http://news.yahoo.com/s/ap/20091208/ap_ ... e_overhaul
By DAVID ESPO, AP Special Correspondent David Espo, Ap Special Correspondent – Mon Dec 7, 9:44 pm ET
WASHINGTON – With time growing short, Senate Democratic liberals are seeking expansion of two large federal programs, Medicare and Medicaid, as part of a compromise that drops a government insurance option from health care legislation sought by President Barack Obama, several lawmakers said Monday.
Under the potential trade-off with party moderates, near-retirees beginning at age 55 or 60 who lack affordable insurance would be permitted to purchase coverage under Medicare, which generally provides medical care beginning at 65. Medicaid, the federal-state health care program for the poor, would be open to all comers up to 150 percent of poverty, or slightly over $33,000 for a family of four.
The compromise under discussion also envisions private insurance companies selling national, non-profit plans, to be overseen by a federal agency, an alternative to a longstanding call by liberals for the government to sell insurance as a means of forcing competition on the industry.
"It's one of those kind of things in the middle that doesn't make everybody very happy but that's our compromise," Sen. Tom Harkin, D-Iowa, said after talks ended for the day. "It's something I'm going to probably have to live with."
Harkin also said Majority Leader Harry Reid had imposed a deadline of Tuesday on the talks as he tries to complete work on the sweeping legislation in the next few weeks.
While Harkin and others spoke with optimism, there were few details available. It was not immediately clear, for example, what the legislation would provide if no insurance company agreed to sell a nationwide non-profit plan.
Senators and aides said the changes have been discussed extensively in recent days as a small group of moderate and liberal Democrats search for a middle ground to assure passage of the bill atop Obama's domestic agenda.
Additionally, the president met privately at the White House over the weekend with Sen. Olympia Snowe of Maine, who supported a Democratic-drafted bill in the Senate Finance Commitee earlier this year but has spoken out against the legislation pending on the floor. Senate Democrats also have been in contact with Snowe in recent days.
Given the complexities of the two programs and the White House's goal of passing legislation by year's end, it wasn't clear whether the negotiations would ultimately bear fruit, or merely prove to be a last stab by liberals at salvaging some concessions in a months long debate over a so-called public option.
As the search for compromise intensifies, several Democrats also said a plan by Sen. Maria Cantwell, D-Wash., was receiving new interest as a means of injecting additional competition into the insurance system. It gives states an option to negotiate with private industry to provide group less expensive coverage for lower income residents. Currently, the bill allows that for any state's residents up to twice the federal poverty level, about $44,000 for a family of four, but that could be raised if negotiators decide they want to do so.
"There's push and pull," said Sen. Chuck Schumer, D-N.Y., who has been involved in the discussions. "We have to find the right balance that satisfies the party as to how much government involvement there should be and how much private involvement."
Democrats need 60 votes to pass their bill over Republican objections, and while liberals far outnumber moderates inside the party, they appear at least four votes short of the number needed. That gives moderates such as Sens. Blanche Lincoln of Arkansas, Mary Landrieu of Louisiana, Ben Nelson of Nebraska and Joe Lieberman, an independent from Connecticut, key leverage as the White House and Reid try to complete work on the bill.
At its core, the legislation is designed to expand coverage to more than 30 million who lack it, while curbing controversial insurance industry practices and generally restraining the growth of medical spending.
Several party officials said the negotiations involving the two wings of the Democratic caucus had given Sen. Mark Pryor, D-Ark., a newly prominent role on the health care legislation, and he has held several meetings in recent days designed to facilitate a compromise. Pryor represents his state in the Senate with Lincoln, who faces a difficult re-election challenge in 2010.
The closed-door talks have proceeded while Republicans on the Senate floor have mounted a series of politically charged challenges to the health care bill. Whatever the long-term political impact, they so far they have failed to win any major changes.
The latest such maneuver came when the Senate rejected an attempt by Sen. Judd Gregg, R-N.H., to prevent Medicare from "being raided" to pay for health care. The vote was 43-56. The bill calls for cuts totaling $460 billion over a decade from projected Medicare spending, much of which would be used to provide subsidies to help lower and middle-income Americans purchase health care.
Another contentious issue is slated for a vote Tuesday, when conservatives from both parties try to stiffen abortion restrictions in the legislation.
Both on and off the Senate floor, the health care debate has become intensely political.
Michael Steele, chairman of the Republican Party, demanded an apology from Reid during the day after the majority leader criticized critics favoring a slower, more incremental approach to health care.
"You think you've heard these same excuses before? You're right. In this country there were those who dug in their heels and said, 'Slow down, it's too early. Let's wait. Things aren't bad enough.' — about slavery," Reid said.
Steele said if Reid won't apologize, "Democrats must immediately reconsider his fitness to lead them."
Jim Manley, a spokesman for Reid, said in response, "Today's feigned outrage is nothing but a ploy to distract from the fact they (Republicans) have no plan to lower the cost of health care, stop insurance company abuses or protect Medicare.
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just more typical big government thinking, they acknowledge that billions of dollars get wasted every year with medicare and medicaid, so their solution is to expand both programs
yeah, that makes a whole lot of sense
