Matt Yglesias points out that the health care deal in the Senate is far from signed sealed and delivered. Sen. Ben Nelson (D-NE), a key Senate moderate whose vote Reid is actively courting, left yesterday’s session early, “telling reporters he remained undecided.” Nelson has serious doubts about the bill’s abortion provisions and the long-term care insurance program known as the CLASS Act. It’s also unlikely that Sen. Joe Lieberman (I-CT) — who has also opposed the CLASS Act — gave Reid a firm commitment to voting for cloture on the bill.
Since Republicans seem “united” against voting for health care reform, Reid will have to address the lingering concerns of his Democratic caucus if he hopes to pass a bill before Christmas, a goal that would require him to file cloture no later than Thursday.
Below are some of the the remaining ‘points of tension’ within the Democratic caucus:
- ABORTION: Democrats and two Republicans tabled Nelson’s Stupak-like abortion amendment. In an effort to please the Senator, Reid suggested that he would be open to strengthening the existing abortion provisions. But the Senators have yet to agree on a compromise that would satisfy both parties.
- CLASS ACT: Nelson and Lieberman view the CLASS ACT as an unfunded liability that could cost the government money over the long term. Both senators are also being pressured by the long-term-care insurance lobby to oppose the legislation. Ditching the long-term care insurance provision could prove difficult however, since the program’s revenues account for more than half of the Senate bills’ deficit reduction in the first 10 years.
- MEDICARE CUTS: Nelson voted several times to strip the Medicare cuts out of the Senate bill. It’s unclear how serious Nelson is about these Medicare changes, since his votes may have been orchestrated to send a message to Democrats.
- COMPARATIVE EFFECTIVENESS RESEARCH: While Nelson hasn’t spoken out about comparative effectiveness research during this debate, in February he teamed up with Sen. Susan Collins (R-ME) to remove CER funding from the stimulus legislation
- OPM TRIGGER: Press reports have indicated that the public option compromise would trigger a public option in the event that non profits did not join the Office of Personnel Management’s (OPM) network of nonprofits. Lieberman has opposed any kind of trigger and it’s unclear if this provision is still part of the compromise.
A rumor from the RPM report suggests that the Senate will vote on the bill on the morning of December 23 and begin a two-week conference on December 26th. The House and Senate could vote on the conference report in mid to late January.
Sen. Jim Webb (D-VA) is not yet sold on health reform:
I voted five times against proposed cuts to Medicare due to my concerns about taking half a trillion dollars out of that system at a time when the pool for Medicare is about to expand with the retirement of those in the Baby Boom generation. I am a long-time supporter of Medicare Advantage programs which have, in my view, greatly improved services in rural areas of Virginia, and I did not want to see cuts to benefits or services.