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Health Care Bipartisanship Fades

As Senate health care negotiations enter the final phase at the committee level, Democrats are emphasizing their own policy preferences and conceding the unlikelihood of attracting significant Republican support for the legislation.

The Senate Health, Education, Labor and Pensions Committee is scheduled to begin marking up its health care reform bill today, with the Senate Finance Committee set to act next week.

Leading HELP Committee Democrats on Tuesday bluntly stated their lack of interest in passing bipartisan legislation that fails to adequately overhaul the system.

Republicans are almost unanimous in their opposition to implementing a government-run, public insurance option as a part of reform, with Democrats nearly equally supportive.

“Nothing would make me happier than to have us come out with a strong bipartisan bill, and I begin the process with that goal in mind. Not to achieve bipartisanship and a weak product, but to have a strong product that’s endorsed across the political divide,— said Sen. Chris Dodd (Conn.), the No. 2 Democrat on the HELP Committee. “If we get through this process and all we’ve done is driven up costs and moved the deck chairs around, we’ll be indicted.—

Dodd is leading the HELP Committee in the absence of Chairman Edward Kennedy (D-Mass.), who is battling brain cancer. The HELP Committee unveiled its bill last week; the Finance panel could release the details of its legislation any day.

[IMGCAP(1)]Finance Chairman Max Baucus (D-Mont.), who champions the bipartisan approach, wavered on exactly how much Republican support would emerge for the bill being written by his committee.

Baucus, who has worked closely with Finance ranking member Chuck Grassley (R-Iowa) for several months, insisted Tuesday that the legislation would “pass the bipartisan smell test.—

However, disagreement over the public plan option has grown into an obstacle overshadowing whatever agreement there might be on other aspects of reform. The cost of an overhaul — and how to pay for it — are also extremely contentious issues.

With most Democrats committed to including a robust, government-run insurance component in the reform legislation, the Senate majority is now angling to pass a transformative bill that can attract a few Republicans.

“The leadership is interested in the possibility of getting a bill that can get some Republicans while still delivering what Democrats want,— a senior Democratic Senate aide said. “I don’t think huge [Republican] buy-in is at all feasible.—

Senate Majority Leader Harry Reid (D-Nev.) made clear Tuesday that he is among the Democrats who support the public plan.

Additionally, key Finance Committee Democrats are proponents of a government-run insurance option, including Senate Democratic Conference Vice Chairman Charles Schumer (N.Y.) and the panel’s No. 2 Democrat, Sen. Jay Rockefeller (W.Va.).

And although Democrats have professed a desire to craft a bipartisan bill as a means to earn public confidence and ensure the legislation’s staying power, Reid said bipartisanship isn’t his overriding goal. Republicans say that they are in favor of health care reform and that agreement on a bill that addresses cost and access issues is possible if the Democrats would simply abandon the public plan.

“As important as bipartisanship is — and it’s very important — it’s not as critical as helping the millions of Americans who have no health insurance,— Reid told reporters.

House Democratic leaders have targeted late July for passage of their health care reform bill. In the Senate, the process calls for Finance and HELP to mark up their bills this month and then merge them after the July Fourth recess. Senate Democratic leaders are hoping to pass the bill on the floor before Congress adjourns in August.

President Barack Obama is demanding that bill land on his desk no later than Oct. 15.

Potentially complicating matters for the Democrats was the Congressional Budget Office’s scoring of the HELP bill at more than $1 trillion over the next decade. Although the score represented only a portion of the HELP bill and the numbers could change after the full legislation is analyzed, Republicans pounced, and even some Democrats expressed concern.

“The CBO information is helpful to the process because we’ve got to get a bill that’s paid for,— Sen. Claire McCaskill (D-Mo.) said. “I don’t think any of us thought that the version that has been scored is in fact the version that we will actually be voting on. … I remain committed to making sure that we have a bill we can pay for.—

Many of the Senate Democratic Conference’s more liberal members are committed to pushing through an overhaul including with measures that seem likely to chase away most Republicans, and possibly a few centrist Democrats. In fact, some of the biggest fans of the public plan are Democrats with key roles on the HELP Committee who could be influential in the merger negotiations with the Finance panel.

Given the Republicans’ resistance to a government-run insurance option — HELP ranking member Mike Enzi (R-Wyo.) has called it a “litmus test— — a second senior Democratic Senate aide said the chamber’s Democrats are ultimately going to have to decide whether bipartisanship is “worth giving up every major tenet of health care reform.—

Sen. Tom Harkin (D-Iowa), who has helped Dodd handle the extra workload in Kennedy’s absence, said he remains concerned that Democrats will prioritize bipartisanship over meaningful reform.

“That’s a kind of fear I have, that I wake up at night thinking that we could end up with a more convoluted system than we have right now,— Harkin said. “Sure, I worry about that.—

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