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House-Senate Conference Will Have Several Disputes to Resolve

While the Senate is finally grinding toward a vote on its health care reform bill this week with the support of every Democrat, the thorny issues of abortion, immigration and taxes remain for the looming health care legislation conference with the House.And while Senate Democrats have warned they cannot make many changes in conference without risking the 60 votes that they need to advance the bill, House Democratic leaders don’t have much leeway either, having passed their bill with only a few votes to spare.Speaker Nancy Pelosi (D-Calif.) is expected to lead a conference call with other House Democratic leaders Tuesday to discuss health care strategy.The abortion issue may be the hardest to bridge, given that the bill was only passed in the House after anti-abortion Democrats led by Rep. Bart Stupak (Mich.) forced adoption of an amendment banning women from buying insurance plans covering abortion if they receive federal subsidies. Stupak told White House Chief of Staff Rahm Emanuel in a phone call Sunday that the Senate bill’s abortion compromise was “unacceptable,— but he urged further talks to try to resolve the issue.The Senate abortion language allows states to ban subsidies for insurance policies that cover abortion, while requiring people enrolled in such plans to send separate checks to cover the abortion piece of the policy. In an interview Monday, Stupak stopped just short of threatening to vote against the bill unless the abortion language is changed. “I don’t know,— he said. “I’d have to see what else is in it.—Stupak also said he didn’t want to issue an ultimatum at the start in hopes that discussions could yield a compromise. Stupak said he’s willing to negotiate – up to a point.“I’m willing to listen to reasonable proposals, but there is an absolute moral line we’re not crossing; we’re not providing public funding for abortions,— he said. “It shouldn’t be that difficult.—Stupak said polls back his amendment. “It’s backed up by the American people,— he said. “I think we’re in a strong position.—Supporters of abortion rights are in a tenuous position after they got clocked by Stupak’s amendment on the House floor, although a number of them have vowed to vote to kill the conference report if the Stupak language survives. That has leaders facing a conundrum of trying to push through the Senate language and risk losing the votes of Stupak and other abortion foes or backing a Stupak-like ban that risks losing votes of abortion-rights supporters.And on the issue of financing the reform package, one key House Democrat signaled a willingness to deal. Rep. Joe Courtney (D-Conn.), who led an effort by House Democrats to oppose a tax on high-end insurance plans that is a cornerstone of funding the Senate bill, said negotiators should be seeking “middle ground.—“There’s always a way with people of goodwill and good intent to resolve a difference,— he said. For now, Courtney said, he doesn’t have a specific compromise proposal to offer the Senate. But he also warned it would be a mistake for Senate Democrats to think they would steamroll their House counterparts in the coming talks — a point that he said Pelosi has made privately to her Caucus. “Everybody is in the same boat here trying to hold together both majorities,— Courtney said. “The notion that the Senate has some kind of automatic edge in terms of the political challenge is not founded on law or politics.—Courtney has gathered 190 House Democratic signatures on a letter to Pelosi urging her to “reject proposals to enact an excise tax on high cost insurance plans that could be potentially passed on to middle class families.— He argued that the House-favored alternative, a surtax on the wealthy, is a more publicly popular approach.Senate Health, Education, Labor and Pensions Chairman Tom Harkin (D-Iowa), who will be a conferee with the House, said he personally would like to take a look at adopting some of the House tax provisions in conference. The House taxes the rich to pay for its plan; the Senate plan includes an array of taxes including the tax on high-cost health care plans.Harkin said the Senate tax package was crafted in part to win Republican votes, to no avail.“Keep in mind that [Senate Finance Chairman Max] Baucus (D-Mont.) bent over backwards,— Harkin said. “He was always trying to get Republican votes in support for the bill. Perhaps had he known in advance Republicans were not going to play fair with him, it might have been a different story, so I think there is room for some negotiations in that area.—Unions have also been pushing strongly to limit or kill the tax on high-cost plans as well. But moderate Sen. Ben Nelson (D-Neb.), who provided the 60th vote that Democrats needed to move forward with the latest deal, warned on CNN on Sunday that adding in the House’s tax on the rich would break the deal that he cut to vote for the bill.Hispanic lawmakers, meanwhile, have complained repeatedly about the Senate bill’s restrictions prohibiting illegal immigrants from buying health insurance through new exchanges. The House bill allows them to buy insurance but prohibits them from receiving subsidies. The White House has supported the Senate’s language, and the issue could be moot if Congress passes immigration reform providing a path to legalization for illegal immigrants before 2014, when the exchanges are fully operational. But that may not pass muster with some members of the Congressional Hispanic Caucus, who provided key votes for the health care plan.The Senate’s approach, however, which eliminates the public insurance option, could attract the votes of some Blue Dog Democrats who voted against the House bill, helping to offset losses.House Democratic leadership remained relatively quiet in the immediate aftermath of the latest Senate deal. House Republicans, like their Senate colleagues, remained on the outside looking in, with little to do but lob rhetorical grenades at the bill.“Over in the Senate, Harry Reid’s ‘cash for cloture’ push forges ahead as people across this country continue to make clear their opposition to a government takeover of health care,— House Minority Whip Eric Cantor (R-Va.) said in a statement Monday. “This is the first time, in our country’s storied history, that such a massive bill, in terms of both cost and scope, will have absolutely no bipartisan support.— Republican Study Committee Chairman Tom Price (R-Ga.), a physician, called the Senate’s abortion language “a fig leaf at best.— But Price predicted that House Republicans would be largely left out of the conference process, should the bill pass the Senate. As evidence, he pointed to joint release from Pelosi and House Majority Leader Steny Hoyer (D-Md.) that said, “We look forward to working with the Obama Administration, the Senate, and our Caucus to reconcile our bills and send final legislation to the President’s desk as soon as possible.—“Clearly they are leaving out a significant portion [of the Congress] that represents about 40 percent of the nation,— Price said.Jackie Kucinich contributed to this report.

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