Democrats reject fast-track reform

WASHINGTON – Though reeling from a political body blow, House Democrats rejected the quickest fix to their health care dilemma Thursday and signaled that any agreement on President Barack Obama’s signature issue will come slowly, if at all.

Democrats weighed a handful of difficult options as they continued to absorb Republican Scott Brown’s election to the Massachusetts Senate seat long held by Edward M. Kennedy. Several said Obama must forcefully help them find a way to avoid the humiliation of enacting no bill, and they urged him to do so quickly, to put the painful process behind them.

House leaders said they could not pass a Senate-approved bill, standing by itself, because of objections from liberals and moderates alike. Such a move could have settled the matter, because it would not have required further Senate action. Brown’s stunning victory has restored the GOP’s power to block bills with Senate filibusters.

Democratic leaders weighed two main options, both problematic. The first would require congressional Democrats to muscle their way past stiff GOP objections despite warning signs from Massachusetts voters and worries about next November’s elections.

The other would pare down the original health care legislation in hopes of gaining some Republican support.

Democrats’ hopes of settling on a strategy by the weekend seemed to fade, as lawmakers struggled to comprehend the drawbacks of every option.

“We have to get a bill passed,” said House Speaker Nancy Pelosi, D-Calif., because her party would have no excuse for failing to revamp health care when it controls Congress and the White House.

The first chief option would require House Democrats to approve the Senate-passed bill along with a guarantee that the Senate would make several simultaneous changes to health law desired by the House. Senate Democrats presumably would do so with a tactic called “budget reconciliation.” It requires only a simple-majority vote for certain budget-related matters.

The second option calls for drafting a new, compromise bill more palatable to moderates, including some Republicans. But numerous officials said it’s far easier said than done.

For instance, a widely popular goal is to bar health insurers from refusing coverage to people already suffering medical problems. But without requiring most people to buy coverage, millions might wait until they have a serious problem before buying a policy, driving coverage costs to unsustainable levels.

Moreover, “individual mandates” to buy insurance would almost certainly require government subsidies for low-income people. And that in turn would require new government revenues, such as taxes.