By Andy Sullivan
WASHINGTON, Aug 21 (Reuters) - Democrats in the U.S. Congress hope to pass President Barack Obama’s overhaul of the country’s $2.5 trillion healthcare system amid mounting public skepticism and unified opposition from Republicans.
Here are some scenarios that could unfold when Congress returns on Sept. 8 from a monthlong break:
WAIT FOR REPUBLICANS
Obama and Democratic leaders have said repeatedly that they hope to win Republican support to build legitimacy in the eyes of the public, but so far it has not been forthcoming.
No Republicans voted for the healthcare bills that have cleared three committees so far in the House of Representatives and one in the Senate.
Democrats do not need Republican cooperation to pass legislation out of the House, and in the Senate they control 60 of the chamber’s 100 seats, enough to pass legislation without Republican support. But two Democratic stalwarts, Edward Kennedy and Robert Byrd, are in poor health and might not be able to vote.
Democratic Senator Max Baucus hopes to craft a compromise with three Republicans on his Finance Committee -- Charles Grassley, Olympia Snowe and Mike Enzi. But months of discussion have so far not resulted in a bill.
Other Democrats are growing impatient and have suggested moving ahead on their own if the group doesn’t reach a deal by Sept. 15.
PASS IT IN PIECES
Democrats could also split healthcare reform into pieces. Controversial aspects that would require new government spending might be brought up for a vote under special Senate rules that prevent opponents from forcing a 60-vote majority. Instead, it would allow budget-related bills to pass with the support of a simple majority of 51 of the chamber’s 100 senators.
The most controversial element of the package, which would create a public health plan to compete with private insurers, could be brought up for a vote under this method.
This would infuriate Republicans, putting other elements of Obama’s agenda at risk, and could result in a piecemeal effort that does nothing to control costs.
Less-controversial aspects that would reform unpopular insurance practices, such as denying coverage to applicants that already have health problems, would be brought up under the Senate’s normal rules since supporters think they can get at least 60 votes to overcome any procedural hurdles.
"That’s been not a first resort but a last resort," said House Majority Leader Steny Hoyer.
SCALE IT BACK
Democrats could also scale back the plan to focus on reforming the existing insurance industry, hoping that would lay the groundwork for more far-reaching reforms later on.
This could attract the votes of centrist Democrats and some Republicans but would anger Obama’s liberal supporters, who believe a public option is essential to reining in costs.
"There’s a point at which realism shades over into weakness, and progressives increasingly feel that the administration is on the wrong side of that line," liberal columnist Paul Krugman wrote in the New York Times.
CALL THEIR BLUFF
The full House is expected to vote in September, and House Speaker Nancy Pelosi said there is "no way" that bill will not contain a public option.
Senate Majority Leader Harry Reid could bring up a similar bill for a vote in his chamber, hoping that wavering moderates will support it. If the bill fails, Democrats could paint Republicans as supporters of a broken system in next year’s congressional elections. (Additional reporting by Patricia Zengerle)