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Public option out, Democrats press on

Pledge to advance weaker health bill

By Lisa Wangsness and Susan Milligan
Globe Staff / December 16, 2009

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WASHINGTON - Senate Democratic leaders abandoned the last vestige of a government health plan yesterday but pledged to move ahead on a sweeping health care overhaul, infuriating many liberals but pleasing President Obama, who said victory on his highest domestic priority was within sight.

Lawmakers, after getting another pep talk from Obama at the White House, said they would rather pass a weaker measure than go home empty-handed and miss a rare opportunity for a historic expansion of health care.

The bill would require that nearly all Americans buy health insurance and would provide government subsidies to those who can’t afford it on their own. The Senate is aiming to vote before Christmas, which would set up a round of conference meetings in January to forge a compromise bill with leaders in the House, which has already passed a measure.

The president, after meeting with Democratic senators, declared that America is on the “the precipice of an achievement that’s eluded Congresses and presidents for generations.’’

Senate leaders said they were giving up for now on the government-run insurance plan, the so-called public option, which many Democrats have sought as a means to pressure private health insurance companies into offering lower health care premiums. Several moderates had objected to the public option, including Senator Joseph Lieberman, a Connecticut independent who over the weekend also told Senate leaders he also opposed a Medicare buy-in for those 55 to 64, Democratic leaders’ last-ditch attempt to get something resembling the public plan.

Lieberman said he opposed the public option and the Medicare buy-in because he believes they could create a new burden for taxpayers. Without Lieberman’s support, the Democratic majority could not muster the 60 votes required to break a Republican filibuster.

“They’re not happy,’’ Senator Dick Durbin, Democrat of Illinois, said of liberals in the Senate Democratic caucus. “I’m not happy.’’ But, he said: “What remains is dramatic. We just don’t want to lose the opportunity, the once-in-a-lifetime opportunity.’’

Democratic leaders focused on keeping progressives’ disappointment and anger in check so the Senate could quickly pass a bill before Christmas deadline. They said that though they have not locked in the 60 votes needed, they are convinced they will within the next week or so.

Advocates for a public option said they planned to continue to pressure for a government plan that would be designed to offer lower premiums to the newly insured. While the public option was slowly whittled away in the Senate to nothing, the House did adopt one in its version of the bill.

Senator Sherrod Brown, Democrat of Ohio, insisted that liberals “are not giving up’’ but that he will vote for the Senate package without a public option to move along in the process.

“There’s too much at stake’’ to hold up the measure any longer, he said.

Former Democratic Party chairman Howard Dean said the bill was worthless without a public option and said if it passes it will represent “a shocking collapse of leadership within the Democratic Party.’’ Representative Anthony Weiner, Democrat of Brooklyn, fumed in a statement that it was time for Obama to “get his hands dirty’’ and fight for “the values our party shares.’’

But House majority leader Steny Hoyer said a bill without a public option could pass the House, signaling that representatives also are prepared to take a more pragmatic course. Still, Hoyer did not miss the opportunity to slam Lieberman, who was angrily denounced by members of his former party throughout the day.

“I talk a lot about the psychology of consensus,’’ Hoyer remarked dryly. “Too often it appears that the psychology in the Senate is the psychology of one.’’

Richard Kirsch, director of Health Care for America Now, a large coalition of organizations supporting the public option, said Lieberman’s stance would do tremendous damage to the Democratic Party, whose progressive activist base has adopted the public option as “the symbol for real health care reform.’’

“Lieberman has basically got a contract with the private insurance industry to kill the public option, and he’s delivering,’’ he said.

Lieberman has denied that home-state concerns about the insurance industry or insurance industry campaign contributions have colored his position. The Standard & Poor’s 500 Managed Health Care Index gained as much as 1.8 percent yesterday, but then ended the day unchanged. The index was led by Hartford-based Aetna Inc., which rose 2.6 percent.

Senate Finance Committee chairman Max Baucus said Obama, in a closed-door meeting that lasted more than an hour, urged all 60 members to recall why they had been elected in the first place.

Amid polls showing diminished support for health care overhaul, Obama argued that political benefits eventually flow from good policy - though Baucus acknowledged with a laugh that it might take a while - and highlighted its many strategies for reducing costs. He said Obama did not bring up the public option, but rather urged Democrats to look at the bigger picture. He said one senator raised the issue of reviving the Medicare buy-in, but Baucus said there was little support for that.

“That was pretty much squelched,’’ he said. Baucus also said Vice President Joe Biden, also at the meeting, made the point that other major entitlement programs began as bare-bones programs but were gradually built up over time.

“He said: ‘Look, be joyful, this is really great what we’re doing here, it’s so significant, it’s a moment in history, and we’ll build upon it in the future, as with Social Security and Medicare,’ ’’ Baucus said.

Several health care and consumer advocacy groups appeared to agree with that view and signed on to the less-ambitious bill yesterday. The AARP, the largest lobby for retirees, endorsed the Senate bill, and planned a press conference for today with the Service Employees International Union, Families USA, the Consumers Union and the American Cancer Society to urge the Senate to pass the bill.

Senate negotiators are eager to get something approved before the holiday recess to keep momentum going.

Leaders believe that once a compromise bill is written by a House-Senate conference committee, lawmakers will be more reluctant to vote against it because of the historic nature of the bill.

“If Congress passes a health care bill, those who voted for it are going to be part of history,’’ said Senator Paul Kirk, Democrat of Massachusetts. “If they decide they’re going to bail on the bill, they’re going to be part of history as well.’’

Kirk plans to make a major speech on the Senate floor today - the anniversary of the late Senator Edward M. Kennedy’s landmark 1969 speech on the need for health care overhaul - underscoring what Kirk believes Kennedy would say if he were alive: The bill isn’t perfect, but if you don’t pass it, you won’t have the chance again for a very long time.

“If we don’t pass it now, now that we’ve come this far, you won’t see health care reform for 20 years,’’ Kirk, who was appointed by Governor Deval Patrick to temporarily fill Kennedy’s seat, said in an interview.

“He had a sense of history,’’ Kirk said of Kennedy. “We’ve never been this close.’’