Health care supporters’ eyes on Massachusetts Senate race, fearing effects of possible GOP win

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Health talks in overdrive, eyes on big Mass. vote

WASHINGTON — President Barack Obama and congressional Democrats rushed to strike final deals on historic health care legislation Friday amid rising concern that the outcome of a special Senate election in Massachusetts could sink the bill. Obama prepared to fly to the state on Sunday for last-minute campaigning.

“If Scott Brown wins, it’ll kill the health bill,” said Rep. Barney Frank, D-Mass. Frank said Democratic candidate Martha Coakley should have campaigned harder for the seat held for decades by Edward Kennedy, but he also said he thinks she’ll win Tuesday’s contest anyway.

The latest polls show an unexpectedly close race between Brown and Coakley. Brown has said he would vote against the health bill, which would probably take it down because Senate Majority Leader Harry Reid, D-Nev., does not have a vote to spare. All Republicans are opposed.

Obama taped a campaign plea that will be telephoned to Massachusetts voters, and he will campaign personally for Coakley this weekend. White House press secretary Robert Gibbs dismissed suggestions the Republican would win in Massachusetts and declared, “As you heard the president say yesterday, we’re going to get health care done.”

Frank’s blunt statement captured anxieties circulating in the Capitol as lawmakers intensified the already frantic pace of negotiations to reconcile the numerous differences between House and Senate versions of the legislation. The goal was to send the tax and spending provisions of the package to the Congressional Budget Office later in the day for a cost estimate, a necessary step before votes are cast. It was not clear if negotiators would pull that off.

“I don’t know,” House Speaker Nancy Pelosi said when asked if the informal deadline could be met. “We’re going to go back to the White House and talk about some other issues this afternoon and probably have a better idea as to when we can send something.”

Obama and congressional negotiators have participated in marathon talks in recent days. Hours of discussion ended after 1 a.m. Friday and resumed in the afternoon at the White House. Adding to the pressure, negotiators were searching both for more funding and additional cost control measures.

A deal with organized labor to weaken a proposed tax on high-cost insurance plans left the legislation short in both areas, though the agreement secured critical political support. The tax was designed to nudge people with generous coverage into more cost-effective health plans, reducing health care spending.

Reducing the impact of the tax left a $60-billion revenue hole in the bill. “That’s part of the conversation — how you make it up,” said Rep. Chris Van Hollen, D-Md.

On the spending side of the ledger, additional funding under consideration to help states defray the cost of expanding Medicaid coverage to more low-income people could add another $20 billion, said Rep. Anthony Weiner, D-N.Y. Negotiators are considering sweetening the federal contribution to cover as much as 95 percent of the expansion, he said.

In a related development, Sen. Ben Nelson, D-Neb., requested withdrawal of a special provision that would have covered the entire cost of the Medicaid expansion in his state. In a letter to Reid, Nelson said every state should be treated equally.

House Democrats heard Friday from former President Bill Clinton who sought to buck them up and alluded to his own failed attempt to pass health reform in 1994. Referencing negative public views on the current bill, Clinton told them they’d have to take a tough vote but sentiment would turn around if they could explain to their constituents what the bill contains. Rep. Phil Hare, D-Ill., summed up part of Clinton’s message: “If you’re going to get chewed out, that goes with the turf.”

A new poll indicates a close race between Coakley and Brown. That could make it imperative for Democrats to push the legislation through before the election results are certified, which could take two weeks or more. Obama wants the bill done in time for his State of the Union address, likely early next month.

Sen. Tom Harkin, D-Iowa, on his way to the White House for another round of negotiations, disagreed with Frank’s view that a Democratic loss in Massachusetts would kill the bill.

“Those are kind of apocalyptic terms,” said Harkin. “The momentum is still there for getting a health care bill done.”

GOP senators unanimously opposed the bill when it passed the Senate on Christmas Eve, although the administration has continued trying to persuade one moderate Republican, Sen. Olympia Snowe of Maine.

The bills passed by the House and Senate before Christmas contain many similarities. Both would extend coverage to more than 30 million uninsured Americans over the next decade at a cost of about $1 trillion, with a new requirement for almost everyone to carry health insurance. They also would impose new requirements for employers and prohibit insurance companies from denying coverage because of pre-existing medical conditions. Lower-income people would get subsidies to help them buy insurance.

Also still unresolved are controversial policy issues, such as financing for abortions, and participants said it could easily take days to reach agreement.

Associated Press writers David Espo, Sam Hananel, Ricardo Alonso-Zaldivar, Alan Fram and Andrew Taylor contributed to this report.