Obama puts heat on Senate to speed health bill

WASHINGTON — The White House, concerned the congressional timetable for passing a health-care overhaul could slip into next year, is stepping up pressure on the Senate for quick action, with President Obama appearing Sunday in the Rose Garden to call on senators to "take up the baton and bring this effort to the finish line."

Obama's remarks came less than a day after the House narrowly approved a landmark plan that would cost $1.1 trillion over 10 years and extend insurance coverage to 36 million uninsured Americans. The president called it "a courageous vote."

But the votes had barely been counted when the White House turned its attention to an even bigger hurdle: getting legislation passed in the Senate.

In the Senate, where proposals differ substantially from the House measure on issues like a government-run plan and how to pay for coverage, the bill is stalled while budget analysts assess its overall costs.

The slim margin in the House — the bill passed with just two votes to spare, and 39 Democrats opposed it — suggests even greater challenges in the Senate, where the majority leader, Harry Reid of Nevada, is struggling to hold on to all 58 Democrats and two independents in his caucus.

While Democrats were forced to make major concessions on insurance coverage for abortions to win House passage of the bill, they were nonetheless ebullient on Sunday, with many saying the vote gave them momentum to push the bill forward.

"For years we've been told that this couldn't be done," Obama said in the Rose Garden. Of the American people, he said, "Moments like this are why they sent us here."

But for all the exultation, there was a sense inside the White House and on Capitol Hill that the hardest work is yet to come.

The House debate highlighted the pressures that will come to bear on senators as they weigh issues like federal financing for abortion, coverage for illegal immigrants and the "public option," a government-backed insurance plan to compete with the private sector.

In the Senate, Reid has merged two bills into one. The fine print is not public, but the broad outlines are known.

Unlike the House bill, which pays to extend coverage by taxing individuals who earn more than $500,000 a year and couples who earn more than $1 million, the Senate bill imposes a 40 percent excise tax on so-called Cadillac plans that cost more than $8,000 a year for an individual or $21,000 for a family.

And unlike the House bill, which includes a national public plan, the Senate measure would allow states to opt out.

But even that is too much government involvement for Sen. Joe Lieberman of Connecticut, a Democrat-turned-independent, who pledged Sunday to wage a filibuster to block any plan with a public option.

"If the public-option plan is in there," Lieberman said on "Fox News Sunday," "as a matter of conscience, I will not allow this bill to come to a final vote."

The Senate bill also faces procedural hurdles. Reid cannot bring it to the floor for debate until he gets an analysis, or "score," from the nonpartisan Congressional Budget Office, expected later this week.

The delay could push Senate consideration until after Thanksgiving, which could make it difficult for Congress to meet Obama's goal of signing a bill by Dec. 31.

Timing is crucial. Administration officials say Obama wants to wrap up health care so that he can turn his attention to other legislative priorities, including passing an energy bill and revamping financial regulations.

But they also know the closer the final vote comes to the November 2010 midterm congressional elections, the more difficult it will be to pass legislation.

Sending members of Congress home over an extended Christmas break without a health-care bill in hand could prove disastrous politically.

Democrats remember the August recess, when the Senate Finance Committee failed to meet Obama's deadline for finishing its measure, and lawmakers were pummeled in town-hall-style meetings.

"We don't want a repeat," said one Democrat, speaking anonymously to discuss strategy. "We could probably survive it, but why take the chance?"

The White House began prodding Reid to move quickly even before Saturday's House vote. In a private meeting with Obama this year, Reid pledged to work to finish the measure by the end of December.

But Tuesday, Reid said the Senate was "not going to be bound by any timelines."

Wednesday, White House Chief of Staff Rahm Emanuel visited Reid to "continue the discussion on ways to get a bill done by the end of the year," said Reid's press secretary, Jim Manley, adding Reid intends to bring the bill to the floor "as quickly as possible."

In case Reid did not get the message, Obama reinforced it Saturday night. In a statement after the House vote, he said he looked forward to signing comprehensive health legislation "by the end of the year."

A big question is whether Reid has the 60 votes almost certainly to be necessary to overcome a filibuster threat and permit debate to begin. Manley said Democrats hoped "the momentum from the House bill will make everyone realize that the Senate should at least have a chance to begin debate."

Still, he conceded there was "no glide path" toward Senate passage.

As the Senate vote draws closer, Republicans are intensifying their opposition as they try to cast Democrats as tax-and-spend liberals.

"Soon, Senate Democrats will propose their own version," Senate Republican leader Mitch McConnell said Sunday in a statement.

"We don't know how big it will be or how expensive," McConnell said, "but we do know with certainty that it will mean higher premiums, higher taxes and massive cuts to Medicare to create even more government programs. That's not reform."