Oct. 14, 2009 -- Lawmakers began the heavy lifting on health care legislation today with White House officials, who paid a visit to Capitol Hill for the first of many closed-door meetings with Democratic leaders.
Chief of Staff Rahm Emanuel, along with Secretary of Health and Human Services Kathleen Sebelius and White House Health Policy Adviser Nancy Anne DeParle were just a few of President Obama's advisers who met with Democratic leaders to discuss crafting out a final health care bill.
The negotiations took place in the room that served as the late Sen. Ted Kennedy's last office on Capitol Hill. Kennedy had moved into the room in late January so he could coordinate health care overhaul efforts with Senate Majority Leader Harry Reid, D-Nev., whose office is adjacent to Kennedy's.
Even as Democrats and Obama celebrate a victory in the Senate Finance Committee, where Chairman Max Baucus' health care bill passed by a 14-9 vote Tuesday, they face what could be a tougher battle ahead.
Baucus' bill received unanimous Democratic support, as expected, but the vote that mattered the most came from Maine Republican Sen. Olympia Snowe, who said she voted in favor because the Baucus bill is "a good place to start.
"This is a historical endeavor and challenge," Snowe said on "Good Morning America" today. "The time has come to grapple with this issue that has eluded us for decades. But we can't postpone the inevitable because it's only going to make it worse for Americans."
"Although we disagree in some aspects of it, it [the Baucus bill] was worth moving it forward in the process. Hopefully, we can make even more improvements," Snowe said of the committee's bill.
Democrat and Republican committee leaders spent four months in closed-door negotiations to devise a bill that could be called bipartisan. But in the end, Snowe was the sole Republican to support any Democratic health care bill.
The centrist Maine senator, however, hopes that bipartisanship is not completely over yet.
"Hopefully, we can bring in others in the process in the Senate," she told "GMA." "They [Republicans] obviously want to contribute to this product. That's what makes it work. ... And I think it can happen, if people are willing to solve the problems."
"It's not about whose giving the idea. It's a matter of it's a good idea," Snowe said. "We can certainly make it happen if we are willing to set aside our political differences."
At the White House Tuesday, Obama praised Snowe but acknowledged big challenges ahead and cautioned that there's still a lot of work to be done.
"We have a lot of difficult work ahead of us," he said. "We are now closer than ever before to passing health reform. But we're not there yet. Now's not the time to pat ourselves on the back. Now's not the time to offer ourselves congratulations. Now's the time to dig in and work even harder to get this done."
Public Option, Costs Key Issues in Health Care Debate
The Senate Finance Committee bill will have to be merged with the more liberal legislation passed by the Senate Health, Education, Labor and Pension Committee in July. There is likely to be a tough fight between moderate Democrats, who say the bill goes too far, and liberals, who say it doesn't do enough.
The challenges will be even greater when House and Senate bills have to be combined. Among the differences that need to be resolved are whether to include the option of a government-run insurance plan to compete with the private sector, how to pay for overhaul costs and where to levy taxes.
Democrats also have to be careful about losing Snowe's support. Even though she voted aye for the Baucus bill, Snowe said her vote doesn't forecast what her vote will be in the future.
Sen. Jay Rockefeller, D-W.Va., who had expressed reservations about the Baucus bill, said during the committee hearing Tuesday, "We are not doing what we set out to do. It is a step in the right direction, but it is not enough."
Public option is likely to be one of the thorniest issues in the debate moving forward. Snowe today expressed concern about including that option, saying she would prefer to first give the private insurance industry a chance to oblige with new requirements set for them.
"I would prefer to allow the private sector to work through these reforms that we are going to require of them," Snowe said. "They're going to have to live up to a certain standard. If they don't, then you can have a public option kick in immediately."
Snowe was the one of the first to suggest the idea of a trigger public option, whereby a government plan would be implemented in regions where private insurance companies did not offer affordable, accessible coverage.
House Democrats are particularly sensitive about the public-option issue. Many of them don't support Baucus' bill because it doesn't include that plan. Instead, Baucus proposed the creation of member-owner, nonprofit co-operatives that would compete with private insurers.
"There is no doubt about it, through this process the Senate bill has gotten watered down and watered down and watered down," Rep. Anthony Weiner, D-N.Y., told ABC News.
Feuding Democrats say the president needs to step in and offer a compromise.
"This is kind of like a baseball game where you bring in your best pitcher at the end to be your closer," Weiner said. "Well, those of us who support a public option are waiting for President Obama to come in out of the bull pen and seal this deal. Up to now every committee has moved this ball forward, now have to make sure we get it right. One thing is clear, if we don't have true competition and true cost containment that only public option can create, we're going to regret this effort in the end."
ABC News' Z. Byron Wolf contributed to this report.