Health Care Overhaul Down But Not Out

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Senate leaders say they will wait until Senator-elect Scott Brown arrives before doing anything more on health care. Senate Democrats have lost the 60th vote needed to overcome repeated Republican filibusters. A way around that would be for the House to approve the bill already passed by the Senate and send it to the president. That wouldn't require another Senate vote.

RENEE MONTAGNE, host:

On Capitol Hill yesterday, Democrats struggled to pick up the pieces of their shattered health care bill. A bill that seemed to be just days from becoming law now appears all but blown to bits by the loss of a single Senate seat. NPR's Julie Rovner looks at where Democrats go from here.

JULIE ROVNER: Even though they'd seen the loss of the Massachusetts Senate seat coming, and with it the 60 votes needed to overcome repeated Republican filibusters, congressional leaders seemed chastened yesterday. House Speaker Nancy Pelosi began the day vowing this to the U.S. Conference of Mayors...

Representative NANCY PELOSI (Democrat, California, Speaker of the House): Heeding the particular concerns of the voters of Massachusetts last night, we heard, we will heed, we will move forward with their considerations in mind, but we will move forward for health care.

(Soundbite of applause)

ROVNER: But both President Obama and Senate Majority Leader Harry Reid quickly took one option off the table: finishing the current negotiations and pushing a final bill through Congress before Republican Senator-Elect Scott Brown is certified and sworn in. Here was Reid yesterday afternoon...

Senator HARRY REID (Democrat, Nevada): We're not going to rush into anything, as you've heard. We're going to wait until the new senator arrives before we do anything more on health care.

ROVNER: Another option would be for the House to approve the bill already passed by the Senate and send it to the president. That wouldn't require another Senate vote. But the Senate-passed bill doesn't have many fans in the House. Ask just about any House Democrat what they don't like about the Senate bill and you'll get a long list. Here's Colorado Democrat Diana De Gette.

Representative DIANA DE GETTE (Democrat, Colorado): I have concerns with the way that the financing is structured. I have concerns about the way the exchange is structured through the states, because I don't think it'll save money.

ROVNER: Meanwhile, in an interview with ABC News yesterday, President Obama suggested the possibility of scaling the bill back to what he called, quote, "the elements that people agree on." Some members, like New York Congresswoman Nita Lowey, are taking that idea a step further, perhaps breaking the bill into small pieces and passing them a piece at a time.

Representative NITA LOWEY (Democrat, New York): For example, would people vote for the pre-existing condition provision? Would they vote for closing the donut hole?

ROVNER: The donut hole was a quirk in Medicare's drug benefit where coverage stops by seniors still have to pay their premiums.

But breaking the bill up would still require it to get through the Senate, where it would still be subject to Republican delay efforts. Republicans, for their part, made it clear their views on the health bill haven't changed. Here was Senate Republican Leader Mitch McConnell on the Senate floor with his interpretation of what the public wants.

Senator MITCH MCCONNELL (Republican, Kentucky): They don't want the government taking over health care. They made that abundantly clear last night in the Commonwealth of Massachusetts.

ROVNER: But Democrats still have one way to overcome Republican objections in the Senate, says House Energy and Commerce Committee Chairman Henry Waxman.

Representative HENRY WAXMAN (Democrat, California): We do have a reconciliation process, which would take only a majority vote. That has been held in reserve and we're probably going to have to use it.

ROVNER: Budget reconciliation is a special kind of bill that can't be filibustered in the Senate and only needs 51 votes to pass. It's considered a last resort, but some think the time may have come. Waxman says the only thing worse would be doing no health bill at all.

Rep. WAXMAN: If we defeat it on our own because we don't, as a leadership, gather our troops to get it across the finish line, I think there'll be hell to pay with the voters in November.

ROVNER: The last time Democrats tried - and failed - to pass a health overhaul bill was in 1994. That year they lost their majorities in both the House and the Senate in the midterm elections.

Julie Rovner, NPR News, Washington.

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