Narrow House vote is prologue to Senate health reform battle

The 220-215 pencil-thin margin of victory for the House Democrats' health reform bill foreshadows a potentially tougher fight in the Senate, The Wall Street Journal reports. "Senate Democrats are struggling to agree on how to pay for the overhaul and whether to create a new public insurance plan to compete with private insurers, as the House did. Friction over how the bill treats abortion, which almost derailed the House vote, is likely to divide the Senate too." Sen. Charles Schumer, D-N.Y., said it is "almost always easier to pass a bill in the House than in the Senate" (Adamy and Bendavid, 11/9).

Kaiser Health News: "Despite months of debate, disputes remain between liberal and moderate Democrats and between the House and the Senate on a raft of core issues. They include how much to spend on an overhaul; how to pay for it; how to deal with a government-run insurance option, and the scope of coverage and subsidies for the uninsured." One thing is clear, KHN reports, the bill passed in the House is "almost certainly the high-water mark of liberal aspirations. On most issues, Democrats will likely have to tack to the right to win the support of Senate moderates" (Pianin and Carey, 11/9).

Politico: "Even before Saturday's House vote, senators had begun to question why Reid suddenly shifted course two weeks ago and threw his weight behind a public option plan, laying bare the deep divisions in his caucus between liberals and moderates." Those divisions are stalling Reid's timeline, possibly delaying debate until after Thanksgiving; Reid has implied that the Senate may not pass a bill until next year (Brown and Raju, 11/8).

Reuters: In the Senate, "Democrats have no margin for error -- they control exactly 60 seats in the 100-member Senate" the number needed to pass legislation, because less than that can lead to a filibuster by opponents. "Some moderate Democrats have rebelled at Reid's plan to include a new government-run insurance program, known as the 'public option,' in the bill" (Whitesides, 11/9).

Associated Press: "A government health insurance plan included in the House bill is unacceptable to a few Democratic moderates who hold the balance of power in the Senate. They're locked in a battle with liberals, with the fate of President Barack Obama's signature issue at stake" (Alonso-Zaldivar, 11/9).

Roll Call: On one hand, llinois Sen. Roland "Burris is hardly the lone Senate Democrat who supports a public insurance option, but unlike other backers, … [he] has made headlines recently for what appears to be an uncompromising stance on the bill: He will oppose it — and may even support a filibuster — if the measure does not include a robust public option (Pierce, 11/9).

Boston Globe: On the other, Sen. Joe Lieberman, I-Conn., has vowed "to support a Republican filibuster of health care legislation if it contains a public health insurance option" (Issenberg, 9/11).

---

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.