Democrats close in on healthcare agreement
WASHINGTON (Reuters) - Congressional Democrats neared a deal on a landmark U.S. healthcare overhaul on Friday, with President Barack Obama pushing for quick action before a special Senate election that threatens the bill's future.
Negotiators from the House of Representatives and Senate reported fresh progress after meeting at the White House for the third straight day and said they were about to send the bill's major provisions to budget analysts for cost estimates.
"We did well today. We agreed on some things," Senate Democratic leader Harry Reid told reporters after the three-hour meeting. He provided no details.
A White House spokesman said in a statement that negotiators worked through a number of issues and would seek a cost estimate on a number of proposals. Negotiators reached no final agreement on an overall package.
"The next step in the process is to evaluate the costs and savings associated with the various proposals for each tenet of the legislation," the statement said.
The talks followed an earlier marathon session that stretched from Thursday night into the early hours of Friday. Obama stayed in that meeting until about 1 a.m. EST. Staff members will continue negotiating over the weekend.
The talks have gained new urgency as polls show the overhaul is increasingly unpopular and Democrats could lose next week's special Massachusetts election to replace the late Senator Edward Kennedy -- costing them their crucial 60th Senate vote and throwing the bill's fate into uncertainty.
Democrats are hustling to finish the bill before Obama's State of the Union speech in early February, when lawmakers hope to turn to an agenda on jobs and the economy ahead of congressional elections in November.
Negotiators expect to focus next week on working out hot-button issues like coverage for abortions and illegal immigrants, House members said.
"We are establishing common ground on some of the very few issues that were different in our bills," House Speaker Nancy Pelosi said of the talks, which also have included key committee chairmen in each chamber.
Democrats scored a breakthrough on Thursday, winning labor support for a revised tax on high-cost insurance plans that was included in the Senate bill but opposed by unions and many House Democrats.
That cleared one of the biggest remaining hurdles, but negotiators still must resolve issues on how to pay for the plan, the structure of the new insurance exchanges created under the bill, the level of expansion for the Medicaid health program for the poor and other issues.
The House and Senate versions of the overhaul must be melded into one bill and passed again by each chamber before Obama can sign it.
Both bills would extend insurance coverage to more than 30 million uninsured Americans, create exchanges where individuals can shop for insurance plans and bar insurance practices like refusing coverage to people with pre-existing medical conditions.
House-Senate negotiators looking for more revenue are considering expanding the tax for Medicare, the health program for the elderly, to income from investments by the wealthiest Americans.
They also have asked the pharmaceutical industry to kick in at least another $10 billion above the $80 billion it agreed to pay last year in a deal with the White House. Other health industries also could be asked to pay more as negotiators look to replace the $60 billion lost in the tax deal with unions.
"There's nothing that's certain ...until we put all the pieces together," House Ways and Means Committee Chairman Charles Rangel said.
The talks appear headed toward adopting a modified version of the House's national insurance exchange with perhaps an ability for states to opt out, House members said. The Senate's bill featured state-based exchanges.
"I am very pleased with what we've come up with," Representative James Clyburn, the No. 3 Democrat in the House, said of the provisions on exchanges.
Negotiators also favor the Senate approach on cuts in Medicare, and some of the elements of the Medicare Advisory Board included in the Senate bill and backed by Obama.
"That's a major issue in discussion still," Representative Chris Van Hollen said of the Medicare board, which is designed to implement payment changes with few chances for congressional interference.
Both the House and Senate have to move carefully in the talks. A shift of three votes in the House could doom the bill, which passed 220-215 in November. In the Senate, the bill passed on Christmas Eve with exactly the 60 votes it needed to overcome unified Republican opposition, and a single defection could doom it.
If the Democrats lose the Massachusetts Senate race, it would take about 15 days to certify the results, state election officials say. That might give Congress time to pass the bill if it hurries.
Robert Blendon of the Harvard School of Public Health says the Affordable Care Act's unpopularity in 12 key states will keep it a central issue in the 2014 elections. Video