Health bill work still being done

WASHINGTON – President Barack Obama’s campaign to overhaul the nation’s health care system is officially on the back burner as Democrats turn to the task of stimulating job growth, but behind the scenes senior Democrats have settled on a strategy to salvage the massive legislation.

They are meeting almost daily to plot legislative moves while gently persuading skittish rank-and-file lawmakers to back a sweeping bill.

This effort is deliberately being undertaken quietly as Democrats work to focus attention on more popular initiatives to bring down unemployment, a tactic used by the president in his State of the Union address this past week.

Many have concluded that the only hope for resuscitating the health care legislation is to push the issue off the front page and give lawmakers time to work out a new compromise and shift public perception of the bill.

“A little bit of time and quiet could help,” said Arkansas Sen. Mark Pryor, a conservative Democrat who was among a group of centrist Democrats from the House and Senate who met last week to discuss a way forward on health care.

“Human nature being what it is, it’s always easier to be against something than to be for it. And if you create any uncertainty with change, opponents can jump on that and just try to scare people. … That has been hard to overcome politically,” Pryor said. “Maybe over time, people will have a chance to understand what is in the legislation.”

House Speaker Nancy Pelosi, D-Calif., and Senate Majority Leader Harry Reid, D-Nev., particularly want to give members time to recover from the shock of Republican Scott Brown’s victory in the Massachusetts Senate race Jan. 19.

In coming weeks, however, they plan to rally House Democrats behind the health care bill passed by the Senate while simultaneously trying to persuade Senate Democrats to approve a series of changes to the legislation using budget procedures that bar filibusters.

Democrats, who would almost certainly get no Republican votes for their bill, still must overcome substantial obstacles.

Many rank-and-file Democrats remain rattled by Brown’s campaign in Massachusetts, which in part targeted the health care bill in Washington.

Some Democrats would prefer to vote on a series of more limited bills targeting pieces of the health care system, an approach that House leaders are exploring. A group of liberal House lawmakers is pushing for inclusion of a new government insurance plan, or public option, in the final bill.

Tensions also remain high between Democrats in the House and Senate. Many House lawmakers blame the Senate bill for fueling public opposition with provisions such as a new tax on high-end “Cadillac” health plans and special aid for Nebraska that was added at the 11th hour to satisfy that state’s Democratic senator.

Democrats hope to use a process known as budget reconciliation, which allows budget-related legislation to be passed with a simple majority in the Senate rather than the 60-vote majority that has become necessary in the face of Republican filibusters.

But many House Democrats do not want to vote on the Senate bill until the Senate passes the fixes they want.

And it is unclear if the Senate could approve a package of changes to its bill before the House approves the underlying legislation, according to senior Democratic aides. Democratic leaders hope to agree on a procedural path forward by the end of this week.

Sen. Tom Harkin, D-Iowa, who chairs the Senate health committee, noted that even before the Massachusetts election, senior Democrats had substantially agreed on a series of compromises that addressed differences between the House and Senate health care bills.

These included scaling back the “Cadillac” tax, boosting aid to help low- and moderate-income Americans buy insurance, closing the so-called “doughnut hole” in the Medicare prescription drug plan, and giving all states the assistance that Nebraska secured to expand Medicaid.