Former President Bill Clinton told anxious Senate Democrats on Tuesday to pass a health care bill soon because the U.S. economy can't resist the toxic combination of exorbitant medical costs and nearly 50 million uninsured for much longer.
"My argument was that this is an economic imperative," Clinton said after the closed-door meeting.
Addressing Democrats' insecurities about the complex legislation, Clinton said he told the senators "there is no perfect bill — you'll always have unintended consequences. There will be amendments to this next year. But the worst thing to do is nothing."
Clinton was the last Democratic president to attempt to revamp the health care system to cover all Americans and try to control costs. The spectacular collapse of his plan probably cost Democrats control of Congress in 1994, but Clinton is still admired for having tackled the issue. He went on to win a second term in office.
"People trust him," said Sen. Max Baucus, D-Mont., one of the architects of the current Senate health care bill.
"His argument was that getting the best bill is not only good for the people, it's the best politics," said Sen. Ben Nelson, D-Neb., one of a clutch of moderates who hold the fate of the legislation in their hands.
Clinton said he hoped all the senators understood his bottom line: "It's not important to be perfect here," he said. "It's important to act, to move, to start the ball rolling."
The House passed its health care bill last Saturday by a narrow 220-215 vote. In Senate, Majority Leader Harry Reid, D-Nev., is working on a final Democratic draft. But the combination of divided Democrats, and Republicans determined to force delays under the Senate's arcane rules, is making it less likely that President Barack Obama will get a bill this year.
"Our goal is to make sure it's out of the Senate this year," said Sen. Dick Durbin, D-Ill., the No. 2 Senate Democrat. The Senate bill would then have to be combined with legislation passed Saturday by the House, and the final version passed by both chambers before it could go to Obama's desk. Finishing that whole process before year's end would be tough.
"They want us to finish quickly. We do too. But some of these things are beyond our control," Durbin said of the White House's desire for fast action.
Complicating the effort, abortion opponents in the Senate are seeking tough restrictions in the health care overhaul bill, a move that could roil the shaky Democratic effort.
Nelson, the Nebraska moderate, said he could not support a bill unless it clearly prohibits federal money from going to pay for abortions. He is weighing options, including offering an amendment similar to the one passed by the House this weekend, which had more stringent language than that approved by Senate committees.
"While there may be different views about abortion, I think there's a strong majority against using federal dollars to fund abortions," Nelson said Tuesday on NBC's "Today."
Senate Majority Leader Harry Reid, who is personally opposed to abortion, said the issue was being negotiated.
"I expect the bill that will be brought to the floor will ensure that no federal funds are used for abortions and that the conscience rights for providers and health care facilities like Catholic hospitals are protected," Reid said Tuesday. "I think we can work that out."
The House-passed restrictions were the price Speaker Nancy Pelosi, D-Calif., had to pay to get a health care bill passed. But it's prompted an angry backlash from liberals at the core of her party, and some are now threatening to vote against a final bill if the curbs stay in.
Obama said the legislation needs to find a balance.
"I want to make sure that the provision that emerges meets that test — that we are not in some way sneaking in funding for abortions, but, on the other hand, that we're not restricting women's insurance choices," Obama said in an interview with ABC News.
The House bill would bar a new government insurance plan from covering abortions, except in cases or rape, incest or the life of the mother being in danger. That's the basic rule currently in federal law, under a provision called the Hyde amendment, which Reid said Tuesday had worked well.
"The one thing we're certain to do is to maintain what we've had in the past," said Reid, D-Nev. "The Hyde amendment has been a pretty good way to go."
The House bill would also prohibit health plans that receive federal subsidies in a new insurance marketplace from offering abortion coverage. Insurers, however, could sell separate coverage for abortion, which individuals would have to purchase entirely with their own money. The committee-passed Senate versions differ on abortion, but none would go as far as the restrictive amendment passed by the House.