WASHINGTON --- Senate Democratic liberals are seeking expansion of two large federal programs, Medicare and Medicaid, in exchange for dropping a government-sold insurance option from health care legislation sought by President Obama, several lawmakers said Monday.
Under the potential trade-off with party moderates, near-retirees beginning at age 55 or 60 who lack affordable insurance would be permitted to purchase coverage under Medicare, which generally provides medical care beginning at 65. Medicaid, the federal-state health care program for the poor, would be open to all applicants under 300 percent of poverty, or slightly over $66,000 for a family of four.
Senators and aides said the changes have been discussed extensively in recent days as a small group of moderate and liberal Democrats search for a middle ground to assure passage of the bill atop Mr. Obama's domestic agenda.
Given the complexities of the two programs, and the White House's goal of passing legislation by year's end, it wasn't clear whether the negotiations would ultimately prove successful, or whether they merely were a last stab by liberals to salvage some concession in a monthslong debate.
Senate Majority Leader Harry Reid, D-Nev., imposed a deadline of today to complete the talks, according to Sen. Tom Harkin, D-Iowa, a participant in the negotiations.
"It's one of those kind of things in the middle that doesn't make everybody very happy but that's our compromise," Mr. Harkin said. "It's something I'm going to probably have to live with."
As the search for compromise intensifies, several Democrats said a plan by Sen. Maria Cantwell, D-Wash., was receiving new interest. It gives states an option to negotiate with private industry to provide 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 discussions. "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."
Said Senate Finance Committee Chairman Max Baucus, D-Mont.: "It's probably the closest proposal thus far that could get the support of 60 senators. It's got legs."
Several party officials said the negotiations involving the two wings of the Democratic caucus had given Sen. Mark Pryor, D-Ark., a newly prominent role on the health care legislation, and he has held several meetings in recent days designed to facilitate a compromise.
The closed-door talks have proceeded while Republicans on the Senate floor have mounted a series of challenges.
The latest 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 purchase health care.
KEY ABORTION VOTE TODAY
Another contentious issue is slated for a vote today, when conservatives from both parties try to stiffen abortion restrictions in the legislation.
The bill requires insurance companies to offer policies that both provide and lack abortion coverage in any state where they offer coverage under a new marketplace where consumers shop for government-regulated insurance policies.
Any consumer who receives federal subsidies to defray the cost of insurance would be required to use personal money to pay for abortions, except in cases of rape, incest or if the life of the mother was in jeopardy.
Conservatives led by Sen. Ben Nelson, D-Neb., and Orrin Hatch, R-Utah, want to ban any insurance plan from providing most abortions if any of their policyholders receive a federal subsidy, a stronger restriction that is more in line with the provisions in the House-passed bill, and unlikely to command the 60 votes needed to prevail.
-- Associated Press