Landrieu Says She'll Back Democrats on Key Health-Care Vote
By GREG HITTJANET ADAMY
WASHINGTON—Democratic Sen. Mary Landrieu said Saturday she would vote to move forward with debate on health-care legislation, as the chamber moved toward an evening vote on whether to bring the bill to the floor.
Sen. Mary Landrieu, pictured with Sen. Tom Harkin, has decided to vote to advance health-care debate in the Senate.
"I've decided that there are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done," said Sen. Landrieu, of Louisiana. Her comments came a day after Sen. Ben Nelson (D., Neb.) also said he would vote to move forward.
Saturday's vote will be the first test in the full Senate for Senate Majority Leader Harry Reid, who unveiled his bill Wednesday night. He needs the votes of all 58 Senate Democrats, plus two independents allied with the party, to overcome a Republican filibuster on the question of whether to proceed with the bill. The legislation would overhaul the nation's health-care system and extend insurance to 31 million Americans now without coverage.
While momentum was building behind Mr. Reid, the support of at least one other Democrat -- Sen. Blanche Lincoln of Arkansas -- remained in doubt. A spokeswoman for Sen. Lincoln, who faces a tough re-election battle next year, said Friday she was still reviewing the bill.
Sen. Nelson said supporting the Republican filibuster -- which threatens to block Democrats from opening debate -- would deny voters in his state a voice on the issue. "I won't slam the door of the Senate in the face of Nebraskans," he said. "The Senate owes them a full and open debate."
The Nebraska senator also secured one of several favors that Democratic leaders doled out to win over waverers: He persuaded them to keep out a provision that would repeal the insurance industry's antitrust exemption, congressional aides said.
A Nelson spokesman said the senator simply pointed out the ramifications of ending the exemption, including the impact on smaller companies. "Sen. Nelson wasn't negotiating this issue," the spokesman said, adding the Democratic leader "chose not to put it" into the bill.
Mr. Nelson's long-awaited decision came as a relief to Mr. Reid, who has scrambled in recent days to shore up support.
Not long after Mr. Nelson's announcement, another Democrat whose backing had been in question, Oregon Sen. Ron Wyden, said he, too, would support moving forward. Mr. Wyden Friday secured a commitment from Mr. Reid to support a $4 billion amendment designed to give workers greater flexibility to purchase health insurance outside the workplace. Mr. Wyden said the proposal represented a "modest step" forward and was "my price" for supporting moving ahead.
Mr. Reid this week also made a strong play for the support of Ms. Landrieu, a centrist Democrat, adding a provision that would steer an estimated $200 million to $250 million in Medicaid funds to her state in fiscal 2011, congressional aides said.
Senate Democratic leaders hope centrist Democrats will warm to some measures in the bill aimed at curbing the growth of health costs, and will take heart from an estimate by the nonpartisan Congressional Budget Office that the bill would reduce the federal budget deficit by $130 billion over 10 years.
But questions linger about how effective those proposals will be. The CBO stressed there is "substantial uncertainty" about the program's long-term impact on the budget.
White House budget chief Peter Orszag said the bill includes four cost-containment recommendations that leading economists outlined in a recent letter to the White House. In addition to not increasing the deficit, the legislation places a new tax on the most generous insurance plans to discourage employers from offering those that lead to wasteful consumption of health services.
The bill also gives Congress more power to trim fat from Medicare and contains provisions that reorient the medical system toward paying for comprehensive, quality care instead of for every individual procedure.
"The Senate legislation hits the four bogies," Mr. Orszag said.
But some health-policy experts question whether Congress will actually follow through with the proposed cuts in Medicare spending. And provisions aimed at rewarding health-care providers for more efficient care will be tested mostly in pilot programs, not in wider initiatives.
Democrats and Republicans reiterated their arguments in the Saturday debate. Democrats argued the bill will expand coverage and lower the federal budget deficit. Republicans said the Democrats' budget numbers won't work and the U.S. can't afford the bill.
"Move over Bernie Madoff," said Sen. Christopher Bond (R., Mo.). "Tip your hat to a trillion-dollar scam."—--Patrick Yoest contributed to this article.
