the last mile on health care reform...

Financial Times: 

The Senate bill, on track to be passed on Thursday, will have to be merged with the House version in conference committee – sometimes called Congress’s third chamber – and passed again before it can be sent to the president’s desk.

In the Senate, where Democrats and aligned independents have the exact number of votes needed to pass the bill, there is little room for manoeuvre. The final legislation will have to look almost exactly like the Senate version if it is to pass the upper chamber again, an outcome that will leave many liberal representatives disaffected.

“There are going to be a few tweaks but I’m sure it’s going to look like the Senate bill on most issues, especially on the public option and abortion,” said Dean Baker of the Center for Economic and Policy Research. “But there is too much at stake here. This will be a huge achievement.”

Conference committee is likely to begin early next year, with Harry Reid and Nancy Pelosi, the Democrat leaders in the upper and lower chambers, hammering out compromises.

There are substantial differences between the two bills, most significantly on a government-run “public option” healthcare system and on abortion funding.

The House bill creates a public plan that would negotiate rates with doctors and hospitals, directly competing with private insurers, but liberal senators had to drop their hopes for any such plan being included in the upper chamber’s bill.

Instead, the Senate would charge the Office of Personnel Management, which funds health insurance for federal employees, with setting up national plans for individuals and businesses.

On abortion, the House bill would not allow anyone who receives federal subsidies to choose an insurance plan that covered elective abortions. These tough new restrictions are not in the Senate bill, which instead allows states to ban abortion coverage from the new state insurance exchanges.

Centrist senators have already started warning that the final legislation cannot veer too far from the deal painstakingly negotiated by Mr Reid.

“It is very clear that the final bill, to pass in the ... Senate, is going to have to be very close to the bill that has been negotiated here,” said Kent Conrad, Democrat of North Dakota. “Otherwise, you will not get 60 votes in the Senate.”

Ben Nelson of Nebraska, a Democrat who withheld support until he was satisfied on abortion funding, has warned that changes on the issue will cost his vote.

He said: “If there are material changes in that conference report ... I reserve the right to vote against the next cloture vote.”

House Democrats have long known that the Senate vote is more finely balanced than theirs but liberals are increasingly frustrated that the upper chamber has given up on providing a public option and some could put up a strong fight during conference.

Posted via email from Jim Nichols