WASHINGTON — When it comes time to vote, every Democrat in the Senate – and perhaps more than one Republican – will support legislation overhauling the nation's health care system, the chairman of the Senate Finance Committee predicted Thursday.
That assertion by Sen. Max Baucus, D-Mont., was a notable show of confidence coming in the midst of negotiations with Majority Leader Harry Reid and White House officials to finalize legislation that can satisfy liberal Democrats without alienating moderates – and get the 60 votes needed to advance in the 100-seat Senate.
Baucus told reporters that lawmakers have a moral obligation to repair the health care system to rein in costs and extend coverage to millions of the uninsured.
"And that is why we are going to pass health care reform legislation this year, and it is why every Democrat will vote for it, and it is why there will be at least one Republican and maybe a couple more who also will vote for it," Baucus said.
"Every Democrat will vote for national health care reform," Baucus emphasized.
Democrats control 60 Senate votes, but that includes two independents, and leaders have been uncertain of support from a number of moderates who've expressed concerns about the price tag of health care legislation and the government's role in a remade system.
Baucus' prediction followed approval by his committee earlier this week of a 10-year, $829 billion bill that makes numerous changes to the health care system along the lines sought by President Barack Obama, but taking a more centrist approach than the other four health care bills approved by House and Senate committees.
Baucus and Reid met Thursday with White House Chief of Staff Rahm Emanuel and other officials wrestling to merge the Finance bill with a more liberal version passed by the Senate Health, Education, Labor and Pensions Committee.
Reid later held out hope of getting support from more Republicans than just Sen. Olympia Snowe, R-Maine, who was the lone GOP "yes" vote in the Finance Committee.
Unanswered is whether Reid will include provisions in the bill to allow the government to sell insurance in competition with private industry. That so-called public plan is supported by liberals, who spoke up in favor of it at a closed-door Senate Democratic caucus meeting Thursday.
But because of opposition from moderate Senate Democrats, any public plan Reid does include likely would be some type of compromise, such as leaving the decision on a public plan to states or offering public coverage only as a backstop in areas where one insurer has a lock on the market – the approach favored by Snowe.
Reid said, "We're going to work very hard ... to see what, if anything, we're going to do" on a government plan.
"I favor a public option. Everyone knows that," Reid added.
House Speaker Nancy Pelosi, D-Calif., mounted a strong defense of a public plan at a news conference, contending that recent attacks from the health insurance industry should dispel any doubts about the need for it.
"Our House bill will have a public option," Pelosi declared.
She referred to an industry-funded study that said insurance premiums would rise under the Senate Finance bill, and also referenced an insurance industry ad campaign targeted at seniors.
The speaker has been on the attack against health insurers for months, but the latest developments clearly strengthened her resolve to make them pay. She also said the House was considering adding to its health care bill a $6.7 billion annual fee on insurance companies that is part of the Senate Finance package.
The design of the public plan in the House bill remains unsettled. However, the stronger version favored by liberals – one that would use reimbursement rates to providers based on Medicare rates – may be gaining favor.
A spokesman for America's Health Insurance Plans said in response to Pelosi's comments that "the American people want policy makers to pursue reforms that are in the best interest of the country, not as retaliation for speaking out about rising health care costs."
Spokesman Robert Zirkelbach also reiterated concerns about the government option, which the insurance industry and other business groups contend could drive private insurers out of business because they wouldn't be able to compete with the weight of the federal government.
Democratic leaders in the House and Senate are aiming to finalize their bills in time to begin floor debate in each chamber within weeks, though likely not this month. Obama wants to sign a bill this year.
Overall, the legislation would carry a price tag around $900 billion over 10 years, require most people for the first time to purchase insurance, provide subsidies to help lower-income people do so, and put new requirements on insurance companies to prevent them from charging much more to older people or denying coverage to people with pre-existing medical conditions.
Obama will aim to rally support for the overall effort Tuesday by appearing in a live Web cast to be shown at house parties organized by his backers.