a Democrat for more than two decades.

It is no surprise then that Nelson has been so steadfastly fixed on the idea of introducing firmer language on abortion in the Senate health care bill.

"Federal taxpayer money ought not to be used to fund abortions," Nelson told ABC News' Jonathan Karl in November. "So whether it is subsidies on premiums or whether it is tax credits or whatever it is... it should not be used to fund abortions."

Bob Kerrey, who held the senate seat before Nelson and is now president of the New School in New York, said the anti-abortion group is a formidable force in Nebraska politics, and their pressure on lawmakers is enormous.

"It certainly accounted for a significant part of my opposition because I held the opposite view," Kerry told ABC News. However, Kerrey differs with Nelson on the issue, arguing that one should make a "decision on what you believe the law should be, not what you believe about the action."

Nebraskan Democrats have raised little ruckus over the deadlock on the abortion issue.

In a statement to ABC News, the Lancaster County Democratic Party in Nebraska said, "While most of the Democratic constituents in Lancaster County do not agree with Senator Nelson's views regarding women's reproductive rights, the Lancaster County Democratic Party understands that our party is a big tent. Our elected officials are not held to a litmus test, but are asked to wisely serve the citizens of our state." Americans' view of abortion remains split. In a November Washington Post poll, 54 percent of Americans said abortion should be legal in all or most cases. Opinions range widely in states across the country.

Nelson, a former state insurance director of Nebraska and industry executive, has also opposed other measures in the health care bill. He is against a new long-term care insurance program and proposed cuts in payments to nursing homes and home health care providers.

Nelson's top source of campaign contributions is the insurance industry, with names such as Aetna and MetLife gracing the list of his donors. Nelson's contributions from the insurance industry amounted to $636,209, according to maplight.org.

Abortion Debate on the Forefront in Health Care Debate

In recent weeks, the White House has ratcheted up pressure on Democratic leaders to pass a health care overhaul bill. President Obama has repeatedly urged his party members to reach a compromise, saying that this is a health care bill, not an abortion bill.

But the controversial issue is unlikely to fade away any time soon, and some liberal Democrats say that the party needs to reframe the debate to reach out to Americans.

Kerrey, who supports what he calls freedom of choice, said that when one argues that they are right and the other is wrong, "you're not going to persuade anybody that some logic exists behind the argument."

"Abortion is so controversial that it becomes a litmus test vote," he said.

At the same time, the issue -- and the division within Democrats on abortion -- is not foreign. According to Kerrey, had the health care plan that the Clinton administration was proposing moved forward, the same scenario would likely have played out.

"I think in 1993, the issue was very much alive and well, it would've produced very similar faultlines within Democrats," the former senator said. "Maybe there are more today but the Democratic party has always had very large number of active participants in state and national level both as supporters and as candidates who are pro-life."

The abortion debate is likely to take center stage as Senate Democratic leaders clamor to gain full support for the health care bill by Christmas.

Nelson's office did not return calls seeking comment, but his counterparts say they will not back down anytime soon.

"This isn't an argument on merit. This is more an argument on their pride," Rep. Stupak said of his Democratic colleagues who opposed his amendment. "They chose this fight and lost."
--
Sen. Ben Nelson, D-Neb., is questioned by reporters before attending a meeting on health care reform, Tuesday, Dec. 8, 2009, on Capitol Hill in Washington.
(Haraz N. Ghanbari/AP Photo)
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Post by SETIsLady » 12-19-2009 10:07 AM

racehorse wrote: Does Sen. Ben Nelson Stand in the Way of Health Care Victory for Democrats?
Not anymore, he is making a statement on TV right now that he will vote for health care. The Dems have their 60 votes. He says as long as there are no major changes he will support it.

Sen. Ben Nelson to announce support for health-care bill

Sen. Ben Nelson (Neb.), the final Democratic holdout on health care, was prepared to announce to his caucus Saturday morning that he would support the Senate reform bill, clearing the way for final passage by Christmas.

"We're there," said Sen. Kent Conrad (D-N.D.), as he headed into a special meeting to announce the deal.

Democratic leaders spent days trying to hammer out a deal with Nelson, and worked late Friday night with Nelson on abortion coverage language that had proved the major stumbling block. But Nelson also secured other favors for his home state.

Asked if he was prepared to support the bill, Nelson said, "Yeah."

With Nelson seemingly on board, Senate Majority Leader Harry M. Reid unveiled the final version of a sweeping overhaul of the nation's health insurance system that would expand coverage to an additional 31 million Americans, coming closer to attaining the Democrats' longsought goal of universal medical coverage.

Full Article:

http://www.washingtonpost.com/wp-dyn/co ... id=topnews
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Schumer: We've Reached Agreement With Nelson

Post by SETIsLady » 12-19-2009 10:13 AM

Sen. Chuck Schumer (D-NY) just told reporters that he and Senate Majority Leader Harry Reid shook hands last night at 10:30 p.m. with Sen. Ben Nelson (D-NE) on an agreement that he would vote for cloture on health care reform, on the basis of the abortion language in the manager's amendment.

The text of the abortion amendment is below the fold.

http://tpmdc.talkingpointsmemo.com/2009 ... hp?ref=fpa
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Post by badspell » 12-19-2009 10:25 AM

This healthcare issue has me on the fence. I do see the positive aspects but fear the manipulative possibilities.
All hear few listen

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Post by Cherry Kelly » 12-19-2009 10:34 AM

badspell -- putting it simply - we the people the huge majority who are against this package have been sold out to the highest bidders.

Its not health care is pork barrel.

Will the finalized Senate version be posted where WE the People can read it? Is it even the bill that Reid and his coherts plan to put up for a vote?

The biggest question of all - is it even Constitutional?

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Post by SETIsLady » 12-19-2009 10:40 AM

Cherry Kelly wrote: Is it even the bill that Reid and his coherts plan to put up for a vote?

The biggest question of all - is it even Constitutional?
CK, you have made these 2 statements a couple of times now, can you please explain in more detail.

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Post by SETIsLady » 12-19-2009 10:45 AM

Because the text is posted:

TEXT OF HEALTH INSURANCE REFORM BILL
Sen. Reid and committee chairs have released the Patient Protection and Affordable Care Act, the Senate health insurance reform bill.

http://democrats.senate.gov/reform/pati ... re-act.pdf
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Post by SETIsLady » 12-19-2009 10:59 AM

SETIsLady wrote: He says as long as there are no major changes he will support it.
Heres what he said about this.
"Without in any way intending to be threatening--to be more in the more of promising--let me be clear, this cloture vote is based on full understanding that there will be a limited conference between the Senate and the House," Nelson said. "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--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.
http://tpmdc.talkingpointsmemo.com/2009 ... hanges.php

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Post by racehorse » 12-19-2009 12:17 PM

SETIsLady wrote: Not anymore, he is making a statement on TV right now that he will vote for health care. The Dems have their 60 votes. He says as long as there are no major changes he will support it.


Will there be major change though in the final legislation that the Senate and House must both agree to?

The bill the House passed is much different.

Progressives who voted for the House bill with it's public option may revolt and join with Republicans and vote against the final legislation ( for different reasons), as Moveon.org and Howard Dean among others have recommended.

This may still be far from over, SETIsLady.
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Post by SETIsLady » 12-19-2009 12:19 PM

racehorse wrote: This may still be far from over, SETIsLady.
I agree Race, I was just updating the thread ;)

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Post by badspell » 12-19-2009 12:21 PM

I agree Race. This is something that should be thought out. Something this important cannot be rushed.

Most things do get better with age:)
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Post by racehorse » 12-19-2009 12:30 PM

SETIsLady wrote: I agree Race, I was just updating the thread ;)


We are likely to witness a very interesting next few days regarding all of this, my friend. ;)
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Post by racehorse » 12-19-2009 12:31 PM

badspell wrote:

Most things do get better with age:)
Promises, Promises! ;)

I hope so. :D
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Post by racehorse » 12-19-2009 01:10 PM

http://thehill.com/homenews/senate/7305 ... ive-for-60

THE HILL

Final Senate healthcare bill released by Reid in drive for 60

By Jeffrey Young - 12/19/09 09:45 AM ET

Senate Majority Leader Harry Reid (D-Nev.) has unveiled a final version of his healthcare reform legislation containing a plethora of changes designed to lock down the 60 votes he needs to pass the historic legislation on Christmas Eve.

The so-called manager's amendment to the bill that has been on the Senate floor for weeks contains in its 383 pages new compromise language, with many of the provisions targeted to satisfy the demands of individual senators.

Reid formally introduced the legislative language on the Senate floor Saturday morning, triggering a parliamentary delay tactic by Senate Minority Leader Mitch McConnell (R-Ky.), who insisted that clerks read the entire document aloud.

Despite the delay the bill reading will cause, Reid’s gambit strongly suggests that he has united his caucus of 58 Democrats and two independents behind a measure that would extend health insurance coverage to around 30 million people and make fundamental changes to the U.S. healthcare system.

The House passed its version of the healthcare bill last month. If Reid is able to keep his 60 Democrats in hand through a vote to approve the Senate bill scheduled for 7 p.m. on Christmas Eve, he will deliver a major victory to President Barack Obama. House and Senate Democrats would then confer during the holiday break and into January on the version that would go to Obama for a signature.

The release of the manager’s amendment marks a watershed moment for Reid’s leadership during the year-long process of drafting and debating healthcare reform legislation. Democrats have been stiffly divided on several crucial issues on ideological grounds with a handful of centrists objecting to key liberal priorities such as the creation of a government-run public option insurance program.

Numerous attempts to find a compromise acceptable to both camps failed, leading Reid to pin his hopes on siding with the centrists and counting on the liberals not to walk away from a bill that still strives for their primary goal of enacting a comprehensive healthcare reform bill that provides coverage to tens of millions of uninsured people.

Reid’s most crucial political compromise was on abortion, the biggest bone of contention for centrist Sen. Ben Nelson (D-Neb.), an abortion opponent who failed in his attempt to amend the bill on the floor with stronger language shielding federal insurance subsidy funds from paying for abortion services and rejected previous compromises offered by Reid and Sen. Bob Casey Jr. (D-Pa.), who both also oppose abortion rights.

After private talks between Reid, Nelson and other Democrats that ran late into Friday night, however, Nelson signed off on the new language and other provisions that cleared the way for him to support the healthcare bill. The language is complex but the biggest change is that states would be permitted to prohibit plans sold within their borders through the health insurance exchange from covering abortion services. “I will vote for healthcare reform because it will deliver relief from rising healthcare costs to Nebraska families, workers, rural communities and employers,” Nelson said.

The early response from abortion-rights supporters was positive, as Democratic Sens. Barbara Boxer (Calif.) and Patty Murray (Wash.) issued a joint statement saying they preserved the principle that women can use their own money to purchase abortion coverage through plans on the insurance exchange. Though the senators emphasized they preferred the original abortion language in the bill, "compromise was necessary to get a healthcare bill for the American people, and this compromise achieves that."

"We said we would not accept language that prohibited a woman from using her own private funds for her legal reproductive health care -- this compromise meets that test," Boxer and Murray said.

Nelson also won a major concession on the proposed expansion of Medicaid to everyone with incomes below 133 percent of the federal poverty level. Nelson, along with governors of both political parties, expressed anxiety that the expansion would burden state budgets. Under the manager's amendment, the federal government will cover more of the cost of the expansion than under the original bill, with special additional funding for Nebraska.

"Thanks to Sen. Ben Nelson for announcing his support for the Senate health care bill, making him our 60th vote," Reid tweeted Saturday morning.

Nelson did not win every battle, however, as Reid preserved the CLASS Act language in the bill, authored by the late Sen. Edward Kennedy (D-Mass.), to create a voluntary federal insurance program for home- and community-based long-term care services.

No trace of the public option remains in the bill but Reid does offer new provisions to appeal to liberal senators, such as additional funding for Community Health Centers and the Children’s Health Insurance Program

In addition, the amendment includes even stricter health insurance regulations and consumer protections than contained in the underlying bill, such as guaranteeing patients the right to appeal coverage denials and additional limitations on year-to-year premium increases that will take effect before the insurance exchange launches in 2014.

The manager’s amendment also would require insurers to spend at least 80 percent of their premium income on medical claims and provide rebates to customers when they fail to meet that threshold. The amendment, however, weakens the original bill’s prohibition against insurers setting an annual monetary cap on benefits.

The legislation still contains an excise tax on high-cost, so-called Cadillac health insurance plans, which is strongly opposed by labor unions and many Democrats but is backed by the White House and is one of the biggest revenue raisers in the legislation. Opponents of the tax are looking to the House-Senate conference committee to roll it back; the Reid amendment makes minor changes, such as exempting longshoremen.

The new language boosts the increase in the Medicare payroll tax that would hit people earning more than $200,000 and families earning more than $250,000 from 0.5 percent to 0.9 percent.

The bill also reduces an annual levy on medical device manufacturers and replaces an excise tax on cosmetic surgery with a 10 percent excise tax on indoor tanning salons.

Reid retained one proposal that emerged from negotiations between liberal and centrist Democrats: the creation of multi-state, nonprofit health insurance plans that would be negotiated by the federal Office of Personnel Management, which manages the Federal Employees Health Benefits Program, as an alternative to the traditional insurance plans that would be offered under the bill.

The new language also includes vouchers for some middle-income people to purchase health coverage on the new insurance exchange rather than from their employers if they earn too much to exempt from the individual mandate to buy insurance but not enough to qualify for federal subsidies. The so-called “free choice” provisions are based on a proposal by Sen. Ron Wyden (D-Ore.).

Small-business advocates such as Sens. Mary Landrieu (D-La.) and Blanche Lincoln (D-Ark.) – who, with Nelson, were among the toughest sells in the Democratic caucus – won a concession that would provide workers at small firms with more generous and more immediate financial assistance.

A group of freshman Democratic senators, many of them also centrists, won the inclusion of more aggressive cost-containment measures based on those already in the bill. Under the manager’s amendment, cost-containment pilot projects would ramp up more quickly and the Department of Health and Human Services would have greater authority to expand those programs without additional legislation.

Reid cut provisions from the bill that would have prevented a 21.5 percent cut in doctors' Medicare fees and replace it with a one-year hike. The House-passed measure includes a fix for 2010, however, and the defense spending bill approved by the Senate Saturday postpones the cut, which would kick in on Jan. 1, for two months. Reid told reporters that physician groups requested the change on the grounds that they want a permanent fix to their payment issues enacted in separate legislation.
--

Walter Alarkon contributed to this report

This story was updated at 12:15 p.m.
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