Democrats in the Senate inched closer to an agreement on health care, taking up the two biggest hurdles blocking overhaul legislation from a final vote: abortion and a government-sponsored public option.
Senators rejected an attempt to stiffen the bill's ban on federal funding for abortion Tuesday, and hours later, a group of five moderates and five liberals announced that they had reached a tentative deal on the public option. The group refused to give any details, pending a cost estimate from the Congressional Budget Office expected Wednesday.
But at a hastily arranged news conference, Reid said, "We have confronted many hurdles, and tonight I believe we have overcome yet another one."
There were conflicting reports about whether the deal jettisons the public option altogether. It is, however, believed to include some role for the federal Office of Personnel Management, which oversees the Federal Employee Health Benefits Plan, the group of private health insurance plans that covers some 9 million federal workers and their dependents.
The deal is also thought to include the chance for uninsured individuals between the ages of 55 and 64 to "buy in" to Medicare coverage early. That's something that appeals to liberals such as Jay Rockefeller (D-WV), one of the negotiators. "I like Medicare buy in a whole lot," he said. "I've been dreaming about that since 2001."
But the change would not be problem-free. Rockefeller himself points out that first "comes the matter of you've got to spend money." Just how much money will be for the CBO to determine.
There are other problems, too. More people on Medicare means more patients getting reimbursed at Medicare rates, which are lower than what private insurance pays. That has already prompted a flurry of angry letters from doctor and hospital groups, who until now were supporting the bill.
But on the Senate floor Tuesday, the drama playing out publicly was over abortion — specifically, the 54-45 defeat of an effort to impose an even stricter ban on federal funding for abortion than the one included in the overhaul legislation.
The amendment, offered by Sens. Ben Nelson (D-NE) and Orrin Hatch (R-UT), would have made the Senate bill's abortion language nearly identical to that adopted by the House last month.
Nelson insisted there was nothing complicated about his plan. "Our amendment only ensures that where taxpayer money enters the picture, people are not required to pay for other people's abortions," he said.
Indeed, most federal funding has been banned for abortion for more than three decades under the Hyde amendment, named for the late Illinois House member and anti-abortion icon Henry Hyde.
But opponents of Nelson's amendment said it would go much further than the Hyde language.
"What this amendment would do, as I read it, is to prohibit any health insurance plan that accepts a single government subsidy or dollar from providing coverage for any abortion, no matter how necessary that procedure might be for a woman's health, even if she pays for the coverage herself," said Sen. Dianne Feinstein (D-CA).
Hatch said that might be true, but women would be able to buy separate insurance coverage for abortions. "Women are allowed to purchase separate elective abortion coverage with their own money. I wish they wouldn't," he said, "but we allow that. And anybody who says otherwise is misrepresenting what we're doing here with this amendment."
But being allowed to purchase separate coverage and actually being able to are two different things, said Michigan Democrat Debbie Stabenow.
"We know that in five states that ... right now allow abortion coverage through riders ... there's no evidence that there are any riders available in the individual market," she said. "Even though technically colleagues will say you can buy additional coverage, it's not offered."
One surprising moment in the debate came from Majority Leader Reid, a longtime opponent of abortion. Reid delivered an impassioned speech about all the times he had voted against federal funding for abortion. Then he went on to explain why he considered the health overhaul bill itself a pro-life measure.
"If we still truly value life in America — and I believe we do — if we still truly value the life of every American, we cannot turn our backs on the 14,000 of us who lose health coverage every single day of every single week of every month of every year in this country," Reid said.
The abortion vote is hardly the last word on the issue. Another round of private negotiations could produce yet another language change if that's what it takes to get Reid the 60 votes he needs to get the bill passed before the Christmas holiday.