How Senate Democrats can get to 60 votes on healthcare

Senate Democrats headed into closed-door meetings Wednesday with growing confidence that they will be able to produce a healthcare bill that can win a critical 60 votes.

Democrats might need all 58 Democrats in the Senate, as well as the two independents who sit with the majority
caucus, in order to get the 60 votes needed to defeat a Republican filibuster.

So they welcomed the return of Sen. Robert Byrd (D) of West Virginia Wednesday, who had been absent for health reasons in recent months. The addition of the first Republican vote for reform – from Sen. Olympia Snowe of Maine Tuesday – also helped.

But the key shift has been an apparent willingness among Democratic moderates to back a reform bill even if means confronting angry voters at home. They are toning down opposition to elements of healthcare reform that only a week ago appeared set in stone.

“I can identify many things that cause me concern, and I hope they can be resolved,” said Sen. Ben Nelson (D) of Nebraska, citing concerns that a public option could undermine the coverage for 200 million Americans who have private insurance.

But he says it’s not necessarily a showstopper: “I’m maybe on the same page as the president when he said it shouldn’t be the mechanism as much as the result.”

Likewise, Sen. Mary Landrieu (D) of Louisiana says that a deal on healthcare reform isn’t out of reach. “We have a ways to go – I wouldn’t say a long way – specifically focused on getting cost down and expanding choice in the market,” she says.

'We're going to do it with or without' Republicans

Now, Senate Democratic leaders are settling down to the task of merging two different healthcare bills – one passed by the Finance Committee and one by the Health, Education, and Labor, and Pensions Committee – into a single bill to be voted on by the full Senate. The chairmen of these two committees, Sen. Max Baucus (D) of Montana and Sen. Christopher Dodd (D) of Connecticut, will be involved, as will White House chief of staff Rahm Emanuel.

“We’re united. We’re all together,” said Senator Baucus. “In a real sense, all senators who want healthcare reform are in the room, because we’ll be talking with them.”

Senate majority leader Harry Reid, after meeting with the Democratic caucus, agreed that now everything is in the hands of the Democrats. “We want healthcare reform, and we’re going to do it with them or without” Republicans.

New idea: Allowing states to opt out of the public option

Democrats might consider further compromises in their closed-door meeting in an effort to ensure 60 votes for the final bill.

Sens. Thomas Carper (D) of Delaware and Charles Schumer (D) of New York are working on a compromise public option that could give states the ability to opt in or out of a national plan.

“If we’ve got some members who say they can’t vote for health reform if it has a public plan and others who say they can’t vote for it if it doesn’t, we’ve got to find some middle ground – and that’s what we’re going to try to do,” said Senator Carper, a member of the Senate Finance panel who opted to wait for closed-door negotiations to present his plan.

Any more Olympia Snowes out there?

Others who have worked across party lines on issues such as judicial nominations and national security are reaching out to GOP moderates to find common ground.

Sen. Susan Collins (R) of Maine, another possible GOP vote for healthcare, has been meeting regularly with moderate Senate Democrats. But she says if the final bill includes a public option, “it will not have my vote.”

Noting the positive tone of today’s caucus discussions on heath care, Senate deputy leader Richard Durbin says: “I feel more positive about that than I have in weeks gone by. I just think there’s a sense of historic opportunity and they can’t resist that.”

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