Video: Health debate fallout moves to fine print

updated 9/11/2009 3:01:41 PM ET 2009-09-11T19:01:41

Health care negotiators in the Senate pressed for a way to ensure that illegal immigrants can't get access to government-funded insurance, a contentious issue now front and center after a Republican congressman's outburst during President Barack Obama's speech.

The issue is one of several thorny problems that came up as a small group of negotiators on the Senate Finance Committee met Friday morning. Finance Chairman Max Baucus, D-Mont., is aiming to finalize legislation on Obama's health overhaul by next week — though whether it's bipartisan or not remains to be seen.

Members of the group said they thought they'd settled the question of illegal immigration, but it came to the fore this week when Republican Rep. Joe Wilson shouted "You lie" at Obama during his speech Wednesday. Obama had said illegal immigrants wouldn't be covered under his health plan.

Senators said that's forced the committee to work on provisions verifying legal status before an individual can get coverage.

"We've always been there, but we have to make sure to get the right process and language," said Sen. Olympia Snowe, R-Maine, one member of the so-called Gang of Six of three Republicans and three Democrats whom Baucus is leading.

Such verification can be tricky. Many Democrats fear that verification procedures keep legal residents from getting insurance, and in the House, they rejected Republican attempts to add verification requirements to the House health care bill.

The negotiators put off extensive discussion of the illegal immigration issue until Monday and said aides would be working on language on that and abortion over the weekend.

Friday's session focused largely on how an expansion of Medicaid would affect states, and on possible provisions to keep down medical malpractice costs.

The prognosis for bipartisan resolution remained cloudy, with Baucus prepared to go it alone even without Snowe and her fellow Republican Sens. Chuck Grassley of Iowa and Mike Enzi of Wyoming.

Snowe said she still couldn't predict whether they'd reach consensus — or whether Baucus would be able to count on her vote.

"I can't answer that at this point. We're working through all these issues and we'll see where it goes from there when we finalize everything," Snowe said.

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The question could be answered as early as Monday when the group meets again.

"Obviously we'll find out who wants to support the (bill) and who doesn't," Baucus said. "I'm hopeful that there will be bipartisan support. And I'll keep working on it frankly over the weekend, on the telephone talking to people, so on and so forth."

Enzi declined to comment Friday and Grassley participated in the meeting by phone from Iowa.

Meanwhile, House leaders predict passage of a sweeping overhaul within a few months, even while acknowledging they are still facing a host of other thorny issues, including medical malpractice and abortion.

"That's the legislative process," House Speaker Nancy Pelosi said as she and other Democrats shifted from praising the president's speech to the less glamorous task of trying to negotiate a bill that will pass muster with a host of opposing factions.

"As issues emerge, let's drill down on the public option, let's drill down on what this means to small business, let's drill down on what this means to seniors," Pelosi, D-Calif., said Thursday.

Presuming both chambers pass legislation, then would come the daunting task of melding the two bills and bringing the finished product back for final votes in both chambers.

The initial House bill is likely to include a new government-run insurance plan to compete with the private market, but Baucus long ago embraced establishing nonprofit cooperatives instead, and it appears unlikely liberals have the votes in his committee to overrule him.

Baucus and many other senators believe a so-called public plan would be unlikely to get the 60 votes needed to advance in the 100-member Senate.

Obama has spoken repeatedly in support of a public plan and did so again in his speech, but he also left room for alternatives like the co-op or a fallback option that would trigger the public plan only if private companies weren't offering enough choices.

The trigger alternative was getting attention from a number of moderate Senate Democrats who met with Obama at the White House on Thursday, according to several who attended. Some moderates oppose a straight-up public plan.

"His willingness to be flexible on that reassured members of our group," said Sen. Evan Bayh, D-Ind. "His willingness to say what matters here is the ends, we shouldn't obsess about the means."

The moderates also responded to Obama's commitment in his speech to holding down costs.

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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