Health Bill Unacceptable to Many Senators

Don't look for the Senate to quickly follow the House on health care overhaul.

A government health insurance plan included in the House bill is unacceptable to a few Democratic moderates who hold the balance of power in the Senate. They're locked in a battle with liberals, with the fate of President Barack Obama's signature issue at stake. (Read "Understanding the Health-Care Debate: Your Indispensable Guide")

If a government plan is part of the deal, "as a matter of conscience, I will not allow this bill to come to a final vote," said Sen. Joe Lieberman, the Connecticut independent whose vote Democrats need to overcome GOP filibusters. "The House bill is dead on arrival in the Senate," Sen. Lindsey Graham, R-S.C., said.

Democrats did not line up to challenge him. Senate Majority Leader Harry Reid, D-Nev., has yet to schedule floor debate and hinted last week that senators may not be able to finish health care this year.

Nonetheless, the House vote provided an important lesson in how to succeed with less-than-perfect party unity, and one that Senate Democrats may be able to adapt. House Democrats overcame their own divisions and broke an impasse that threatened the bill after liberals grudgingly accepted tougher restrictions on abortion funding, as abortion opponents demanded. See 10 players in health-care reform.

In the Senate, the stumbling block is the idea of the government competing with private insurers. Liberals may have to swallow hard and accept a deal without a public plan to keep the legislation alive. As in the House, the compromise appears to be to the right of the political spectrum.

Republican Sen. Olympia Snowe of Maine, who voted for a version of the Senate bill in committee, has given the Democrats a possible way out. She's proposing to allow a government plan, if after a few years premiums keep escalating and local health insurance markets remain in the grip of a few big companies. This is the "trigger" option. See TIME's health and medicine covers.

That approach appeals to moderates such as Sen. Mary Landrieu, D-La. "If the private market fails to reform, there would be a fallback position," Landrieu said last week. "It should be triggered by choice and affordability, not by political whim."

Lieberman said he opposes the public plan because it could become a huge and costly entitlement program.

For now, Reid is trying to find the votes for a different approach: a government plan that states could opt out of. He will keep meeting with senators this week to see if he can work out a political formula that will give him not only the 60 votes needed to begin debate, but the 60 needed to shut off discussion and bring the bill to a final vote.

Watch TIME's video "Uninsured Again."

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