Senate Democrats' drive to pass health care overhaul by Christmas sputtered Wednesday as a lone moderate holdout remained undecided and Republican delaying tactics stretched an already protracted debate even further.
Despite a one-on-one meeting Tuesday with President Barack Obama that lasted 30 minutes, Sen. Ben Nelson, D-Neb., said he still has concerns about abortion and other issues. Nelson, the only known holdout among 60 senators whose votes are needed to move the bill, said it had been his third meeting in eight days with the president.
Obama "made a strong case for passing health care reform now," said Nelson. "But I think it still remains to be seen if it was compelling." The legislation needs to be improved, he added, and liberals resisting his proposals — even saying the bill should be scrapped — are running out of alternatives.
"I do say if nothing is done, I'm not sure what Plan B is," he said. "If Plan B is start over...it's quite possible that it just won't happen. It seems to me that we have a chance right now to fix a flawed bill."
To make matters more complicated, the Senate stumbled into health care gridlock after a Republican senator forced the clerk to read aloud a 767-page amendment.
GOP Sen. Tom Coburn of Oklahoma had sought approval to require that any amendment considered by the Senate must be offered 72 hours in advance and with a full cost report.
When he was rebuffed by Democratic Sen. Max Baucus of Montana, Coburn invoked his right to require that an amendment by another Democrat be read aloud. That sent the Senate into limbo, since the amendment by Vermont Independent Bernie Sanders is 767 pages long. It calls for guaranteeing coverage to all through a public program similar to Medicare.
Obama cajoled restive Democrats on Tuesday, urging them not to lose perspective amid intense intraparty battles over government's role and reach in health care. The public plan liberals hoped for appeared dead in the Senate, as did a Medicare buy-in scheme offered as a fallback.
"The president and vice president pointed out that you take your victories when you can and nothing prevents you from fighting on for the things you believe should have been achieved," said Sen. Sheldon Whitehouse, D-R.I. "But why spurn a victory in hand?"
Sen. Mary Landrieu, D-La., a moderate who had been on the fence, said Tuesday night it's time to pass the bill.
But Majority Leader Harry Reid, D-Nev., was still scrambling to secure the 60 votes he needs to overcome a Republican filibuster. One holdout — Connecticut independent Sen. Joe Lieberman — was coming around fast. Another — Nebraska's Nelson — continued to criticize the bill.
"History will be made either way," Senate Republican Leader Mitch McConnell of Kentucky said Wednesday. "A handful of Democrat leaders press ahead in a blind rush of frantic dealmaking to find 60 votes by Christmas; a handful of other Democrats are wondering which side they really want to be standing on when the dust settles."
Just as unhappy with the legislation was former Democratic Party Chairman Howard Dean, an outspoken liberal.
Interviewed on ABC's "Good Morning America," the physician and former presidential candidate said the Senate bill has some good provisions, "but there has to be a line beyond which you think the bill is bad for the country."
"This is an insurance company's dream," Dean said. "This is the Washington scramble, and it's a shame."
Obama said Democrats were "on the precipice" of victory, not breakdown.
The president said differences still remain over details but described the bill as an accomplishment for the history books.
The legislation includes "all the criteria that I laid out" in a speech to a joint session of Congress earlier in the year, he said. "It is deficit-neutral. It bends the cost curve. It covers 30 million Americans who don't have health insurance, and it has extraordinary insurance reforms in there to make sure that we're preventing abuse."
Democrats were still awaiting a final cost analysis from the Congressional Budget Office on the latest version of the bill. At its core, the legislation is designed to spread coverage to 30 million Americans who now lack it, impose new consumer-friendly regulations on the insurance industry and try to slow the rate of growth in health care spending.
Most Americans would be required to purchase insurance, and the government would establish new insurance supermarkets called "exchanges" through which consumers could shop for policies.
Large companies would not face a requirement to cover their employees. But the government would impose charges if any of them did not do so and any of their workers qualified for federal subsidies to help them afford private coverage.
It would be financed with tax increases and Medicare cuts.
Democratic leaders mapped out a timetable that envisioned passage before Christmas — but just barely. The House approved its version of the bill earlier this fall, and final negotiations between the two chambers would follow a vote in the Senate.