Sides getting ready for final battle over health care reform

By Lisa Mascaro

Monday, March 22, 2010 | 2 a.m.

What might be the final chapter of the long-fought battle over health care reform could open this week in the Senate.

As the House worked over the weekend to pass the bill, Senate Majority Leader Harry Reid attended a rare Saturday meeting of House Democrats to assure them that his often unruly Senate majority is on board and intends to pass the bill by the end of this week.

But Senate Republicans are not about to let this final battle end easily.

They believe they have the power of public opinion on their side and are willing to take dramatic steps, even bringing the Senate to a standstill, to stop the bill.

Sen. Lamar Alexander of Tennessee, part of the Republican leadership team, said opponents of the bill plan to go through it “sentence by sentence” as they raise challenges on the Senate floor.

House Democrats were hesitant to vote on the version of the bill that the Senate approved Christmas Eve, fearing changes they hope to make in simultaneous legislation would falter in the Senate. If the Senate failed to pass that secondary bill, House Democrats would be left owning many of the Senate provisions they oppose: the Cornhusker Kickback, as well as taxes and subsidies they are changing in their mop-up bill.

Republicans have increasingly tapped into this worry, reminding anxious House Democrats that they have no guarantee the Senate will hold up its end of the bargain.

Republicans are furious over Democrats’ decision to use the reconciliation procedure to pass the subsequent bill, a process that requires just a 51-vote majority in the Senate rather than the 60 that is typically needed to advance legislation.

Yet Democrats’ decision to use the reconciliation process affords Republicans the opportunity to challenge the bill and offer unlimited amendments.

“We have a responsibility that the rules of the Senate aren’t abused, and the people of the country expect us to do that,” Alexander said.

Theoretically, such objections could extend indefinitely, until one side wears the other out. During traditional reconciliation debates this has led to a rapid-fire succession of votes that earned the nickname “vote-o-rama.”

“I would imagine there would be some significant time devoted to amendments,” a senior Republican aide said. “I don’t think our senators, after fighting for this for over a year, are going to give up without taking as long as possible.”

Yet it is hard to know how far Republican opponents of the $940 billion health care overhaul will go to make their case. They are under great pressure from the restive Tea Party contingent and their conservative flank to make a dramatic stand.

Still, several Republicans bristled this month when Republican Sen. Jim Bunning of Kentucky shut down the chamber over his objections to extending unemployment benefits with emergency funds.

It is unclear if Republicans will risk being seen as obstructionists, prolonging the inevitable, at a time when voters want both parties to address jobs and the economy. Talk of extending the floor debate into Easter has cooled as some think it would not be logistically possible.

Sen. Judd Gregg of New Hampshire, the top Republican on the Budget Committee who is leading his party’s efforts in the Senate, implied he was looking for quality attacks over quantity.

Gregg is zeroing in on a few amendments that he thinks could deliver knockout punches to the bill. For example, the House’s changes to the excise tax on high-priced insurance plans — the so-called Cadillac tax — do not comply with reconciliation process rules because they add revenue to Social Security, which is off-limits for any changes under reconciliation.

If Republicans could strike a provision in the House bill, it would send the legislation back to that chamber for another vote. Killing a major provision like the excise tax would be a complication the House would likely struggle to resolve. The tax is a needed revenue source.

Reid is confident the Senate will pass the bill by week’s end.

The majority leader has been working behind the scenes — meeting with senators, House leaders and remaining in constant contact with the White House, including speaking with President Barack Obama.

Staff from both Democratic and Republican Senate offices have been meeting with the Senate parliamentarian to review the bill — Democrats seeking assurances the provisions will withstand challenges, Republicans looking for vulnerabilities.

And Democratic senators have penned a letter assuring House Democrats they have their back.

This week, Reid’s Senate, again, could write a crucial — possibly final — chapter in the long health care debate.