GOP regroups for Senate health showdown

By David Lightman

McClatchy Newspapers

WASHINGTON - The final lap of the historic health-care marathon is expected to begin today in the Senate, where Democrats are confident they have the votes to complete revamping the nation's health-care system.

First, though, the measure must survive a last-ditch effort by Republicans to derail it. Their major challenge is expected to involve Social Security policy, and the outcome could depend on the Senate parliamentarian's ruling.

At the White House today, President Obama plans to sign the Senate-authored health-care bill that the House approved Sunday night, 219-212. A South Lawn ceremony is planned, to which Obama is inviting all lawmakers who supported the bill, press secretary Robert Gibbs said.

In a formality before Obama's own signature, House Speaker Nancy Pelosi (D., Calif.) signed the bill yesterday, saying, "Last night we made history."

Once Obama signs it, the Senate will consider a so-called reconciliation package of House changes to the measure.

Debate on the package will be limited to 20 hours, and 51 votes will be needed to pass it. Democrats control 59 of the 100 Senate seats, but they expect to lose the votes of some of their conservatives.

Sen. Blanche Lincoln (D., Ark.), who faces a difficult reelection campaign, said she would oppose the measure, contending that the reconciliation package "wasn't subject to the same transparency and thorough debate that we used in the Senate."

Sen. Ben Nelson (D., Neb.) also said he would oppose it. Nelson objects to a proposed restructuring of the student-loan program that is included in the measure that he said could eliminate 30,000 banking-industry jobs, some in Nebraska.

Republicans began their Senate assault yesterday, as Minority Leader Mitch McConnell of Kentucky contended that Democrats "want us to endorse a raft of new sweetheart deals that were struck behind closed doors last week so this thing could limp over the finish line."

The White House is countering with its own campaign. Obama plans to promote the legislation Thursday in Iowa City, Iowa, where he laid out his health-care proposal as a candidate in 2007.

The reconciliation package, which the House approved Sunday night, 220-211, with no Republican support, would provide more government help with insurance premiums for lower- and middle-class families, more prescription-drug benefits for most Medicare beneficiaries, and help for states with Medicaid, the state-federal health program for lower-income people.

It would also delay a new tax on high-end insurance policies to 2018, and increase the Medicare payroll tax for the wealthy. Single people who earn more than $200,000 annually, and joint filers who make more than $250,000, would see the tax go up 0.9 percentage point in 2013, to 2.35 percent. They would also pay a 3.8 percent tax on dividends, interest, and other unearned income.

The complicated two-step approval process for the health-care overhaul was made necessary because Senate Democrats lost their filibuster-proof supermajority in a special Senate election in Massachusetts in January. The reconciliation measure will be considered under fast-track Senate rules that do not allow minority-party filibusters.

Republicans, though, plan a two-pronged effort to stop the Democratic plan, through parliamentary challenges and amendments.

GOP leaders think they have a potent weapon for the fall midterm election campaigns as well as the moral high ground in the health-care debate, and they are echoing the argument made by Sen. Jim DeMint (R., S.C.).

"Unless this trillion-dollar assault on our freedoms is repealed, it will force Americans to purchase Washington-approved health plans or face stiff penalties," DeMint said.

Obama's 2008 presidential election rival, Sen. John McCain (R., Ariz.), told ABC's Good Morning America he was repulsed by "all this euphoria going on" over the health bill's passage.

"Outside the Beltway, the American people are very angry," he said. "They don't like it, and we're going to repeal this."

The repeal movement was becoming popular quickly among conservatives. Former New Hampshire Attorney General Kelly Ayotte, a Republican Senate candidate, said yesterday that if elected, "I'd be the first to back this [repeal] bill," because "New Hampshire citizens tell me every day that they don't want a federal takeover of health care."

Republicans' best hope for thwarting the Democrats in the Senate probably lies in the parliamentary process. Under the "Byrd rule," named for Senate master tactician Robert C. Byrd (D., W.Va.), reconciliation measures must relate directly to the federal budget process.

One key Republican test centers on Social Security. The measure would delay a Senate-approved excise tax on high-end insurance policies by five years, until 2018. That delay, Republicans say, would encourage employers to continue offering more elaborate insurance policies in lieu of increasing wages. Since wages up to a certain level are subject to Social Security tax, the change is likely to mean less Social Security revenue.

Reconciliation is not supposed to affect Social Security, Republicans contend. If Senate Parliamentarian Alan Frumin agrees, Democrats could need 60 votes to overturn his ruling - a difficult hurdle - and a failure to get those votes would effectively scuttle the reconciliation measure.

Staffers from both parties met with Frumin for an hour yesterday, and a spokesman for McConnell said he issued an informal guidance suggesting he disagreed with the Republicans' challenge of the legislation.

"I'm confident the parliamentarian will see the fallacy of the argument," said Sen. Jeff Bingaman (D., N.M.).

Amending the reconciliation bill is expected to be difficult, but Republicans see political gain from forcing Democrats to go on the record on controversial issues. Republican leaders are discussing amendments that would reduce the size of proposed cuts to Medicare, cut back the Medicare tax increase, and scale back the health-care legislation's $938 billion price tag.