Health care reform deal closer

WASHINGTON – Democratic leaders on Capitol Hill worked throughout the day Thursday to settle lingering intraparty disagreements over abortion, federal insurance subsidies and other issues – seeking agreement on the finishing touches for a health care package they hope to send President Barack Obama before the end of the month.

But senior Democrats acknowledged that they were not ready to move forward, and could miss a tentative deadline for a first vote next week.

“It’s not done yet and that’s an understatement,” Senate Majority Leader Harry Reid, D-Nev., told reporters at the Capitol.

House Speaker Nancy Pelosi, D-Calif., said she wanted to give her members “at least one week” to review the package before they vote on it. “It may take longer,” she said after House Democrats met behind closed door for two hours with Nancy-Ann DeParle, head of the White House Office of Health Reform.

Democratic leaders believe that the House will have to vote first on the health care bill approved by the Senate last year without trying to change it. Leaders then plan to use a process known as budget reconciliation to push a package of changes sought by House Democrats through the House and Senate.

Because budget reconciliation measures cannot be filibustered under Senate rules, Democrats could move the package through the Senate with 51 votes.

Democrats in the House and Senate have largely agreed on the basic shape of the reconciliation package, which parallels the health care blueprint outlined by Obama last month.

And many Democrats are eager to finish the debate. “I think everybody understands we need to move on. We’ve got other things we’ve got to do,” said Rep. Gerry Connolly, D-Va., president of the Democratic freshman class in the House. “This is our last best chance.”

The health care package is expected to boost subsidies for low- and moderate-income Americans who will be required to buy health insurance. It will scale back a new tax on high-end “Cadillac” health plans, which was a key part of the Senate bill.

It will phase out a gap in Medicare’s drug coverage, and it will provide additional aid to states to help them expand their Medicaid programs for the poor.

But Democratic officials were still trying to assess the final cost of the changes.

And tensions remain around some issues such as abortion, with a group of conservative House Democrats threatening to oppose the health care legislation unless party leaders take steps to toughen restrictions on federal funding for insurance coverage of the procedure. Democratic leaders believe budget rules preclude them from including abortion language in the reconciliation package.