WASHINGTON — A White House-backed overhaul of the nation's health care system survived a long day of Republican challenges over abortion, illegal immigration and other issues Wednesday, and the bill's architect claimed enough votes for passage by the Senate Finance Committee, possibly by the end of the week.
Emotions in Congress are running high as both houses edge nearer to floor votes on the legislation that is President Barack Obama's top domestic priority. Republicans expressed outrage that one House Democrat summed up their alternative as an invitation to sick Americans to "die quickly."
"We're coming to closure," said Sen. Max Baucus, D-Mont., the Finance Committee chairman who has presided over daily sessions that began last week and occasionally stretched deep into the evening. "It's clear to me we're going to get it passed."
Baucus sidestepped when asked if he expected any Republican support. Olympia Snowe of Maine is the only GOP senator whose vote is in doubt, and she has yet to tip her hand. While she has voted with Democrats on some key tests — to allow the government to dictate the types of coverage that must be included in insurance policies, for example — she has also sided with fellow Republicans on other contentious issues.
Passage would clear the way for debate on the Senate floor on the bill, designed to accomplish Obama's aims of expanding access to insurance as well as slowing the rate of growth in health care spending overall. The bill includes numerous consumer protections, such as limits on co-pays and deductibles, and relies on federal subsidies to help lower-income families purchase coverage. Its cost is estimated at $900 billion over a decade.
While the legislation would not allow the government to sell insurance in competition with private companies, as Obama and numerous Democrats would like, the White House was working to make a version cleared committee. Sen. Jay Rockefeller of West Virginia, a Democrat who has been outspoken in his criticism of features of the bill, said Obama called him earlier in the day to seek support. "I was noncommittal," the senator said.
The committee met as Senate Majority Leader Harry Reid of Nevada announced the full Senate would begin debate on health care legislation the week of the Columbus Day holiday. Initial action is expected to be slow, consumed largely with parliamentary maneuvers in which Democrats try to set the stage for passage and Republicans erect a 60-vote hurdle as a test vote.
The precise details of the bill brought to the Senate floor will be determined by Reid, in consultation from the White House and Democratic leaders of the Finance Committee and a panel on health, education, labor and pensions.
In the House, a Democratic lawmaker angered Republicans when he summed up their health care alternative as the GOP wanting Americans to "die quickly" if they get sick. Rep. Alan Grayson of Florida has refused to apologize for his remarks on the House floor Tuesday night.
Republicans are likening the remarks to Rep. Joe Wilson's widely criticized shout of "You lie!" during Obama's address to Congress earlier this month. They say Democrats should insist that Grayson apologize just as they insisted Wilson, R-S.C., should.
Inside the Senate Finance Committee, Democrats rejected attempts by Republicans to insert stronger anti-abortion provisions into the measure, as well as proposals to require photo identification to prove eligibility for benefits under federal health programs for the poor.
Sen. Orrin Hatch, R-Utah, argued that provisions already in the bill to restrict federal funding for abortions needed to be tightened to guarantee they would be ironclad. He said his goal was to incorporate the restrictions into law, "so we don't have to go through it every year."
In recent years, Congress has prohibited federal funding for most abortions through annual spending bills, and Hatch's proposal would have eliminated the need for those yearly votes.
But abortion rights supporters said the proposal would have expanded the current restrictions, and could deny coverage for abortions to working women signing up for coverage through private plans.
Its approval would be a "poison pill ... if it is hung on this legislation," said Sen. Maria Cantwell, D-Wash.
The committee also rejected a proposal from Hatch to strengthen existing legal protections for health care professionals who refuse to perform abortions or other procedures on grounds of moral or religious objections.
Both failed on nearly party line votes of 13-10, with Snowe siding with most Democrats in opposition, and Kent Conrad, D-N.D., voting with Hatch.
Republicans also failed in their attempts to require applicants for federal health programs to furnish photo identification as proof of eligibility, an issue that dealt with illegal immigrants. Charles Grassley, R-Iowa, said the goal was to prevent fraud, but Bob Menendez, D-N.J., said the proposals went beyond a required birth certificate required as proof of citizenship.
Conservatives also are determined to strengthen prohibitions against illegal immigrants getting federal funding to buy insurance.
Grassley offered an amendment he said was designed to cut fraud in health care programs for the low-income. It would have required applicants to present a government-issued ID when applying for Medicaid or the children's health care program.
But Democrats said unscrupulous medical providers — not beneficiaries — are usually the ones responsible for fraud. They said current ID requirements for beneficiaries are strong enough.