Democrats Consider Bypassing G.O.P. on Health Care Plan

By ROBERT PEAR - The New York Times

WASHINGTON — With solid majorities in both houses of Congress, Democrats are tempted to use their political muscle to speed passage of health care legislation with minimal concessions to the Republican minority.

That approach may be the only way they can fulfill President Obama’s campaign promises, but it carries high risks as well.

In the budget blueprint for the coming year, Democrats may resort to an obscure procedure known as reconciliation to clear the way for Senate passage of a comprehensive health bill with a 51-vote majority, rather than the 60 votes that would otherwise be needed.

A health care bill written mainly or entirely by Democrats would look different from a bipartisan product. It would almost surely create a new public health insurance program, to compete with private insurers. It would require employers to provide insurance to employees or contribute to its cost. Employers who already offer insurance to their workers could be required to provide more or different benefits, and Congress could limit the tax breaks now available for such employer-provided insurance.

The committee chairmen writing the Senate health bill, Max Baucus of Montana and Edward M. Kennedy of Massachusetts, both Democrats, have been assiduously courting business groups and labor unions, consumer groups, doctors, hospital executives and other health care providers.

Those groups — eager for a seat at the table, eager to sound constructive — have been remarkably restrained so far. They have held back in their criticism of proposals being seriously considered by Congress and the White House. But the strains are beginning to show. Labor leaders have conveyed their concern about taxing health benefits to Mr. Baucus in the strongest possible terms. Employers have warned Congress against requiring them to provide any specific amount of insurance.

Steven Kreisberg, director of collective bargaining and health care policy at the American Federation of State, County and Municipal Employees, said: “We absolutely oppose a change in the tax treatment of employee health benefits. It would endanger the current employer-based health care system at a time when we are trying to sustain it.”