WASHINGTON - With the Senate Finance Committee finally poised to complete its work, the volatile health-care debate now shifts into closed-door negotiations taking place around the conference room of Senate Majority Leader Harry Reid, D-Nev.
Reid must now weave together different health-care proposals from the finance and health committees with similar broad goals of insuring millions of uninsured Americans in a way that does not raise the federal deficit. But the proposals differ in critical areas that threaten the outcome, placing Reid in the eye of an ideological storm for Democrats.
Reid's own recent statements have run the gamut of the diverse positions held throughout his 60-member caucus, particularly on the so-called public option, the proposal for a government-funded competitor to private insurance companies. A week ago Reid called a compromise idea to delay the public option decision for several years a "pretty doggone good idea." By midweek, Reid's top lieutenants adamantly pushed for the public option approved earlier by the health committee, forcing the leader to backtrack. "We are going to have a public option before this bill goes to the president's desk," Reid said in a conference call Thursday.
By late Thursday evening, his office released a statement proclaiming that the majority leader would only guarantee to "include a mechanism to keep insurers honest, create competition and keep costs down."
Such wavering is symptomatic of every majority leader in recent decades as they try to push major legislation through the Senate - now prone more than ever to minority-led filibusters requiring 60-vote hurdles. Republicans, who remain almost universally opposed to the proposal.
On Tuesday Finance Chairman Max Baucus, D-Mont., expects his committee to formally approve his legislation and send it to Reid, who will gather Baucus and other key committee chairmen to work out the differences between the competing plans. Both Reid and House Speaker Nancy Pelosi, D-Calif., hope for votes in the full House and Senate possibly in late October, with the goal of approving a final compromise version before Christmas. Pelosi already has begun near daily gatherings of her leadership team to debate the competing versions approved by three House committees. But the differences on the House side are more narrow, and that chamber's authoritarian rules will allow Pelosi to squeak by with a bare majority if necessary.
Reid will have to smooth over the different positions of key players in the legislative fight, and many hope that Obama and his advisers will weigh in to force Democrats into some form of unity.
And Reid must pull this all off while keeping one eye back home on Nevada. After higher-profile Republicans took a pass on challenging Reid, several GOP challengers have emerged in recent weeks with polls showing Reid could be the latest majority leader to suffer political humiliation.
Reid won a special assurance from Baucus that a tweak in Medicaid funding would not harm Nevada. It's a provision that will help his re-election, but it also brought consternation from colleagues wishing for similar home-state provisions.