Health overhaul moving forward

WASHINGTON - Democratic negotiators in the Senate struck a tentative agreement Tuesday night to drop the controversial government-run insurance plan from their overhaul of the health care system, hoping to remove a last major roadblock preventing the bill from moving to a final vote in the chamber.

Under the deal, the government plan preferred by liberals would be replaced with a program that would create several national insurance policies administered by private companies but negotiated by the Office of Personnel Management, which oversees health policies for federal workers.

In addition, people as young as 55 would be permitted to buy into Medicare, the popular federal health program for retirees. And private insurance companies would face stringent new regulations, including a requirement that they spend at least 90 cents of every dollar they collect in premiums on medical services for their customers.

The announcement came after six days of negotiations among 10 Democrats -- five liberals and five moderates -- appointed by Senate Majority Leader Harry Reid, D-Nev., to work out differences between the two camps on the public option and other pressing issues. Reid hailed the deal as a broad agreement that has the potential to "overcome a real problem that we had" and push the measure to a final Senate vote before Christmas.

When asked whether the deal means the end is in sight after nearly a year of work on President Obama's most important domestic initiative, Reid smiled. "The answer's yes."

The deal represents only an agreement among the 10 negotiators to send the package to congressional budget analysts, not an agreement to support its elements. One of the negotiators, Sen. Russell Feingold, D-Wis., quickly issued a statement criticizing the deal.

"While I appreciate the willingness of all parties to engage in good-faith discussions, I do not support proposals that would replace the public option in the bill with a purely private approach," he said. He added, however, that he will base his vote "on the entirety of what is in the bill."

A potential breakthrough

If the Senate approves the agreement, it will face a huge obstacle in the House, where Speaker Nancy Pelosi, D-Calif., has fought hard to preserve a public plan in the face of opposition from moderates.

If the deal holds, it will represent a major breakthrough on one of the most contentious issues of the health care debate, settling a dispute between moderates wary of excessive government intrusion into the private sector and liberals determined to create a strong competitor able to curb the most egregious abuses in the private insurance industry.

Earlier in the day, the Senate turned back an amendment that would have barred millions of Americans from purchasing subsidized insurance policies that cover abortion, as Democratic leaders struggled to maintain a delicate party coalition. The amendment was rejected 54-45. Although the outcome of the vote was not a surprise, the defeat could cost Reid the support of Sen. Ben Nelson of Nebraska, a conservative Democrat who has threatened to join a GOP filibuster of the bill unless abortion restrictions are tightened.

Nelson is one of five moderates in the Democratic caucus demanding changes to the legislation, forcing Reid to balance their concerns with those of liberals as he seeks to maintain the 60 votes needed to push a bill across the finish line. The biggest challenge has been determining the fate of the public option, a chief priority for progressive Democrats.

Key liberals said they were prepared to abandon a government-run insurance program if it would move the chamber closer to a final deal, provided it was replaced with other coverage options and tighter restrictions on insurance companies.

'A fair middle ground'

Although the House voted Nov. 7 to bar their public plan from offering abortion coverage and to prohibit people from using federal subsidies to purchase private policies that cover elective abortion, Senate Democrats rejected Nelson's measure despite the potential threat to final passage. Six Democrats joined all but two Republicans to support the tighter rules, but some Democratic abortion opponents, including Reid, opposed the amendment as too far-reaching.

In a speech on the Senate floor, Reid said the current Senate language, which would allow individuals who qualify for insurance subsidies to purchase abortion coverage with their own money, represented "a fair middle ground."