Democrats pursue trade-off

WASHINGTON -- With time growing short, Senate Democratic liberals are seeking expansion of two federal programs, Medicare and Medicaid, as part of a compromise that drops a government insurance option from health care legislation sought by President Barack Obama, several lawmakers said Monday.

Under the potential trade-off with party moderates, near-retirees starting at age 55 or 60 who lack affordable insurance would be permitted to buy coverage under Medicare, which generally provides medical care starting at 65. Medicaid, the federal-state health care program for the poor, would be open to all comers up to 150 percent of poverty, slightly more than $33,000 for a family of four.

The compromise under discussion envisions private insurance companies selling national, nonprofit plans, to be overseen by a federal agency, an alternative to a long-standing call by liberals for the government to sell insurance as a means of forcing competition on the industry.

"It's one of those kind of things in the middle that doesn't make everybody very happy, but that's our compromise," Sen. Tom Harkin, D-Iowa, said after talks ended for the day. "It's something I'm going to probably have to live with."

Harkin also said Majority Leader Harry Reid had imposed a deadline of today on the talks as he tries to complete work on the legislation in the next few weeks.

While Harkin and others spoke with optimism, few details were available. It was unclear what the legislation would provide if no insurance company agreed to sell a nationwide nonprofit plan.

Senators and aides said the changes have been discussed in recent days as a small group of moderate and liberal Democrats search for a middle ground to assure passage of the bill atop Obama's domestic agenda.

Also, the president met privately at the White House over the weekend with Sen. Olympia Snowe of Maine, who supported a Democratic-drafted bill in the Senate Finance Committee earlier this year but has spoken out against the legislation pending on the floor. Senate Democrats have been in contact with Snowe in recent days too.

As the search for compromise intensifies, several Democrats said a plan by Sen. Maria Cantwell, D-Wash., was receiving new interest as a way of injecting more competition into the insurance system. The plan gives states an option to negotiate with private industry to provide less expensive group coverage for lower-income residents. Currently, the bill allows that for any state's residents up to twice the federal poverty level, about $44,000 for a family of four, but that could be raised if negotiators decide they want to do so.

"There's push and pull," said Sen. Chuck Schumer, D-N.Y., who has been involved in the talks. "We have to find the right balance that satisfies the party as to how much government involvement there should be and how much private involvement."

Democrats need 60 votes to pass their bill over Republican objections, and while liberals far outnumber moderates inside the party, they appear at least four votes short of the number needed. That gives moderates such as Sens. Blanche Lincoln of Arkansas, Mary Landrieu of Louisiana, Ben Nelson of Nebraska and Joe Lieberman, an independent from Connecticut, leverage as White House officials and Reid try to complete work on the bill.

The legislation is designed to expand coverage to more than 30 million who lack it, while curbing insurance industry practices and restraining the growth of medical spending.

The closed-door talks have proceeded while Republicans on the Senate floor have mounted challenges to the health care bill. They have failed to win any major changes.

The latest such maneuver came when the Senate rejected an attempt by Sen. Judd Gregg, R-N.H., to prevent Medicare from "being raided" to pay for health care. The vote was 43-56. The bill calls for cuts totaling $460 billion over a decade from projected Medicare spending, much of which would be used to provide subsidies to help lower and middle-income Americans buy health care.

Another contentious issue is slated for a vote today, when conservatives from both parties try to stiffen abortion restrictions in the legislation.

Reid angered the GOP on Monday by likening that opposition to the Senate health care bill to those who fought against abolishing slavery, a woman's right to vote and civil rights legislation.

"Instead of joining us on the right side of history, all Republicans can come up with is this: Slow down, stop everything, let's start over. If you think you've heard these same excuses before, you're right," Reid said.

Republicans denounced the majority leader's comments. Sen. John McCain, R-Ariz., demanded that Reid return to the Senate floor, "if not (to) apologize, certainly (to) clarify his remarks."