Senate healthcare reform debate: Week 1 down, how many more to go?

The Senate has debated historic healthcare reform legislation for a week now. What have we learned?

Two basic points seem clear, following the drone of five days of Senate speeches and a handful of votes:

1. The Senate Democratic leadership does not yet have the 60 votes needed to pass the bill with a filibuster-proof majority. If Senate majority leader Harry Reid of Nevada had the support, he would cut things short and call the question. Instead, the Democratic caucus continues to discuss internally possible compromises related to the bill’s two key political issues: abortion coverage and a government-run “public option” insurance plan.

2. The whole thing is going to take even longer than most people thought. This is partly due to the sweep and complexity of the bill and to the difficulties inherent in trying to forge consensus on controversial items, even among members of the Democratic Party. Democrats complain it is also partly due to stalling tactics on the part of Republicans.

“We had hoped for a much different approach.... Republicans are not being forthcoming in either allowing us to vote on our own amendments or in offering their own,” said Sen. Richard Durbin (D) of Illinois, assistant majority leader, Friday in a conference call with reporters.

Right now, the Senate is bumping along at a pace of dealing with about one amendment per day. Though more votes seemed likely late Friday, the pace is still so slow that it equates with finishing in perhaps May – of 2011.

When the way forward on the most contentious parts of the bill seems clearer, the speed is likely to pick up. Even so, majority leader Reid is now carrying through on his threat to make the Senate work on weekends, continuing the debate.

The one exception Reid is willing to make is to let senators have time to attend church services.

“I think it very likely we wouldn’t come in until noon or somewhere around noon on Sunday,” said Reid on the Senate floor.

So far, senators have voted largely along party lines. They have adopted an amendment from Sen. Barbara Mikulski (D) of Maryland that increases insurance benefits for women through yearly screenings for breast cancer. They have rejected an amendment from Sen. John McCain (R) of Arizona that would have eliminated $500 billion in Medicare cuts from legislation.

One amendment was passed by unanimous vote. Proposed by Sen. Michael Bennet (D) of Colorado, the provision guarantees that current Medicare benefits guaranteed under law won’t be taken away by anything included in healthcare reform legislation. Widely seen as being a Democratic response to GOP charges that the bill endangers Medicare, this amendment passed by 100 to 0.

While the debate grinds forward on the floor, much of the real work continues behind the scenes.

This hidden effort focuses on what Senator Durbin says are the two main obstacles to passage: abortion and the pubic option.

Sen. Ben Nelson (D) of Nebraska plans to soon introduce an amendment that contains strict abortion funding limitations. Originally he had planned to sponsor this provision in conjunction with Sen. Orrin Hatch (R) of Utah, but the joint aspect of this venture has apparently fallen through.

The abortion amendment will probably come up early next week, according to Durbin. The Democratic leadership needs Senator Nelson’s vote for final passage. But the abortion issue could split the caucus, alienating liberals who see a need to defend abortion rights.

“We know Senator Nelson feels very strongly about this,” Durbin said.

On the public option, a group of lawmakers led by Sen. Thomas Carper (D) of Delaware is currently trying to forge a compromise. They met Thursday night to present their ideas to Sen. Joseph Lieberman (I) of Connecticut and others skeptical of a government-run insurance plan.

Senator Carper’s compromise so far involves a nonprofit insurance enterprise that states could opt to join if private firms don’t provide their residents with enough insurance choice at the right price. Senator Lieberman emerged from the Thursday meeting sounding dubious, saying that at this point he had heard nothing that changed his opposition to the concept.

Still, Durbin insists that the Senate is moving toward the point where the Democratic leadership can begin talking about the end game.

“Our goal is to finish this before Christmas. We’re going to stick with this and get it done,” he insisted.

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See also our Healthcare Holdouts series:

Blanche Lincoln wants to focus on jobs

Mary Landrieu likes her $300 million

Ben Nelson says abortion funds mean 'no' vote

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