By Tom Curry National affairs writer
msnbc.com
updated 1/22/2010 11:38:58 AM ET 2010-01-22T16:38:58

Claim: Since enactment of a sweeping overhaul seems unlikely, Democrats will opt for an incremental bill.

Last August, centrist Democrat Rep. Joe Donnelly of Indiana, said of the Democrats' insurance reform effort, "Sometimes when it becomes too big, it makes it impossible to get any part of it done." He asked rhetorically, "Are there a couple of incremental steps, rather than trying to bite off the whole thing at one time?" He wondered, "Would people accept it better if it were just one or two steps to try to fix some of the things that are broken?" Now, five months later, with the Democrats' loss of Tuesday's Senate election in Massachusetts, other Democrats are pondering what Donnelly discussed: taking a few pieces from the bill and trying to enact them. For example: limiting insurers' ability to deny coverage to people with pre-existing medical problems, and sending subsidies to low-income people to pay premiums.

Fact or fiction?
Unclear. The fragile compromises that form the legislation were reached over months with many individuals and groups. It would be time-consuming to re-negotiate them now. And many Democrats are fatigued by the months already spent on the bill. "We need to get health care finished as quickly as possible and get to other issues that Americans care about," said Rep. Rick Boucher, D-Va., Thursday. A supporter of a comprehensive bill, Ron Pollack of Families USA, said, "Insurance market reforms implemented alone will lead to skyrocketing premiums as sicker, older people secure coverage and younger, healthier people don't. This incremental approach is a recipe for disaster….." Even if Democrats wanted to pass only a requirement that insurers cover everyone, "It's almost impossible to start out in that direction without ending up with a huge bill," said economist John Calfee at the American Enterprise Institute.

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