Senate healthcare bill advances with rejection of imported drugs

Reporting from Washington — 

The path to enacting the first major healthcare overhaul in decades opened wider Tuesday, as the Senate voted down a divisive proposal for direct importation of prescription drugs, and President Obama rallied Democrats behind a decision to put aside one of liberals’ most cherished ideas -- creating a government alternative to private medical insurance.

Obama summoned Senate Democrats to the White House on Tuesday to urge them not to let disagreements over details of the legislation derail or delay the landmark effort.

“This reform has to pass on our watch,” the president said. “We are on the precipice of an achievement that has eluded Congresses and presidents for decades.”

And while some liberals expressed continuing unhappiness that the Senate bill would not have an alternative to private insurance, leaders of several progressive groups pushed for lawmakers to act rather than risk stalling their drive.

“The final bill won’t include everything that everybody wants,” Obama said.

Reflecting the push for unity in the face of divisions, Sen. Joe Lieberman of Connecticut, the Democrat-turned-independent who only days before had thwarted Senate leaders in a last-ditch effort to include a modified form of a government-run insurance option, was among those attending the meeting.

The defeat of the drug importation proposal from a bipartisan group of lawmakers, which would have made it easier to import cheaper prescription drugs from Canada and Western Europe, was a crucial victory for Obama and the pharmaceutical industry.

The politically charged amendment had held up the Senate for a week and threatened to derail the whole healthcare bill.

The vote on the amendment -- cosponsored by Sens. Byron L. Dorgan (D-N.D.) and John McCain (R-Ariz.) -- was 51 to 48, nine short of the 60 needed to pass.

The president’s bid for unity despite differences within his party came at a crucial moment, in advance of key votes on the overall compromise that did not include the “public option” government plan or an alternative plan to expand Medicare, which was popular with liberals.

A vast array of details has yet to be pinned down, but the framework of the bill came into view as Majority Leader Harry Reid (D-Nev.) continued pushing the Senate to finish work before Christmas.

The sense of gathering momentum was fueled as disputes on other issues appeared to be moving toward resolution. Democrats were still trying to find a way past their differences over restrictions on federal funding for abortion.

The drug amendment had in the past enjoyed broad support from Democrats, including Obama. But the White House and Senate leaders feared that if the amendment had been approved, pharmaceutical companies would turn against the legislation. The companies had struck a deal with the White House earlier this year to back a healthcare overhaul in return for limiting the economic effect on their industry.

To mollify critics, Reid has pledged to work with House leaders to ensure that a final bill would close the so-called Medicare doughnut hole, a gap in prescription drug coverage that forces millions of seniors to pay for thousands of dollars of medications out of their own pockets.

On the broader questions, Reid plans to unveil the details of his final compromise today after receiving an official report on its costs and impact from the nonpartisan Congressional Budget Office.

After that, he is expected to begin the complex procedural steps required to cut off a Republican filibuster, with the first in a series of crucial votes coming as soon as Friday.

Without any GOP support, all 60 senators in the Democratic caucus, including Lieberman and another independent, would have to vote for the procedural motions in order for the bill to advance. It would then have to be reconciled with a version passed last month by the House, a stronger bulwark of liberalism than the Senate.

House Democrats welcomed the apparent end of the Senate’s stalemate, but were not happy about the drift of its compromises.

“We in the House have made a beautiful souffle, but the Senate has scrambled an egg,” said Rep. George Miller (D-Martinez), noting that Reid already had said that he expected to go along with the House in closing the Medicare doughnut hole.

Some liberals pledged to vote against the bill if it is in the Senate mold, but Democratic leaders steered clear of such ultimatums. House Majority Leader Steny H. Hoyer (D-Md.) told reporters that the House could pass the healthcare bill without a public option, contrary to earlier warnings.

Liberals acknowledged that they were in a weak bargaining position because conservatives were willing to kill the bill over their disagreements -- and Democrats were not.

“We progressives are negotiating with a gun to our heads,” said Rep. Anthony Weiner (D-N.Y.).

The final push for Senate action picked up important support Tuesday from several leading consumer groups, including AARP, the American Cancer Society Cancer Action Network, Consumers Union and Families USA.

The groups plan to join the Service Employees International Union, which has been a leading advocate for a new government insurance plan, at the Capitol today to urge senators to quash a Republican-led filibuster next week.

The White House meeting came one day after Senate Democrats backed down from the idea of expanding Medicare in lieu of the public option, bowing to opposition from conservative Democrats and Lieberman.

Democrats were furious at Lieberman, the former Democratic vice presidential nominee, because he had supported the expansion of Medicare in the past.

But the White House tried to defuse that anger.

“If we held flip-flops against everybody in the Congress, we’d probably not have many people there,” Vice President Joe Biden said in an interview on the MSNBC program “Morning Joe.”

At the White House, Lieberman signaled that he planned to vote for the bill, according to sources briefed on the meeting.

Obama urged others to see the glass as half-full, emphasizing that the legislation, like the landmark 1965 law that created Medicare, would be a foundation for further improvements later.

“Be joyful; be grateful,” Obama said, according to Senate Finance Committee Chairman Max Baucus (D-Mont.). “We’ll build upon it in the future.”

In his public comments after the meeting, the president said that the emerging Senate bill meets the major criteria he set out in a September healthcare speech before a joint session of Congress: It would slow the growth of healthcare costs, reduce the ranks of the uninsured, not add to the deficit, and impose new regulations on insurance companies to curb abusive practices.

Beyond that, Obama said, “We simply cannot allow differences over individual elements of this plan to prevent us from meeting our responsibility to solve a long-standing and urgent problem for the American people. . . . They are waiting for us to act. They are counting on us to show leadership. And I don’t intend to let them down.”

Sen. Sherrod Brown (D-Ohio), a staunch liberal who had steadfastly refused to compromise on a public option, said after meeting with Obama that he would vote for the bill despite his reservations.

“There is too much at stake,” he said.

noam.levey@latimes.com

janet.hook@latimes.com