A RACE TO WIN ONE MORE VOTE FOR OBAMA'S HEALTHCARE BILL

On the left is President Barack Obama and on the right is Senator Ben Nelson of Nebraska



By JEFF ZELENY and ROBERT PEAR
Published: December 17, 2009
WASHINGTON

The White House and Senate Democratic leaders seem willing to give Senator Ben Nelson, Democrat of Nebraska, just about anything he wants to win his support of major health care legislation. Anything, that is, but the item at the top of Mr. Nelson’s wish-list: air-tight restrictions on insurance coverage for abortions.


The bid to win Mr. Nelson’s support has become a race against the clock. The Senate majority leader, Harry Reid of Nevada, has developed plans for a series of votes beginning at 1 a.m. Monday and round-the-clock Senate sessions intended to meet his deadline of completing the health care bill before Christmas.

But Mr. Reid is still at least one vote short of the 60 he needs to move the bill ahead, and as much as anyone, Mr. Nelson appears to hold the legislation’s fate in his hands.

Other Democrats, liberals as well as centrists, have not yet committed to vote for the bill. And the abortion provisions are just one of numerous concerns that Mr. Nelson has expressed about it. But the biggest obstacle seems to be his demand for tighter restrictions, which are being resisted fiercely by a bloc of senators who support abortion rights.

Mr. Nelson on Thursday issued a statement saying a compromise on abortion language drafted at his behest was “not sufficient.”

Asked by a home-state radio station on Thursday if Democrats could meet their deadline, Mr. Nelson said he did not think so.

“I can’t tell you that they couldn’t come up with something that would be satisfactory on abortion between now and then and solve all the other issues that I have raised to them,” he said. “But I don’t see how.”

Mr. Nelson, a former governor, state insurance commissioner and insurance company executive now serving his second Senate term, is the focus of increasingly intense entreaties by Mr. Reid and the White House. He has met personally with President Obama three times in the last nine days, and daily with Mr. Reid.

Pete Rouse, a senior White House adviser, has been assigned specifically to address Mr. Nelson’s concerns. Senator Bob Casey, a freshman Democrat from Pennsylvania and a prominent opponent of abortion rights, was tapped to devise some sort of compromise language on coverage for abortions to bring Mr. Nelson on board.

But Mr. Casey’s initial efforts have come up short, though he said he would keep trying. “I want to be a fountain of ideas on this topic,” he said.

To help divine Mr. Nelson’s thinking, a wide array of Democrats have reached out to him in recent days, including former Senators Tom Daschle of South Dakota and Bob Kerrey of Nebraska. In the calls, Mr. Nelson has not disclosed how he is leaning, but his friends say they can sense the pressure he is facing.

One potentially crucial factor is Mr. Nelson’s fondness for the president, his friends say. When he was running for re-election three years ago, there was only one Democratic Senate colleague he invited to Nebraska: Mr. Obama. A year later, Mr. Nelson was among the first senators to endorse Mr. Obama for president.

“You never like to disappoint a friend, but that friendship only goes so far,” Mr. Kerrey said. “I don’t think it will cause him to vote for the bill, if he believes on balance that the bill shouldn’t be passed.”

Mr. Nelson said that Mr. Obama “made a strong case” when they met one-on-one Tuesday, “but it remains to be seen if it was compelling.”

Still, at the White House and in the Capitol, no one can predict what Mr. Nelson will do if Mr. Reid pushes for a final vote, possibly on Christmas Eve. Mr. Nelson has said that at the moment he would vote no — and that abortion was only one of many concerns.

“There are other substantive issues,” Mr. Nelson said in the radio interview, with KLIN in Lincoln, Neb. But, speaking about abortion, he added, “That alone is a reason.”

Nebraska’s governor, Dave Heineman, a Republican, has written to Mr. Nelson urging him to oppose the bill because of proposed reductions in Medicare spending and also because of the cost to the state of a proposed expansion of Medicaid.

Mr. Nelson has said he wants to change the bill to let states decide if they want to expand Medicaid, though he has not suggested how very low-income people would otherwise gain insurance coverage. Democratic leaders said they were working on a compromise.

The abortion issue, though, is the central one.

Nebraska Right to Life, the state’s largest anti-abortion lobbying group, has long supported Mr. Nelson, who is the only Democrat elected statewide in Nebraska.

“A Democrat has to walk a pretty fine line to survive in Nebraska,” said John R. Hibbing, a professor of political science at the University of Nebraska-Lincoln. “It is a pro-life state. More than that, the energy the pro-life community puts into races is impressive.”

Julie Schmit-Albin, the executive director of Nebraska Right to Life, said the group was closely monitoring the situation in Washington. “We know he is under enormous pressure from both sides,” she said. “We’ve stood by him, and we’ve enjoyed a good working relationship.”

Mr. Nelson also has deep ties to the insurance industry, having worked as a general counsel and president of the Central National Insurance Company before becoming the executive vice president of the National Association of Insurance Commissioners.

In trying to work out a deal on abortion, Mr. Casey said he had proposed stricter requirements for insurance plans to separate federal tax dollars from private premiums paid by subscribers so that no government money is used for abortions.

The fight over abortion arises because, under the bill, the federal government would take on new responsibilities for health care, subsidizing coverage for millions of people. At issue is whether policies bought with subsidies could cover abortions even if private premiums are separated.

Advocates of abortion rights say that women who now have insurance covering abortion could lose it under the restrictions that would be imposed under a health bill passed by the House last month.

“It’s something we never had to deal with before,” Mr. Casey said. “There is no model.”

David M. Herszenhorn contributed reporting.