Senate Democrats face rocky road on the way to the health reform finish line

"The 60 votes aren't there any more," The Associated Press reports: "With the Senate set to begin debate Monday on health care overhaul, the all-hands-on-deck Democratic coalition that allowed the bill to advance is fracturing already. Yet majority Democrats will need 60 votes again to finish." 

In addition to some senators calling for tighter restrictions on abortion, others say they will defect "unless a government plan to compete with private insurance companies gets tossed overboard. Such concessions would enrage liberals, the heart and soul of the party." The public, in the meantime, remains "ambivalent" about the legislation, The AP reports, with half of supporters of reform saying they don't like what they hear about that plans (Alonso-Zaldivar, 11/30).

Politico: "... the C-SPAN cameras won't see the real action. The next phase in the Democrats' health care push will be waged in the privacy of the Senate leadership office, where Majority Leader Harry Reid (D-Nev.) will attempt to do something that has eluded him all year: negotiate a compromise on the public insurance option that can garner 60 votes and win over a public still leery of reform." 

Senate action is slated to begin at 3 p.m. today "with each side offering one amendment — a sign of how difficult the debate will be, since the two sides couldn't agree to terms of the debate beyond the first two amendments." Republicans are calling for six weeks of debate, but Democrats could avoid that length by reaching a deal on the public option "and filing cloture on the bill, which would set up the final crucial test vote before final passage" (Budoff Brown, 11/30).

CNN: "The debate will feature amendments intended to delete or change controversial provisions in the 2,074-page bill, including creation of a government-run public health insurance option to compete against private insurers, tax increases and provisions intended to prevent federal tax dollars from paying for abortion except in cases of rape, incest or danger to the mother's life. For the most part, battle lines are clearly drawn" (Hayes and Cohen, 11/29).

The New York Times reports that Reid has just 25 days to meet his goal of finishing the bill by Christmas, something many Democrats fear could make consideration of the bill slip too far into 2010, a midterm election year. "Republicans are likely to try to eliminate or sharply reduce some of the Democrats' proposed new taxes, including an increase in the Medicare payroll tax for high earners. Most of the Republican amendments will fail because the Democrats have the votes to set them aside" (Herszenhorn, 11/29).

Meanwhile, Kaiser Health News tracked health policy developments during the long holiday weekend, including the continuing debate regarding the abortion language included in the House and Senate proposals, advance coverage of what lies ahead as the Senate is poised to begin its health bill debate and reports indicating that the public option will be a focal point.