No. 2 House Democrat Hoyer pushes for health care overhaul but acknowledges ‘no easy choices’

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Hoyer presses for health overhaul, no easy options

WASHINGTON — There are no simple fixes for President Barack Obama’s health care overhaul, the No. 2 House Democrat said Tuesday, as supporters agonized over whether to move the bill forward or hit the pause button until political resistance subsides.

House Majority Leader Steny Hoyer insisted that the goal remains to pass far-reaching legislation that would expand coverage, reduce costs and improve quality. But difficulties increased as moderate Sens. Evan Bayh, D-Ind., and Blanche Lincoln, D-Ark. — both face re-election this year in Republican-leaning states — said they would oppose the strategy Democratic leaders are considering to reconcile the House and Senate bills.

“There are no easy choices,” said Hoyer, D-Md., after Democrats lost the Massachusetts Senate seat last week — their 60th vote — and with it undisputed control of the congressional agenda.

“There is no rush,” Senate Majority Leader Harry Reid, D-Nev., said after a luncheon meeting of Democrats that focused on jobs and the economy, not health care. Reid said he’ll keep talking with House Democrats and White House officials.

Lawmakers hope Obama will help guide them out of the health care swamp when the president delivers his State of the Union address Wednesday. Obama is unlikely to delve into the strategy for passing a bill, Hoyer said, but he is expected to stress the importance of getting comprehensive legislation along the lines of what the House and Senate already passed.

Democrats now have four options, Hoyer said: No bill, a scaled-back measure designed to attract some Republican support, the House passing the Senate bill, or the House passing the Senate bill with both chambers making changes to bridge their differences.

“Democratic leaders are taking time to talk to our members about what they are hearing from their constituents, and to digest with some clarity the messages that voters in Massachusetts were sending,” Hoyer said in a speech.

Unlike Reid, Hoyer said he thinks moving quickly is important. “By next week we need to come to focus on the way we want to move forward,” he told reporters.

Opposition to the health care remake in Washington helped spark the Massachusetts revolt, Democrats acknowledge. Obama called the monthslong debate on Capitol Hill “an ugly process.”

“It looks like there are a bunch of back room deals,” the president said in an interview with ABC News.

Of the four options that Hoyer outlined, only one has been ruled out. House Speaker Nancy Pelosi, D-Calif., said last week she does not have the votes to pass the Senate bill without any changes.

Democratic leaders are coalescing around the idea of the House passing the Senate bill, with both chambers agreeing to follow-up legislation that would settle major differences. Stripping special Medicaid deals for Nebraska and Louisiana, and scaling back a proposed tax on high-cost insurance plans, are among the changes being sought by House members.

The strategy calls for the Senate to use a special budget-related procedure — reconciliation— that requires only 51 votes to advance. Even so, leaders may not be able to round up the votes. Bayh and Lincoln already said they oppose it, and other Democrats may also be reluctant.

“My concern is that if reconciliation is used, that will really destroy any prospects for bipartisan cooperation on anything else for the remainder of this year,” Bayh said. “That would be a regrettable state of affairs, something I think the American public would not react well to.”

Moderates say forging ahead with sweeping legislation would risk a backlash from voters already turned off by 2,000-page bills seen as a big government power grab. Instead, they’re arguing for more modest legislation built around elements that can attract some Republican support.

“This is one where we need to make a pie a piece at a time, as opposed to a comprehensive approach,” said Sen. Ben Nelson, D-Neb. “We’ve tried a comprehensive approach and it’s clear that won’t be possible.”

Said Sen. Dianne Feinstein, D-Calif.: “I think right now it’s a time out and the leadership is re-evaluating. They’ve asked us to keep our powder dry and see what they come up with, and I’m certainly willing to do that.”

Associated Press writers Charles Babington, Donna Cassata, Alan Fram and Erica Werner contributed to this report.