MELISSA BLOCK, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block in Washington.
MADELEINE BRAND, host:
And from California, I'm Madeleine Brand. I'll be hosting for the next two weeks.
BLOCK: And it's great to hear you again on the program, Madeleine. Welcome back.
BRAND: Well, thanks Melissa. It's great to be back. And let's check in with politics today. They were waiting for the outcome of the Massachusetts Senate race. That could decide the fate of the health care overhaul bill in Washington. And if he wins, Republican Scott Brown has vowed to become the key vote to block a final version of the bill.
As NPR's Julie Rovner reports, Democrats are scrambling for Plan B.
JULIE ROVNER: At his weekly briefing with reporters this morning, House Majority Leader Steny Hoyer insisted that negotiations between the House and Senate on a final health bill are proceeding on schedule.
Representative STENY HOYER (Democrat, Maryland): I'm not going to anticipate or speculate or hypothesize on what may or may not happen in Massachusetts today. I am very hopeful and my expectation is that Attorney General Coakley will be elected to the United States Senate.
ROVNER: That would be Martha Coakley, the Democratic candidate who's lost a double-digit lead in the polls in the past few weeks. But behind the scenes, Democrats have been scrambling to put together options to pass a health overhaul bill if Coakley loses. The easiest option is to simply finish the current negotiations and get a bill to the president. They should have about two weeks before the Massachusetts election is certified. Hoyer didn't hesitate when he was asked if he thought negotiations could be done by then.
Rep. HOYER: Yes.
ROVNER: After that, though, things get considerably less simple. The next option, says Bill Hoagland...
Mr. BILL HOAGLAND (Lobbyist, CIGNA): You could have the House hold their no's and vote for the Senate passed bill and get it to the president with the understanding that through forthcoming must-pass legislation, you start making modifications to the Senate passed bill.
ROVNER: Hoagland, a longtime Senate Republican budget aide and now a lobbyist for insurance giant CIGNA, says he doesn't consider that option very likely. That's because there are so many aspects of the Senate bill that House Democrats don't like. The Senate bill, for example, doesn't have a government sponsored insurance option. It includes a controversial tax on high-cost health plans and it's far less generous in terms of subsidies for lower middle income Americans, which brings up a third possibility: budget reconciliation.
Republicans call it the nuclear option because it doesn't allow senators to filibuster and only requires 51 votes to pass. The bad news says, Hoagland, is that it would basically require lawmakers to start the process over again. A new health bill would have to go back through committees and floor debate.
Mr. HOAGLAND: This probably stretches it into the spring. But it clearly is an option, it's still available to the president and to the Congress until a new budget resolution is adopted.
ROVNER: Hoagland says even the insurance industry, which opposes key elements, said the bill is now under discussion, wants to see something settled as soon as possible.
Mr. HOAGLAND: There comes a point when you just want some clarity so we can make plans going forward. And while, yes, there are things that the industry has not been happy with, there are other things that we've been prepared to get on with.
ROVNER: Things like eliminating restrictions on preexisting conditions. Meanwhile, Ron Pollack of Families USA has come up with a Plan D he thinks might work. He would have the House vote almost simultaneously on the Senate passed health bill and a separate bill that would embody the negotiated changes. That second bill would be in the form of a budget reconciliation bill, which would only need 51 votes in the Senate.
Mr. RON POLLACK (Executive Director, Families USA): This clearly works, I believe that it can happen quickly. And I think it can end up with a very good result.
ROVNER: And, says Pollack, it might even have an advantage over the current negotiations by letting some reluctant moderate Democrats in the Senate simply vote no.
Mr. POLLACK: So, I think it frees up the negotiators to come up with an agreement that's more to the liking of the House and Senate leadership and the president.
ROVNER: Of course, what Democrats really want is Plan A, for Coakley to win in Massachusetts so they don't have to worry about any of these contingencies.
Julie Rovner, NPR News, Washington.