Democrats reportedly settle key issues on health bill but no final accord yet

Politico reports: "President Barack Obama and senior Democratic lawmakers closed in Friday on a final health care reform package, finishing a week of intensive negotiations on tax and coverage issues that had once threatened to derail the bill. … Obama and congressional leaders do not plan to negotiate through the weekend, signaling that they had wrapped up talks on major portions of the bill and were preparing to send it to the Congressional Budget Office for a cost estimate.

"'We've worked through the gamut of issues in great depth, but there are no final agreements and no overall package,' the White House said in a statement. 'The next step in the process is to evaluate the costs and savings associated with the various proposals for each tenet of the legislation.'"

Meanwhile, Politico reports, "at least one industry group is threatening to pull its support for the bill. Billy Tauzin, president of the Pharmaceutical Research and Manufacturers of America, sent an email to board members saying the group would pull its endorsement if lawmakers reduced the proposed 12-year monopoly on biologic drugs as part of the health care deal" (Budoff Brown and O'Connor, 1/16).

Rollcall reports that a source says although "tentative deals on most major issues appear to have been worked out, … 'key' outstanding issues … concern abortion and immigration provisions" (Pierce, 1/15).

The Washington Post reports: Democratic leaders hope "to settle lingering disputes before Tuesday, when a special election in Massachusetts could hand Republicans their 41st vote in the Senate and the power to defeat Obama's top domestic initiative. ... "

Democrats have begun plotting "a health-care strategy if they lose their supermajority in the Senate. Senate aides said House Speaker Nancy Pelosi (D-Calif.) has shut down talk of the most obvious option: avoiding the need for another Senate vote by having the House approve the Senate-passed version of the health bill, rather than merging the two and having each chamber vote again. Pelosi has repeatedly said she could not rally the votes" to approve the package. They have also considered delaying the process to seat Republican Scott Brown if he wins the office formerly held by the late Sen. Edward Kennedy, the Post reports. But "senior Senate aides acknowledged it would be difficult to justify a postponement long enough to push the health bill to final passage."

Others have said they could use the "fast-track procedure, known as reconciliation, that would permit the bill to pass the Senate with 51 votes. … But reconciliation would require lawmakers to start over, dismantle the bill and scale it back dramatically." (Montgomery, 1/16)

In another article, The Washington Post reports: Former president Bill Clinton Friday added his voice to the critics of the Senate health care bill's provision to give Nebraska a special deal in which the federal government would "pay forever for extra poor people to join Medicaid" under the expansion of the program. "'Get as much gunk out of the Senate bill as possible. That Nebraska thing is really hurting us,' Clinton told House Democrats in a closed-door speech at the Visitors' Center at the Capitol, according to a House aide who attended the session. … He also warned Democrats that they should not attempt to separate themselves from President Obama in their reelection campaigns, as Clinton felt Democrats did back [in 1994] to him" (Bacon, 1/15).

The Wall Street Journal reports: Among the key issues in talks Friday was 'how to pay for a deal giving a five-year reprieve on a new tax on expensive health plans to as many as 12 million union members. The agreement cleared away a significant hurdle to reaching a final deal on a health-care overhaul. But unions estimated that softening the tax would reduce revenue by $60 billion over a decade. The deal would exempt workers in collective bargaining agreements, as well as state and municipal government workers, from the tax until 2018. The tax would kick in for other workers in 2013. … Officials said negotiators were looking at raising fees and cutting reimbursements to various industries, as well as applying the Medicare tax to unearned income for the first time for upper-income Americans" (Meckler and Bendavid, 1/15).

The New York Times reports: "President Obama has taken full control of the health care negotiations, casting himself for the first time in the role of mediator between the House and Senate during a 72-hour marathon of talks that have turned his White House into a de facto Congressional conference. … 'It was always our sense that once the bills were passed that he would have to play a much more direct role in helping work out the details,' his senior adviser, David Axelrod, said in an interview, as the talks went on down the hall from his West Wing office. 'This has been a prodigious task from start to finish; we knew it would be.' … Senator Dianne Feinstein, Democrat of California, in a telephone interview from her home state, said, 'I think the president has to do this or there won't be a bill, candidly.'" (Stolberg and Herszenhorn, 1/15).

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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.