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September 21, 2014

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Compromise means ‘more choices’ for insurance

Reid hails agreement he says brings competition to the market; Senate also casts a pivotal abortion vote

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HARRY HAMBURG / ASSOCIATED PRESS

Senate Majority Leader Harry Reid speaks at a news conference Tuesday in the Capitol. After voting to quash an amendment to the health care reform bill that would have restricted abortion access, he announced an agreement had been reached related to the public option.

Harry Reid

Harry Reid

As the health care debate pressed forward Tuesday in the Senate, it was hard to decide whether to keep an eye on the floor action or behind the closed doors where deals were being made down the hall.

Developments were playing out in both theaters of operation on two of the trickiest issues that have dogged Democrats — abortion and the public option — as they try to craft legislation that can win the necessary 60 votes for passage.

Senate Majority Leader Harry Reid instructed a behind-the-scenes group of 10 senators to step up their efforts this week to reach a compromise on the public option, and the nudge paid dividends. Well past dinnertime, a broad agreement was announced.

But Reid also became central to the abortion debate as he voted against a pivotal amendment to restrict access to the procedure, setting up a complicated negotiation with the House.

Democrats are racing the clock to pass President Barack Obama’s signature domestic policy issue by year’s end. Their struggles show not only the pressures on Reid but also the challenges of maintaining a big-tent caucus whose 60 members carry so many diverse political views.

As Democratic Sen. Ron Wyden of Oregon put it late Tuesday: “We are stretching the big tent to get everybody under.”

Momentum has been building for an alternative to the public option — the proposed government-run insurance plan that would operate similar to Medicare and is coveted by progressives as competition to private insurance for those who are uninsured.

Late Tuesday night, after the Senate had closed for the day, Reid emerged with two members of the negotiating team to announce that a “broad agreement” had been reached.

Talks between the group of 10’s conservative and liberal senators focused on creating a new health care exchange modeled on the federal employees health benefits plan, which would offer the uninsured a menu of private insurance options.

To stoke competition and ensure quality health care by private insurers, such a proposal could be bolstered by a requirement that insurance companies reinvest would-be profits into providing care. Book-ending that would be another requirement to allow adults who are 55 years old and older to buy in to Medicare, rather than waiting until they are 65, giving hard-to-insure older Americans more options.

Reid would not disclose details of the agreement reached, but he insisted that “insurance companies will certainly have more competition. The American people will certainly have more choices.”

Such a proposal could accomplish Reid’s delicate task of appeasing the four moderate senators who have opposed the public option while holding onto progressives who have fought intensely for an alternative to insurance companies.

“Tonight we’ve overcome a real problem that we’ve had,” Reid said. The proposal will be sent for a budget analysis Wednesday, a process that could take up to one week at the Congressional Budget Office.

The late-night deal shows the fragility of the talks and sometimes haphazard process in which legislation comes to life.

Meanwhile, the floor action continued Tuesday on whether to toughen the bill’s language on restricting abortion.

Such an amendment was unlikely to reach a 60-vote threshold needed for passage, but Reid allowed abortion rights supporters to call a procedural vote to table the amendment, and joined them in killing it swiftly on a 54-45 vote.

Reid’s mission was twofold: He cut short a potentially drawn-out debate on an issue that is not helpful for his party while protecting his senators who want to be seen as having tried to restrict abortion.

Just before the vote, Reid, who is a Mormon and longtime opponent of abortion, delivered an emotional 20-minute speech recounting his past record of voting against abortion rights, insisting the underlying bill maintains the status quo on the issue.

“Our health care bill now before this body respects life,” Reid said, adding that this was not the time to debate the divisive issue.

“This is a health care bill. It is not an abortion bill,” Reid said. “We cannot afford to miss the big picture ... Neither this amendment, nor any other, should overshadow the entire bill or overwhelm the entire process.”

Reid’s record on abortion issues has often infuriated abortion opponents, who believe he should do more with his position as majority leader to advance their cause.

They were not surprised by Reid’s maneuver, saying he essentially doomed the abortion issue early on by not including it in the Senate bill he crafted. His omission put the onus on anti-abortion senators to find enough votes to insert it.

“It was a trademark Harry Reid performance,” said Douglas Johnson, legislative director of the National Right to Life Committee.

The Senate vote creates yet another difference to be negotiated with the House-passed bill, which last month approved stricter abortion language in its bill.

Both the House and Senate bills ban the use of proposed government insurance subsidies for the uninsured to pay for abortion coverage. But anti-abortion groups and the nation’s Catholic bishops insisted no abortion coverage should be offered in the public option plan, even if policyholders use their own money to pay for it.

The House approved the more restrictive language in an eleventh-hour deal to appease conservative and moderate Democrats who were withholding their support of the full bill. Sen. Ben Nelson of Nebraska, among the most conservative Democrats in the caucus, sought similar restrictions with his amendment in the Senate.

Nelson is among those Reid has been courting as he seeks 60 votes to pass the Senate bill, and the defeat of Nelson’s amendment leaves his vote in question. “I am disappointed,” Nelson said in a statement after the vote.

Reid’s vote appeared an abrupt reversal from his track record on abortion, but it actually had been forming for weeks, an aide said.

He decided early on that the House language was too restrictive, believing it went beyond current law that prohibits federal funding for abortion except in cases of rape, incest or possible death of the mother.

Once he made the decision to oppose the amendment, he sought the bully pulpit of the Senate floor to explain himself to voters back home — where his vote will surely become campaign fodder in his difficult reelection campaign.

Leading Republican opponents in Nevada also oppose abortion, and national abortion opponents will likely criticize Reid for his vote.

Yet Nevada’s libertarian streak has suggested that candidates must tread carefully on the abortion issue, lest they be seen as involving government too heavily in individual rights, particularly after voters approved a measure nearly 20 years ago making Nevada an abortion rights state.

Lisa Mascaro can be reached at (202) 662-7436 or at [email protected].

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