Massachusetts election could unhinge health care

WASHINGTON (AP) -- Something is better than nothing on health care, the House's second-ranking Democrat asserted Tuesday, facing the outcome of an unpredictable Massachusetts election that may give Republicans the power to kill the bill.

Even the legislation already passed by the Senate -- which many rank-and-file House Democrats find unappealing -- would be better than failing to deliver on President Barack Obama's top domestic initiative, House Majority Leader Steny Hoyer, D-Md., told reporters.

"The Senate bill clearly is better than nothing," Hoyer said. While insisting it would be feasible to quickly pass major legislation like health care, Hoyer refused to speculate on whether House Democrats could be cajoled into voting for the Senate bill without any changes, and sending it to Obama.

That option was unthinkable as recently as last week.

But if Republican state Sen. Scott Brown defeats Democratic Attorney General Martha Coakley in Massachusetts, it would put the seat held by the late Sen. Edward M. Kennedy in the hands of a committed opponent of the bill. That would deprive Democrats of the 60-vote Senate majority needed to pass health care if the House made changes in the bill and sent it back for a Senate vote.

After more than a year of tortuous effort to produce history-changing legislation for Obama, Democrats are facing the possibility of defeat in their quest to guarantee health insurance coverage for all Americans.

Amid the Democratic hand-wringing, Obama continued to court Republican Sen. Olympia Snowe, the Maine moderate who was the only GOP lawmaker to back the bill in committee.

Obama called Snowe on Friday to discuss health care, according to a congressional aide speaking on condition of anonymity because the conversation was private. The aide said the call was not prompted by the developments in Massachusetts but was the continuation of an ongoing conversation between Snowe and the White House over elements of the legislation.

Snowe told The Associated Press earlier this month that she wants to improve the bill even if she ultimately votes against it. She opposed the measure in the Senate's Christmas Eve vote.

"Undeniably, we need to have health care reform," she said during that interview.

Salvaging health care was at the top of the agenda Tuesday for House Speaker Nancy Pelosi, who scheduled meetings with her top lieutenants and the full Democratic caucus. The evening meeting with rank-and-file Democrats would occur as the polls were closing in Massachusetts.

Pelosi, D-Calif., says there will be no wavering on health care.

"Let's remove all doubt," Pelosi told reporters Monday in her hometown of San Francisco. "We will have health care one way or another."

"I heard the candidate in Massachusetts, the Republican candidate, say, 'Let's go back to the drawing board,'" she continued. "The drawing board for the Republican Party on health care is to tear it up and throw it away, and shred it and never revisit it. This is the opportunity of a generation. If this opportunity is not realized, there won't be health care for all Americans."

As recently as Friday it seemed as if Democratic congressional leaders and Obama were close to a deal that would remove remaining obstacles to final passage of the bill in the House and Senate.

Two fallback options if Democrats lose in Massachusetts were discussed over the weekend, but they represent a long shot.

One option calls for the House to pass the Senate bill and send it to Obama for his signature. But that ignores at least two significant problems.

To begin with, labor unions are adamantly opposed to an insurance tax in the Senate bill, and they successfully negotiated with Obama last week to weaken it in key respects. Second, a core group of anti-abortion Democrats says the Senate bill's provisions on restricting taxpayer funding for abortion are unacceptable because they don't go far enough.

On top of that, many House Democrats do not believe the Senate bill provides enough aid to make health insurance affordable. The core legislation would require most Americans to carry coverage for the first time, while providing subsidies to help low- and middle-income families pay premiums. Most of the benefit would go to people not currently covered by employer insurance.

A senior Democratic leadership aide, speaking on condition of anonymity because discussions are private, said it is very difficult for the House to simply pass the Senate bill on its own.

Those difficulties lead to the second fallback option: getting the Senate to accept changes to its bill as a condition for House passage. But without 60 votes needed to overcome Republican delaying tactics, it would require Senate Democratic leaders to use a special budget-related procedure to pass the changes with only 51 votes. That would enrage Republicans, and it's not clear that Senate Democrats would have political support to pull off the gambit.

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Associated Press writer Erica Werner contributed to this report.