Senate Majority Leader Harry Reid unveiled a final compromise Saturday morning to the Senate health care bill that some progressive Democratic leaders, labor unions, and grassroots organizations said has been gutted of any meaningful consumer reforms and amounts to a bailout for the insurance industry.
The language in Reid’s 383-page "manager's amendment" includes further concessions over abortion that were made in order to win the support of Sen. Ben Nelson, (D-Nebraska), who had said he would not vote for the bill if it did not include tighter restrictions prohibiting the use of federal funds for abortion.
On Saturday morning, after marathon negotiation sessions with Reid, Nelson announced that he intended to put his weight behind the bill, becoming the crucial 60th vote. Reid needs the support of 60 senators to cut off debate and fend off a Republican-led filibuster.
At a news conference Saturday morning, Nelson said, “Change is never easy, but change is what’s necessary in America. And that’s why I intend to vote for health care reform.
Reid tweeeted Saturday morning, "Thanks to Sen. Ben Nelson for announcing his support for the Senate health care bill, making him our 60th vote."
Under Reid's new proposal, according to the New York Times, "states would have the authority to bar coverage for abortions by new government-approved health insurance plans."
A section of the bill titled “state opt-out of abortion coverage” explains how this would work: “A state may elect to prohibit abortion coverage in qualified health plans offered through an exchange in such state if such state enacts a law to provide for such prohibition.”
Some health plans receiving federal subsidies could offer coverage for abortion, but they could not use federal money to pay for the procedure. They would have to use money taken from premiums paid by subscribers and would have to keep it separate from federal money.
The government would subsidize premiums for many low- and moderate-income people. Under Mr. Reid’s amendment, some health plans receiving federal subsidies could offer coverage for abortion, but they could not use federal money to pay for the procedure. They would have to use money taken from premiums paid by subscribers and would have to keep it separate from federal money.
The Hill reported that 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.
Nearly two months after Reid announced details of the Senate health care bill, which included the coveted public option and an "opt-out" provision, meaning individual states could decline to participate; the legislation has been dramatically altered to the point of being unrecognizable.
The public option has been dropped entirely, although Reid, as recently as last week, insisted that it was still part of the final package albeit in the form of a provision that expanded Medicare to individuals beginning at age 55.
But Reid stripped that provision from the bill this week after Sen. Joe Lieberman, (I-Connecticut), said he would move to filibuster the legislation if the amendment remained intact.
The concession, which came at the urging of senior Obama administration officials, angered some Democratic lawmakers and led grassroots organizations, such as Moveon.org, to launch an online campaign urging supporters to sign a petition calling for the Senate bill to be defeated.
“The latest Senate health care bill has no public option. No expansion of Medicare. And it does too little to guarantee that uninsured Americans will actually be able afford the coverage they'll be required to purchase,” said Moveon’s “No Deal” email sent to supporters Friday.
In a statement Saturday, President Obama said, "As with any legislation, compromise is part of the process."
But the president said he's "pleased that recently added amendments have made this landmark bill even stronger. Between the time the bill passes and the time when the insurance exchange gets up and running there will now be penalties for insurance companies that arbitrarily jack up rates on consumers.
"And while insurance companies will be prevented from denying coverage on the basis of pre-existing conditions once the exchange is open, in the meantime there will be a high risk pool where people with pre-existing conditions can purchase affordable coverage."
The way in which Democrats now propose to expand affordable health care coverage to millions of uninsured Americans is simply by tightening regulations governing the health care industry.
Reid, according to The Hill, did leave intact a proposal to create 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 Congressional Budget Office (CBO) released a cost analysis of the revised bill Saturday, which said the legislation would cost $871 billion over 10 years and cut the federal deficit by $132 billion during that timeframe.
Reuters noted that the figures "meet President Barack Obama's goal of cutting the deficit and having a total cost of about $900 billion over 10 years. The rosy report card could help the proposal gain support."
Still, Rep. Lynn Woolsey, (D-California), chair of the Congressional Progressive Caucus, said Thursday the Senate bill “is much more expensive than it appears and will leave taxpayers holding the bag for a huge give-away to the private insurance industry.”
“The Senate plan requires everyone to buy health insurance, creating some 30 million new customers for insurers, but it does not have a public option to control costs,” Woolsey said, calling the Senate bill a “gift” to health insurance companies. “By providing low-cost competition, the public option would have forced insurers to rein in the spiraling costs of premiums.”
An NBC/Wall Street Journal poll conducted this week underscored the discontent among liberals over the fact that the public option had been scrapped.
According to the poll, 47% said the health care package in its current state is a “bad idea,” while 32% said they believed it was a “good idea.”
MSNBC reporter Chuck Todd, said via Twitter Wednesday that much of the “movement on the 'bad idea' comes from some of the president's core support groups, folks upset about lost public option."
Todd added that “large majorities of the president's core support groups believe his plan is a ‘good idea,' but the margins have shrunk."
Still, according to the poll, 41% of respondents said they believe that the Senate should pass something as opposed to not passing reform legislation at all.
Woolsey said the public might not realize that the Senate bill will cause financial hardship for many.
“The Senate bill insists that people buy insurance that many cannot afford now, and many more will not be able to afford in the future, given that premiums are rising four times faster than wages.” she said. “So who will pay when people must buy health care insurance they can’t afford? Taxpayers.”
New York Times columnist Paul Krugman, however, said it's time to "take a deep breath."
"Consider just how much good this bill would do, if passed — and how much better it would be than anything that seemed possible just a few years ago," Krugman wrote Friday. "With all its flaws, the Senate health bill would be the biggest expansion of the social safety net since Medicare, greatly improving the lives of millions. Getting this bill would be much, much better than watching health care reform fail."
The fractious nature of the health care debate among Democrats reached a boiling point earlier this week when Howard Dean, a physician and the former chair of the Democratic National Committee, told Vermont Public Radio Tuesday that the health care bill marked “the collapse of health care reform in the United States Senate.”
“Honestly the best thing to do right now is kill the Senate bill, go back to the House, start the reconciliation process, where you only need 51 votes and it would be a much simpler bill,” Dean said.
The former Vermont governor followed up his statements with hard-hitting opening salvo in an op-ed published in Thursday’s Washington Post.
“If I were a senator, I would not vote for the current health-care bill,” Dean wrote. “Any measure that expands private insurers' monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform. Real reform would insert competition into insurance markets, force insurers to cut unnecessary administrative expenses and spend health-care dollars caring for people. Real reform would significantly lower costs, improve the delivery of health care and give all Americans a meaningful choice of coverage. The current Senate bill accomplishes none of these.”
White House senior adviser David Axelrod reacted angrily to Dean’s earlier statements and said it would be “insane” to derail the legislation because of ideological differences over the inclusion of a government-run insurance program to compete with the private sector.
"We're on the verge of doing something that would make an enormously positive difference for people," Axelrod said on MSNBC’s “Morning Joe.” "I don't think you want this moment to pass. It will not come back again."
Former President Bill Clinton agreed.
He said Thursday that although the Senate bill is not drafted the way he would have drafted it, nor does it contain "everything everyone wants," abandoning it would be a "colossal blunder" for the Democratic Party and "far more important, for the physical, fiscal, and economic health of our country."
Labor unions, including the Services Employee International Union (SEIU), meanwhile urged passage of the Senate bill, but the groups were critical about the concessions Democratic leaders made this week to secure passage of the legislation.
SEIU President Andy Stern said Thursday, “We don’t like the bill. It has to be improved. But we don’t think that these senators are going to do any better.”
Unions spent millions of dollars on lobbying efforts this year to gain support of health care reform, due in large part to assurances by Democrats that a bill would include a government-operated insurance program.
Stern said he holds out hope that earlier proposals along the lines of a public option will find their way back into a final piece of legislation before it’s sent to Obama for his signature. In a letter to union members Thursday, he called on Obama to uphold his campaign promise before signing legislation into law.
“President Obama must remember his own words from the campaign. His call of ‘Yes We Can’ was not just to us, not just to the millions of people who voted for him, but to himself. We all stood shoulder to shoulder with the president during his hard-fought campaign,” Stern wrote.
AFL-CIO President Richard Trumka, however, registered deep disappointment with the Senate bill, saying in a statement Thursday that “it bends toward the insurance industry, will not check costs in the short term, and its financing asks working people and the country to pay the price, even as benefits are cut,”
“The House bill is the model for genuine healthcare reform,” Trumka said. Working people cannot accept anything less than real reform.”
Republicans, who stand united against the health care bill, promised to make it difficult for Democrats to hold a final vote on the legislation, expected to take place Christmas Eve.