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GOP Launches Strategy to Trip Up Health Bill

Correction Appended

Senate Republicans, acknowledging they lack the votes to block a health care reform bill outright, have implemented a comprehensive political strategy to delay, define and derail.

With Democratic leaders and White House officials holed up in Senate Majority Leader Harry Reid’s (D-Nev.) office negotiating a final bill, Republicans are demanding a deceleration of the process and moving to define whatever plan that emerges as a combination of Medicare cuts, tax increases, higher insurance premiums and rising overall costs.

“Where they’re headed is inconsistent with the American people, so I’m not sure it’s as much about us as it is about making sure that the American people express their deep concerns over this,— Sen. Richard Burr (R-N.C.) said last week. “Certainly they’ve got the votes, but they’re going to have to hold every one of them in the United States Senate to make it through this.—

Senate Democrats are rejecting Republicans’ demands to slow things down, charging that the GOP isn’t interested in working with the majority to craft a bipartisan health care bill. Rather, Reid said repeatedly last week, the Republicans’ primary goal is to sink reform in order to undercut President Barack Obama.

Negotiations on a final Senate bill are set to resume today with Reid, Finance Chairman Max Baucus (D-Mont.), Sen. Chris Dodd (D-Conn.) and senior White House officials. Republicans have not been invited to participate in the talks, although Reid said Thursday that he has reached out to a few GOP Senators and is likely to consult moderate Sen. Olympia Snowe (Maine). Snowe was the lone Republican last week to support the Senate Finance Committee’s version of a health care overhaul.

“There are challenges that lie before us because the Republicans are going to insist that we do it alone,— Reid told reporters.

Unable to mount a filibuster on their own and calculating that Democrats are on track to send a health care bill to Obama by year’s end, Senate Republicans figure the only way to stop or reshape the measure is to give the public enough time to figure out what’s in it and what they don’t like about it.

Doing that is going to take some time, and the process of amending bills during a floor debate — which can include demanding a 60-vote threshold for all amendments — could provide the minority ample opportunity to slow things down. Republicans could also benefit from some built-in delays, including the fact that Democratic leaders have said they’d like to wait for a Congressional Budget Office cost estimate on the bill before beginning debate.

This process could repeat itself when the chamber prepares to consider the final House-Senate conference report. Earlier in the year, Republicans were hoping that Democratic divisions would do to Obama’s health care agenda what the GOP can’t, but they no longer expect moderate Democrats to stand in the way of passage — even one that includes a public insurance option.

“The votes are the reality, so the only way you win this thing if you’re in our camp is if the American people are completely on your side,— a senior Republican Senate aide said. “To have a positive outcome and get back to doing what we think is good for our health care system, we need to have the American people understand this thing.—

And just in case that isn’t enough, Republican leaders last week began playing the process card, accusing the Democrats of backroom dealing and rushing to pass a bill before the public can figure out what’s really going on. Senate Minority Leader Mitch McConnell (R-Ky.) is demanding the final package be posted on the Internet for “a minimum— of 72 hours prior to being introduced on the floor.

“Right down here in the Majority Leader’s conference room they’ll be writing the real bill,— McConnell told reporters last week, adding: “Once it’s on the floor, what is a reasonable amount of time to spend in the United States Senate debating one of the most important issues we could ever have before us?—

McConnell said Republicans are going to “insist— on several weeks of debate and argued an issue like health care — equivalent to 20 percent of the national economy — deserves more than the four weeks accorded the most recent farm bill and at least as much time as the seven weeks given the No Child Left Behind education reform effort and the eight weeks given to an energy bill earlier this decade.

The Republicans also plan to use the time between now and a final floor vote to deliver a narrowly focused message via a series of floor speeches, press conferences and media appearances. And even though GOP Members will discuss their counterproposals for health care reform, criticism of the Democratic bill will be the priority.

Obama has said he will not sign a health care bill that costs more than $1 trillion over 10 years and adds to the federal deficit. But even if the final Senate bill meets these requirements, as the $829 billion Finance package does, Republicans are prepared to pounce. The final measure will be some combination of the Finance package and competing legislation approved by the Health, Education, Labor and Pensions Committee.

The GOP will argue that no bill that relies on tax or fee increases can be considered deficit-neutral. Additionally, they will push to enlist the opposition of the all-important seniors vote — seniors are reliable voters, particularly in midterm election years — by continuing to flog the Medicare cuts that Republicans believe will be a part of any final bill.

Republicans also intend to try to personalize the issue, charging that the Democratic health care agenda will raise insurance premiums on individuals and families, while failing to lower the overall amount of money that the U.S. spends on health care.

The GOP made those arguments last week about the Finance package, even though the nonpartisan CBO predicted the bill would reduce the deficit, even as it extends coverage to millions of uninsured Americans. However, the bill is deficit-neutral in part because it raises revenue from taxes and fees on the medical industry and gold-plated health care insurance plans.

“I don’t know how you can characterize anything as reform that raises premiums, raises health care costs, raises taxes and cuts Medicare for seniors,— Senate Republican Policy Committee Chairman John Thune (S.D.) said.

Correction: Oct. 19, 2009

The article incorrectly stated that the health care reform bill approved by the Senate Finance Committee would lower the cost curve of the U.S. health care system. According to Finance Committee testimony by Congressional Budget Office Director Douglas Elmendorf, while the Finance bill is projected to lower the federal deficit by $81 billion over the first 10 years, it remains unclear whether the bill would reduce health care expenditures during that time frame.