Starting an eighth day of health care debate Monday, the top Senate Democrat said lawmakers are approaching the end game on the far-reaching legislation and fully expect to prevail. A vote on the divisive abortion issue was expected later in the day.
"We've tried to get to this point with health care legislation for almost 70 years, and we're there," said Majority Leader Harry Reid, D-Nev., after a weekend of work capped by a presidential pep talk Sunday. The rare weekend session saw intense negotiations among liberal and moderate Democrats—along with Republican Sen. Olympia Snowe of Maine, who may yet vote for the bill.
Moderates and liberals are working to find a compromise on a government-sponsored health insurance plan to compete with private companies. The latest version under discussion — non-profit private plans overseen by the same agency that oversees health insurance for federal employees— doesn't approach the muscular government-run program that liberals wanted — and the insurance industry feared.
"We're not there yet," said Sen. Charles Schumer, D-N.Y. "But we're finding a good deal of give-and-take that can lead to common ground."
Compromise seems much less likely on abortion coverage. Anti-abortion lawmakers in both parties have insisted that taxpayer funds not be used to pay for abortions in government-run health programs. Sen. Ben Nelson, D-Nev., will offer an amendment Monday that would bar private plans operating with government subsidies in a new insurance marketplace from covering abortion, except in cases of rape, incest, or to save the life of the mother.
Abortion rights supporters say that goes too far because it would bar coverage of a legal medical procedure even if paid for entirely from the patient's own share of insurance premiums.
Sen. Claire McCaskill, D-Mo., said Monday she wouldn't be able to accept the Nelson language. It appeared unlikely that it would gain the necessary 60 votes in the 100-member Senate, according to numerous lawmakers.
"Let's be clear, the bill as it stands does continue the current law" banning the use of federal money for abortions in most circumstances, she said. "What this amendment does, is it goes further," McCaskill said. "You can't use private money in the private market ... and frankly I think that goes too far." She spoke on CBS' "The Early Show."
The House last month adopted similarly tough restrictions, angering liberal groups who vow to prevent the Senate from doing the same. Nelson said his amendment reflects the House language.
In a rare visit to the Capitol on Sunday, President Barack Obama urged Senate Democrats to overcome their differences and make history by overhauling the nation's health care system — even if some of them might face angry voters. He stuck to general themes in his 45-minute closed-door speech and did not dwell on specific topics such as abortion.
The Senate bill would cover more than 30 million additional Americans over the next decade with a new requirement for nearly everyone to buy insurance. The federal-state Medicaid program for the poor would be expanded, and there would be a ban on unpopular insurance company practices such as denying coverage based on medical history.
It would create marketplaces where people could shop for and compare insurance plans. Lower-income people would get subsidies to help them buy coverage.
A government-run insurance program, or "public option," is one of the bill's most contentious issues. At the urging of Reid, a group of moderate and liberal Democrats will keep meeting to seek a compromise. After their Sunday evening meeting, senators said it could be days -- or a week— before they know if they can reach a deal.
The latest idea calls for national nonprofit insurance plans to be administered by the Office of Personnel Management, which oversees the popular Federal Employees Health Benefits Program.
The proposal seems to appeal to a key Republican, Snowe of Maine, who met with Obama at the White House on Saturday.
On Sunday, Snowe called the possible compromise "a positive development" because it would give consumers more options for buying insurance.
Snowe's potential support for the Democratic-crafted bill is crucial. Supporters need 60 votes to overcome filibusters, and the chamber's 40 Republicans hope to draw at least one Democrat to their side.
It could be Nelson, who says he will not support final passage of a health care bill unless it includes the tight abortion restrictions he wants. If so, Democrats would have to woo moderate Republicans such as Snowe.