WASHINGTON — Caught off guard, congressional Democrats are grappling with President Barack Obama's unexpected call for immediate access to insurance for those with pre-existing medical conditions, as well as richer Medicare drug benefits than envisioned in early versions of health-care legislation.
Additionally, Obama's pledge in last week's prime-time speech to hold the overall cost of legislation to about $900 billion over a decade has spread concern among House Democrats, who have long contemplated a costlier measure.
Yet another late complication, according to several Democrats, is the president's statement that he will not sign a bill "if it adds one dime to the deficit, now or in the future, period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize."
A 'difficult' target
The $900 billion target is "very difficult," Rep. Charlie Rangel, D-N.Y., chairman of the House Ways and Means Committee, told reporters. "This is reducing coverage for poor and working people."
Rangel spoke of other "restrictions the president has given in his speech," commenting after senior House Democrats pressed top administration officials in a private meeting for an explanation of Obama's $900 billion price tag.
Obama outlined his conditions in last week's speech and an accompanying fact sheet posted on the White House Web Site as Democrats point toward votes in the House and Senate this fall.
After months of bipartisan negotiations, Sen. Max Baucus, D-Mont., chairman of the Finance Committee, told associates during the day he intends to unveil a detailed outline of legislation today and convene the panel next week to vote on it.
There were clear indications that Baucus had fallen short in his quest to assemble a coalition of senators from both parties behind his plan.
Call for co-ops
Baucus' proposal is certain to shun the liberals' call for the government to sell insurance, and rely instead on co-ops to offer coverage in competition with private industry.
His approach includes a requirement for individuals to buy insurance, with financial penalties for those who don't.
Rather than a mandate for larger businesses to provide coverage for employees, they would be required to defray the cost of any government subsidies their employees would qualify for.
"I fully expect Republican support coming out of committee," he said, but other Democrats said they believed Sen. Olympia Snowe, R-Maine, might be the only one of the panel's 10 GOP members to vote for the package. Sens. Charles Grassley of Iowa and Mike Enzi of Wyoming have also been involved in the marathon negotiations, but both have raised late objections.
Liberals, too, expressed their unhappiness.
"The way it is now, there is no way I can vote for the package," Sen. Jay Rockefeller, D-W.Va., said on a conference call with reporters.
Obama's decision to detail terms for health-care legislation came after months of public deference to lawmakers.