Magic Number for Democrats in Senate on Health Bill Is 60

WASHINGTON (By Carl Hulse, NYT) September 17, 2009 — The unveiling of a compromise health care proposal has Senate Democrats pondering a daunting mathematical challenge: how to keep all 59 Democrats united and attract at least one Republican to pass an overhaul measure.

As many lawmakers on Wednesday got their first detailed look at a Finance Committee plan that was months in the making, senators immediately began exploring whether the plan — when combined with elements of another, more liberal one — could win enough senators to reach that magic procedural number of 60.

“We have to meld a couple of things together and see where we are,” said Senator Christopher J. Dodd, Democrat of Connecticut. “I wouldn’t say today with absolute certainty that you could get to 60, but it would be just as foolish to say you can’t get there either. This is the Senate.”

In trying to reach critical mass for legislative success, advocates of health care overhaul face an extremely delicate balancing act. With the death of Senator Edward M. Kennedy of Massachusetts, Democrats control 59 seats, meaning they need at least one Republican to join them if they are to proceed without employing a procedural shortcut that could cause havoc in the Senate.

And Senate Democrats have substantial differences of their own. More liberal members like Senator John D. Rockefeller IV of West Virginia and Senator Bernard Sanders, independent of Vermont, have been strong advocates of a public insurance option; many of the more centrist Democrats have come down just as strongly against one. Centrists are interested in holding costs down; progressives want to bring more Americans under the insurance umbrella, a push that drives costs up.

As a result, changes intended to bring the centrists and conservatives in line could drive away progressives, while any move to draw in the more liberal elements could end up alienating the centrists. There is little margin for error.

“I continue to believe you start at the center and then move to collect additional support on both ends of the political spectrum,” said Senator Ron Wyden, an Oregon Democrat and health policy expert whose seat on the Finance Committee makes him a key player as that panel considers the new plan from Senator Max Baucus, the Montana Democrat who leads the committee.

Juggling the individual party demands can be dizzying. Another Finance Committee member, Senator Bill Nelson of Florida, is digging in against potential Medicare cuts. Senator Bob Casey of Pennsylvania wants to make sure the plan does enough for poor children, while Senator Evan Bayh of Indiana is worried about health costs for small businesses and middle-class families.

And Senator Ben Nelson of Nebraska, typically one of the hardest votes for Democratic leaders to corral, is looming as a particularly tough sell. “At the end of the day, I want to see everything before I commit to anything,” said Mr. Nelson, who added he would have trouble backing a bill that did not have some Republican support.

Yet winning over just one Republican will take extraordinary effort, partly because of the intense pressure from colleagues to deny Democrats a legislative victory. Senator Olympia J. Snowe of Maine, the Republican viewed as the most likely to back the proposal, did not endorse the plan on Wednesday, though she is talking to Democrats.

Other Republicans considered potential allies under the right circumstances have their own reservations. Senator Susan Collins, another Maine moderate who has joined with Democrats in the past, has not seen enough emphasis on cutting health care costs over all.

Senator George V. Voinovich of Ohio, who is retiring and thus may face fewer political constraints, said he feared the expansion of coverage for the poor could bankrupt states. “To be candid, I don’t know how you pay for it,” he said.

Given the steep climb toward 60, Senate Democratic leaders have begun to make another argument to lawmakers. They are pressing colleagues to vote with the party on procedural matters related to health care legislation and against any filibuster — a 60-vote issue — even if they intend to oppose the measure in the end when simple majority rules.

Senators are usually reluctant to clear the way for a bill they might vote against since they relinquish their most powerful leverage, but the message is evidently reaching some.

“It is difficult to ask someone to facilitate the enactment of legislation with which they disagree,” Mr. Bayh said. “But to move the process forward, to improve things, to get to the point where you can support it substantively, that of course I would be willing to do.”

Even with all the policy disputes compounded by political and procedural hurdles, Democrats said they still believe they can get a bill through. But it will not be easy.

“Do I believe there is enough consensus around here to get a bill done in the end? Yes,” Mr. Casey said. “But I also believe it is going to be a difficult couple of weeks.”