He declined to disclose details but said the proposed approach "would exclude any kind of federal funds directly or indirectly being used to fund elective abortions, and the question is always how you get them as tight as you can and still be able to get a common understanding and something that you could all agree to."
"We're looking at that to see if it does it sufficiently. That's the key — sufficiently," Nelson said during a break in closed-door talks in the Capitol with Senate Majority Leader Harry Reid, senior White House officials and others. The discussions were expected to continue into the night as Reid rushes to finalize the legislation in time for a first vote likely within days. Nelson is the lone holdout in the 60-member Democratic caucus — exactly the number Reid needs to overcome Republican opposition and pass the legislation.
Several officials said Nelson was seeking to ease the impact of a proposed insurance industry tax on nonprofit companies, as well as win more federal funds to cover Nebraska's cost of treating patients in Medicaid, the state-federal health care program for the poor. These officials, speaking on condition of anonymity because of the sensitivity of the talks, said the administration and Democratic leaders had offered concessions on those points.
In another sign of progress, Nelson said legislative language on Medicaid might be drafted in anticipation of agreement.
Nelson has spoken openly of seeking stricter abortion curbs, except in cases of rape, incest or when the life of a mother is in danger. An earlier proposed compromise on that issue — which attempted to separate public from private funds for abortion coverage — won the tentative support of Catholic hospitals. But the National Right to Life Committee objected, dismissing it as an accounting gimmick.
Later Friday, Cardinal Daniel DiNardo of the U.S. Conference of Catholic Bishops also rejected to the proposal. He said it "does not comply with long-standing ... restrictions on federal funding of elective abortions" that govern other government programs. The bishops played a significant role in drafting an abortion-related provision in the House bill.
If Republicans cared much about the outcome of negotiations, it wasn't apparent.
"This massive piece of legislation that seeks to restructure one-sixth of our economy is being written behind closed doors without input from anyone in an effort to jam it past not only the Senate but the American people before Christmas," said Sen. Mitch McConnell of Kentucky, the Republican leader.
"They are virtually thumbing their nose at the American people who are virtually screaming at us, don't pass this bill," he added.
Public opinion polls show lagging support for the measure, although Democrats argue that will change once legislation passes and consumers see benefits.
Not all liberals saw it that way.
MoveOn.org, which helped fuel Obama's election last year, announced its opposition to the measure, citing its lack of a government-run insurance option. It urged its members to sign a petition saying, "America needs real health care reform — not a massive giveaway to the insurance companies."
The bill is designed to extend coverage to millions who lack it, prohibit the industry from denying insurance on the basis of pre-existing medical conditions and generally slow the rate of growth of medical spending nationwide.
At a cost of nearly $1 trillion over a decade, it includes hundreds of billions of dollars to defray the cost of coverage to individuals and families at lower and middle incomes.
Reid, D-Nev., has been preparing a final series of revisions to the 2,074-page bill, with Senate debate expected to begin on them shortly after they are made public sometime early Saturday.
In addition to the negotiations with Nelson, there were talks with Sen. Olympia Snowe, R-Maine, who voted for an earlier version of the legislation when it cleared the Senate Finance Committee.
Republicans, who have been accused by Rush Limbaugh and others for failing to oppose the legislation vigorously enough, have threatened to force Senate clerks to read the entire text of the proposed changes aloud, a process that could consume eight hours or so.
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