President Barack Obama and congressional allies signaled Wednesday they may try to scale back his sweeping health care overhaul to keep parts of it alive in the wake of a stinging rebuke in the Senate race in Massachusetts.
A simpler, less ambitious bill emerged as an alternative only hours after the loss of the party's crucial 60th Senate seat forced the Democrats to slow their all-out drive to pass Obama's signature legislation despite fierce Republican opposition. The White House is still hoping the House can pass the Senate bill in a quick strike, but Democrats are now considering other options.
No decisions have been made, lawmakers said, but they laid out a new approach that could still include these provisions: limiting the ability of insurance companies to deny coverage to people with medical problems, allowing young adults to stay on their parents' policies, helping small businesses and low-income people pay premiums and changing Medicare to encourage payment for quality care instead of sheer volume of services.
Obama said the election results wouldn't sour his interest in passing a health care bill.
"Now, I could have said, 'Well, we'll just do what's safe, we'll just take on those things that are completely non-controversial,'" Obama said in an interview with ABC News. "The problem is: the things that are non-controversial end up being the things that don't solve the problem."
Yet, the goal of trying to cover nearly all Americans would be put off further into the future.
Obama urged lawmakers not to try to jam a bill through, but scale the proposal down to what he called "those elements of the package that people agree on."
"We know that we need insurance reform, that the health insurance companies are taking advantage of people," the president said. "We know that we have to have some form of cost containment because if we don't then our budgets are going to blow up. And we know that small businesses are going to need help."
One potential Republican convert for health care legislation remained an enigma. Sen. Olympia Snowe of Maine, who has been in regular contact with Obama, roundly criticized the Democrats' hard push to pass their bill. But she would not rule out voting for something in the end.
Asked if the Democratic bills are dead, Snowe responded: "I never say anything is dead, but clearly I think they have to revisit the entire issue."
Some Democrats weren't ready for that, despite the president's new words.
One option, still alive and stirring strong emotions, called for the House to quickly pass the Senate version of the broader bill — simply accepting it and therefore bypassing the Senate problem created by the loss of the Massachusetts seat to Republican Scott Brown. But that appeared to be losing favor.
"That's a bitter pill for the House to swallow," said the No. 2 Senate Democrat, Dick Durbin of Illinois.
"Full speed ahead is off the table," said Rep. Earl Pomeroy, a moderate Democrat from North Dakota. "We are still very much in the exercise of drawing meaning from the public disquiet."
Nevertheless, the quick approach remained on the table, despite some House members' deep misgivings. In fact, administration officials were working behind the scenes on that idea, which would be the fastest and cleanest route to getting a bill to Obama, said a senior administration official, who spoke on condition of anonymity to more freely describe private talks.
House Speaker Nancy Pelosi and other Democratic leaders were gauging support for the idea among liberals and moderates. The initial reaction was not encouraging.
"If you ran that Senate bill right now on the House floor, I'll bet you would not get 100 votes for it," said Rep. Bart Stupak, D-Mich.
It takes 218 votes to pass legislation. A majority of House Democrats oppose a tax on high-cost insurance plans in the Senate bill that unions see as a direct hit on their members. Stupak and other abortion opponents, backed by Catholic bishops, say the Senate bill falls short in restricting taxpayer dollars for abortion.
A week ago, House and Senate Democrats were working out the differences in their respective bills, and a quick resolution seemed likely. But feuding broke out after Brown's upset victory secured the seat held by the late Sen. Edward M. Kennedy for the GOP.
Some Democratic senators suggested it was up to the House to save the day by passing the Senate bill.
"The Senate has passed the health care bill. The House has to make a decision how they want to proceed," said Sen. Patty Murray, D-Wash., a member of the leadership.
Republicans said that would make their day.
Trying to push the Senate bill through would be a desperate ploy seen as such by voters, said Sen. John McCain, R-Ariz., Obama's 2008 presidential rival. "If they try to jam it through the House, they'll pay a very heavy price."
As the day wore on, those urging moderation seemed to be winning the argument.
"We're not going to rush into anything," said Senate Majority Leader Harry Reid, D-Nev. "We will wait until the new senator arrives."
Many Democrats are wary of starting over with the goal of drafting a bill that reaches for the political middle. They doubt they'll get any cooperation from Republicans.
"You cannot dance with someone if they are not willing to dance with you," said Sen. Robert Menendez, D-NJ. He called GOP complaints that the Democrats wrote a partisan bill "pretty lame, when they have made a political calculation that their path to victory is to have the president fail."
But House Majority Leader Steny Hoyer, D-Md., said a more modest approach would be a "reasonable alternative" that could appeal to the public even if Republicans still oppose it.
"Given the public concern, I think that we ought to focus on that which...the public can support and will be positive in terms of making health care more affordable and obtainable," he said.
Instead of one big bill, health care overhaul could be broken into chunks and passed over time.
"Medicare wasn't done in one fell swoop," said House Majority Whip Jim Clyburn, D-S.C. "You lay a foundation and you get this thing done over time."
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