Centrists Could Give Reid Trouble on Healthcare

A handful of centrist Democrats with Sen. Olympia Snowe, R-ME, could pose a major problem for Senate Majority Leader Harry Reid, D-NV, as he tries to bring major healthcare reform legislation to the Senate floor.

Snowe, in concert with Sen. Ben Nelson, D-NE, has hosted a group of about five to six moderates, including Sens. Joe Lieberman, D-CT, Mary Landrieu, D-LA, Blanche Lincoln, D-AR, and, at times, Susan Collins, R-ME.

Senate Majority Leader Harry Reid, D-NV, will need 60 votes to start debate on healthcare in the coming weeks, but centrist Democrats seem to be girding for a possible fight, should Reid put anything in the bill with which they do not agree.

Several members of this group have expressed concern already with the possibility that a government-run insurance plan could emerge from closed-door talks in the Majority Leader's office, though they are not outright opposed to a public option, in general.

Sen. Kent Conrad, D-ND, and a number of senior Democratic officials, have said a national public option, giving states the ability to opt out if they can provide substantially-competitive coverage to the uninsured and underinsured, is becoming more popular in negotiations among Senate Democratic leaders and White House officials.

Snowe, who has also met regularly with Administration officials, including recently with senior health adviser Nancy-Ann DeParle, ever present at the Reid meetings, called the emerging proposal "just another public option. I do not support it."   Snowe went one step further and warned that any inclusion of this "opt out" measure would cause her to withhold her support from proceeding to the bill.

Her "no" vote alone would not be enough to stop the bill from moving forward, but in what could be an ominous sign for Reid, Nelson called the "opt out" public option a "difficult option" and wondered how difficult it would be for states to opt out, adding, "I've not said my cloture vote is a given here."

That would put Reid one vote short of the 60 he would ineed to invoke cloture and proceed to debating healthcare. But Nelson might not be alone.  Sen. Blanche Lincoln, D-AR, in a difficult re-election race back home, said she had a lot of questions about this national opt out public option.

Another big concern in the group, the ability to see the bill in time before debate starts.  Snowe said she wants to examine and "hold tutorials" on what's in the bill before it even heads to the Congressional Budget Office (CBO), the nonpartisan agency that analyzes and tallies the price of legislation.

"Rushing it to CBO before making sure the policy is right" is not the way to go, Snowe said, adding that once the Senate is officially on the bill, it's "harder to get 60 votes to strip things out."

Lincoln and Nelson, both, echoed those concerns, viewing the closed door negotiations as their best opportunity to get the bill in an acceptable form, rather than go through legislative and procedural gymnastics.

Snowe said her goal, shared by some of her centrist colleagues, is "not to rush this train out of the station."  The senator pointed to a vote Reid lost on Wednesday related to Medicare doctor reimbursements, the same kind of procedural motion that will come on a broader healthcare reform bill, as "a warning" to Reid, saying that could easily happen on the bigger bill.

Still another centrist Democrat, who asked not to be named to speak more freely about negotiations, said, "Mark my word, the trigger will be the public option in the Reid bill."

This senator was referring to a proposal by Snowe that would, at some point soon after the overhaul takes affect, authorize a government-run insurance plan if reform efforts proved unsucessful in bringing insurance costs down.

No doubt Democrats in the centrist healthcare group are in the middle of a tug-of-war for their cloture vote.  More liberal senators who really want a robust government-run insurance plan have said that those who are opposed to it should just get out of the way on cloture and then vote "no" on final passage, when Reid only needs 51 votes to succeed.

Reid has said he would make the bill and a full CBO score available to members before bringing the bill to the floor, but even this small group could sideline the effort, if they do not go along.