Dec. 6, 2009 -- President Obama appeared on Capitol Hill today during a rare weekend session to urge Senate Democrats to reach a compromise on a health care bill they hope to pass before year's end.
Accompanying the president were Vice President Joe Biden, Health and Human Services Secretary Kathleen Sebelius, Interior Secretary Ken Salazar, White House health care czar Nancy-Ann DeParle and White House senior adviser David Axelrod. The president did not speak to reporters before or after the closed-door meeting with Senate Democrats.
The president's 40-minute meeting with members of the Senate Democratic caucus stayed broad, according to senators and aides who were at the meeting. He mentioned neither the public option nor abortion, the two issues that Democratic leaders acknowledge continue to vex efforts to find compromise in the Senate.
Instead, the president made a broad case for overhaul. He touted this year's major legislative accomplishments, cited recent encouraging employment news and argued that if Senate Democrats pass the health care initiative, the politics will take care of itself, in 2010 and far beyond.
The president made a broad appeal for health care overhaul in "only words Barack Obama can utter," Senate Majority Leader Harry Reid said.
"Not since Social Security have we had such an issue in this country," Reid of Nevada said. "Ten, 20, 30, 40 years from now, people are going to look back at what this Congress did."
Sen. Kent Conrad, D-N.D., said, "I hope he gives that speech to the nation."
But the president did not change the minds of moderate Democrats uncomfortable with the bill.
"For those who have made a decision to be supportive, I think he was persuasive," said Nebraska's Sen. Ben Nelson, who's undecided about whether to support the bill. "There are still issues that have to be resolved. You're always hopeful that the stars will align and all of those interests will be decided."
GOP Leader: Reform a 'Completely Partisan Effort'
Republicans were not invited to meet with the president, prompting some critics to charge that the health care debate is an example of politics-as-usual-partisanship.
"The fact that the president of the United States is meeting with Democrats only tells you where the debate has gone," Senate Minority Leader Mitch McConnell, R-Ky., said to reporters at the Capitol Sunday. "It's drifted off into a completely partisan effort."
And Sen. John McCain, R-Ariz., whose amendment to strip the bill of $460 billion in Medicare cuts failed last Thursday, said it was time to stop "this behind-closed-doors" routine.
"I would love for the president to come meet with the 40 of us on the other side of the aisle," McCain said. "Let's all sit down together, Republicans and Democrats with C-Span in the room, so American people can see what's happening."
Reid emerged from the meeting sounding upbeat.
"There's still a few things we have to work out in the bill but issues are being narrowed as we speak," Reid said. "We will arrive at a consensus as quickly as we can."
He said he wasn't bothered by the president's not addressing the public option or abortion.
"Progress is being made and that's not just talk," Reid said. "We've made a lot of progress."
Reid said he called and personally asked five moderates and five progressive Democrats to "work things out on the issues that they care a lot about."
Those moderate Democrats include Nelson, Arkansas Democrats Sen. Blanche Lincoln and Sen. Mark Pryor, Delaware Sen. Thomas Carper and Louisiana Sen. Mary Landrieu. The liberal Democrats include Wisconsin Sen. Russ Feingold, Iowa Sen. Tom Harkin, Ohio Sen. Sherrod Brown, West Virginia Sen. Jay Rockefeller and New York Sen. Chuck Schumer.
The president's appearance signals Democrats' urgency to pass health care legislation before the end of the year, as well as the difficulty of the task.
At least two major sticking points remain on reaching the votes they need; the controversial public option and abortion services.
"Thanks to Senator Harry Reid's leadership, we're down to two major issues, abortion andpublic option. And I think we're coming to closure on those issues. We're likely to come to a vote on the abortion question maybe by tomorrow," Sen. Richard Durbin said on "Fox News Sunday."
A new alternative to the public option was put forth Saturday that could satisfy fiscally conservative Democrats who're opposed to the public option, such as Sen. Evan Bayh, D-Ind., or for whom voting for the controversial measure would be politically risky, such as Lincoln of Arkansas.
The new alternative would essentially offer Americans a national health plan similar to the one that federal employees receive. The new plan would be administered by the Office of Personnel Management, which already runs the Federal Employee Health Benefits Plan that provides members of Congress and federal employees low-cost insurance.
Only not-for-profit insurance options would be offered in the new plan.
"There has to be an approach that either creates a new public option or an expansion of current public programs," Sen. Feingold said Sunday on ABC's "This Week." "We have tohave some competition for the insurance industry."
That proposal is gaining some interest from senators who have said they would support a Republican filibuster unless the public option is stripped from the bill that Senators have been debating on the Senate floor.
"I'll feel more comfortable when its out," said Sen. Joe Lieberman, a Connecticut independent who caucuses with Democrats. "I don't understand exactly what's in this new proposal so I want to see it if its private and there's no federal government financial exposure and the government is not creating an insurance company, well that's one way."
But the proposal is still in its planning stages and must be fleshed out. That could further delay the floor debate as Democrats try to meet the latest in a series of self-imposed deadlines, passing a bill through the Senate this year.
Internal disagreements about the public option reflect a wide gap in the Democratic Party. Some, such as Sen. Arlen Specter of Pennsylvania, support a more robust public option plan.
"It isn't a single payer [system] and it is not going to add to the deficit. It's going to be a level playing field," the former Republican said at a joint news conference with Sen. Susan Collins, R-Maine, and Lieberman. "I would invite everyone to read the fine print."
Asked whether his final vote will be determined on the public option, Specter said, "I'm not going to make any concessions ... on a strong public option."
Sen. Ron Wyden, D-Ore., said on ABC's "Top Line" Thursday that the public option as structured in the Senate health care bill would result in a pool insuring only the unhealthiest, unless it's available to all Americans.
"My concern is you can't let the public option be something of a health care ghetto," Wyden said. "Right now, it looks like the folks that are going to be getting into it are people that haven't had insurance. The evidence shows that those are folks who didn't get check-ups, didn't get prevention, didn't get chronic care or maintenance."
Some Democrats are on the opposite side of the spectrum and want to nix the option altogether.
Reid is walking a fine line with the public option. He has attempted to appease all sides by offering a public option plan in an insurance exchange, yet it would be one that's only open to the uninsured and which states would be able to opt out of.
But he could lose votes of his own party members and that of the lone Republican who sided with the Democrats, Sen. Olympia Snowe of Maine, who has repeatedly said she does not want to see a public option in the final bill.
The House bill, passed in early November, offers a public option, although the Congressional Budget Office forecasted that premiums for it would be more expensive than for policies sold by private firms.
"This is a philosophical difference so it is not easily compromised," Collins, a moderate Republican, told reporters Friday.
Still, Feingold says Democrats are getting closer to a compromise.
"I am cautiously optimistic that we're going to be able to pull everybody together," he said.
Abortion continues as a hot topic as Nelson prepares to offer an amendment on Monday with strict abortion restrictions, similar to the Stupak amendment that passed in the House health care bill. The language in the Reid bill restricts the use of public funds for abortion services but Nelson wants to take the restrictions beyond that.
Despite the liberal outrage about his abortion proposals, the moderate Democrat has threatened to reject the final bill if it is not included, putting an all-important 60-vote count in jeopardy.
"At the end of the day, we need Senator Nelson's vote," Sen. Dick Durbin of Illinois said Friday. "We still don't have a promise of a vote from the Republican side, so we would need his vote."
The House bill includes an amendment by Rep. Bart Stupak, D-Mich., that would not only cut federal funding for abortion-related services, but limit access to abortions for people who would receive federal subsidies and would have to buy insurance through a health insurance exchange.
One of the ways to pay for the Senate legislation, which would cost $849 billion over 10 years, according to the nonpartisan Congressional Budget Office, would be through cuts in Medicare, as well as cost savings.
Democrats defeated Thursday a proposal by Sen. John McCain, R-Ariz., to shelve the legislation until lawmakers find a way to fund it other than by cuts in Medicare. But lawmakers unanimously approved a proposal by Sen. Michael Bennett, D-Colo., that the bill cannot restrict current Medicare benefits in the future, while at the same time leaving $460 billion in Medicare cost savings.
Republicans assailed the measure, calling it a sham.
"Seniors do not want senators fooling with Medicare," McConnell of Kentucky said. "They want us to fix it, to strengthen it, to preserve it for future generations, not raid it like a giant piggy bank in order to create some entirely new government program. Yesterday's vote was particularly distressing for the nearly 11 million seniors on Medicare Advantage."
The House bill also pays for the $1.2 trillion costs over 10 years with more than $400 billion in cuts in Medicare spending over the same period.
Women's Health Coverage
Democrats Thursday passed, by a vote of 61-39 and some bipartisan support, a proposal by Sen. Barbara Mikulski, D-Md., that would require insurers to cover and provide women access to preventive screenings such as mammograms in the basic health care overhaul plans. It also mandates that all health plans cover women's preventive care and screenings with no copayments. The proposal is expected to add nearly $1 billion to the overall cost and was rejected by two Democrats.
Reid hailed Mikulski's measure.
"Sen. Mikulski of Maryland -- who for decades has been a champion for women's health -- made it better by making sure women can get the mammograms, check-ups and other preventive tests they need to stay healthy, and get them at no cost," Reid said on the Senate floor
Sen. Lisa Murkowski, R-Alaska, offered an alternative, saying the government should not determine health guidelines based on the recommendations of the government-appointed U.S. Preventive Services Task Force, which made the controversial recommendation last month that women didn't require mammograms as frequently and women between 50 and 74 should have it every other year instead of annually. The amendment, which would also have barred abortion from being considered as a preventive service, was rejected.
GOP: No Voter Support for Health Overhaul Bill
McConnell argued Saturday that Republicans are responding to public pressure to oppose the legislation.
"What I hear the American people saying to us, 'Vote for this bill and you'll be history," McConnell said on the Senate floor. "This is not in the gray area. The American people are asking us to stop this bill and start over."
In a heated exchange, McCain accused Democrats of hatching a deal with medical industry lobbyists behind closed doors to get their support for the bill despite cuts to Medicare home health services.
"I don't know what the deal was cut that bought them, but I know deals have been going on and I know they are unsavory," McCain said.
A Republican amendment that would have sent the bill back to the Senate Finance Committee to restore home health care cuts failed 41-53 Saturday. A Democratic amendment stating that nothing in the bill would result in the reduction of home health care benefits passed 96-0.
At a news conference, Republican leader McConnell was asked to speculate on why Democrats were keeping the Senate working on weekends. He argued that Democrats thought Republicans would blink if forced to work on weekends but he vowed they would not.
But even among Democrats, deep divisions remain, guaranteeing a rocky road as the debate approaches its final phases, with a vote expected by month's end.
Meanwhile, moderate and liberal Democrats and a few moderate Republicans are negotiating behind closed doors on a health care bill that would get the 60 votes it needs to pass on the floor. Republican senator Olympia Snowe participated in a separate meeting with moderate Democrats Saturday.
Senators Thursday voted on four amendments in the 2,000-plus-page legislation, mostly on party lines. Nearly 72 amendments have been proposed for the bill, crafted chiefly by Reid.
Lieberman, Specter and Collins introduced what they hailed as a "tri-partisan" amendment expanding measures in the Reid bill and introducing more cost containments. But even as the three promoted health care overhaul and their joint proposal, they publicly sparred over provisions, mainly the "public option."
ABC News' Jennifer Parker, Huma Khan, Dean Norland, Jake Tapper and David Kerley contributed to this report.