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Senate Upset Foils Democrats' Health Reform Agenda

Future direction of Obama's top domestic priority remains unclear

WEDNESDAY, Jan. 20 (HealthDay News) -- House and Senate Democrats' ambitious plans to revamp the nation's health-care system were torpedoed Tuesday night in the wake of a Massachusetts special election that delivered the seat long held by the late Sen. Edward Kennedy to a Republican.

State Sen. Scott Brown, who won the crucial seat by more than 100,000 votes, has vowed to vote against the health-care legislation that Congress is considering. Without 60 Democrats in the Senate to hold off a Republican filibuster, health reform legislation -- at least in its current form -- seems much less likely to advance, pundits say.

Carol Pryor, a health policy analyst based in Boston, said Brown's message resonated with voters in part because of the complexity of the legislation -- detailed in voluminous House and Senate bills passed in 2009.

"People really had lost sight of what's in it, or didn't have a good sense of what was in it, and there was a lot of misinformation spread around about it," she explained.

"I do think that the dragged-out negotiations and all of the deals that people had to make in order to get this through Congress, especially with the need for 60 votes in the Senate, after a while made it seem like there was just a lot of deal-making going on behind the scenes," Pryor added.

Appearing on Fox News Sunday this week, Senate Minority Leader Mitch McConnell (R-Ky.) characterized the election as a "referendum" on the national health reform initiative, which he claimed Democrats were trying to work out in secret.

"They have arrogantly ignored American public opinion all the way to this point," he said. "And they're trying to get their members to continue to ignore public opinion one more time."

Robert Restuccia, executive director of Community Catalyst, a national consumer health advocacy organization, disagreed. "I don't think it was a referendum," he said. "I think fundamentally this came down to two campaigns: one that was pretty effective and one that wasn't, in an environment that was probably not as good as when Obama ran."

And while the vote fundamentally changes the calculus in the Senate, it doesn't alter the need for specific reforms, Restuccia stressed.

"I think there's still an urgency to pass something," he said.

In the wake of the Senate shakeup, Democratic leaders in both chambers were pondering ways to move the legislation forward. The House could pass the Senate version of the bill, avoiding another Senate vote, although that scenario seemed unlikely given the many concessions House members would have to make.

In remarks to MSNBC, Rep. Anthony Weiner (D-N.Y.), a progressive Democrat, conceded it may be time for his party to take a new tact on health care.

"I think we've made some crucial mistakes along the way by making this more complicated than it needs to be," he said. Weiner said he supports a "much simpler approach" to health care as part of a jobs bill.

Pryor said she hopes that whatever Congress decides to do will ultimately salvage some key elements of the legislation, including an expansion of Medicaid and health insurance market reforms.

While public support for "health reform" may be lagging, Restuccia said the public remains strongly in favor of specific elements of health reform.

"What the package is, how to move forward, is going to be the question now," he said. "I still think it's very high on the agenda, and I would be surprised if it disappears between now and the next election."

More information

For more on what the House and Senate proposed, visit the Henry J. Kaiser Family Foundation.

SOURCES: Carol Pryor, health policy analyst, Boston; Robert Restuccia, executive director, Community Catalyst, Boston

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