Democrats struggle to revamp health reform strategy

Efforts to save the reform effort were teetering "on the brink of collapse Thursday as House and Senate leaders struggled to coalesce around a strategy to rescue the plan," Politico reports. "The legislative landscape was filled with obstacles: House Democrats won't pass the Senate bill. Senate Democrats don't want to start from scratch just to appease the House. And the White House still isn't telling Congress how to fix the problem. … But for the first time in the yearlong push, Democratic aides — and even some members — finally acknowledged privately that the fear of failure was real." Congress recessed for the weekend (O'Connor and Budoff Brown, 1/21).

The Christian Science Monitor:  "After meeting with the House Democratic caucus today, Speaker Pelosi told reporters that she does not see the votes to pass the Senate bill. 'Without any change, I don't think it is possible to pass the Senate bill in the House,' she said at a briefing (Thursday). … That vote count - by a Speaker noted for being good at it - derails what had been the fastest track to moving healthcare through the Congress. Passing the Senate bill as written avoids further action in the Senate, where Democrats no longer have the 60 votes needed to block a Republican filibuster. Democrats are in agreement on about 80 percent of policy, she said" (Chaddock, 1/21).

Roll Call reports on the Democrats' differing opinions on the next steps. "'You couldn't get the House to pass the Senate bill if your life depended on it,' said Rep. Raúl Grijalva (D-Ariz.), co-chairman of the Congressional Progressive Caucus. … Democratic Senators and aides said they still do not believe that House passage of the Senate bill is completely off the table, despite Pelosi's statement. They said the Speaker has told them privately that, in order to secure enough votes for the Senate bill, she would need a promise of Senate action on the House's concerns" (Dennis and Pierce, 1/21).

The Washington Post has more on Pelosi and House members who "demanded that the Senate pass a separate bill amending the health-care legislation before they consent to support it." House members worry about the — what they term insufficient — level of federal subsidies the Senate version would offer the uninsured and an excise tax on so-called "Cadillac" insurance policies. "Senate Democrats agreed to many of the changes during negotiations this month to merge the chambers' respective bills. ... The only other option under consideration is to write a new bill, possibly scaled back considerably to win Republican support, an undertaking that could consume months, with no guarantee of success" (Murray and Kane, 1/22).

The Wall Street Journal: While some Democrats "said they weren't in a rush to push ahead and needed time to absorb the new political dynamic," and others urged a more populist tone, Republicans were sending a clear message. "Congress needed to start from scratch. 'The American people right now want this health-care bill defeated,' said Eric Cantor, the No. 2 House Republican. 'They want health-care reform, but not in the way that has been constructed under either one of these bills'" (Adamy and Bendavid, 1/21).

McClatchy: "The White House bowed to the need to pause on health care. 'The president believes it is the exact right thing to do, by giving this some time, by letting the dust settle, if you will, and looking for the best path forward,' White House Press Secretary Robert Gibbs said" (Lightman and Douglas, 1/21).

Gannett/Statesman Journal: Brown's election has wracked Democrats and led to conflicting views of the direction the president should take. "Will he pull back to the center, reassess and cut deals, like Bill Clinton? Or will he press ahead on health care reform and other issues dear to liberals?" Liberals say the Massachusetts vote punished Democrats for timidity on health care; centrists argue it's a call for the party to reassess priorities (Raasch, 1/21).

Meanwhile, certain consumer groups, patient advocates and doctors are urging Democrats "not to abandon the comprehensive health overhaul they've worked so long to pass," according to the Los Angeles Times. The AARP, American Cancer Society Cancer Action Network, Consumers Union, Families USA and the Service Employees International Union sent a letter in support of the reform bills to Pelosi and Senate Majority Leader Harry Reid.

"Leaders of the American Medical Association also voiced continued support for efforts to expand insurance coverage and reshape the nation's healthcare system. 'We're the last ... industrialized country that has not figured out how to do this. It is time,' said Dr. Nancy Nielsen, immediate past president of the AMA." Liberal groups MoveOn.org and Health Care for America Now also reasserted their support (Levey, 1/21).

Another group of stakeholders -- insurers -- who seem to have reason to celebrate the "possible collapse" of the reform effort may find that the recent difficulties may "not actually be such good news," The New York Times reports. In exchange for agreeing to "offer coverage to everyone, regardless of medical status … the government could ensure that people, even the young and healthy, would have to sign up." As many as 30 million more customers would have meant significant new revenues for insurers, analysts say. Now, "the insurers still face the daunting challenge of selling a product that is increasingly out of reach for more Americans as the cost of medical care — and thus premiums — continues to climb" (Abelson, 1/21).