Thursday, November 19, 2009

Getting and Spending We Lay Waste Our Powers!

(See 1 and 1a below.)

We must not criticize. We must stay mute and let our politicians run roughshod over us. They must always have the last word. It is called ''reform-ism and change' and it accords with the dictates of PC'ism. (See 2 below.)

All great nations have had their ups and downs and some have declined permanently never to recover. America remains a great and powerful nation but there are ominous signs our decline is gaining momentum. We are spent economically, militarily and now lack strong leadership.


As Thanksgiving approaches, signs of our celebratory meal - the turkey - are everywhere. This year, based on accomplishments, the biggest Tom resides in the Oval Office.

Our president has spent his first year in office traveling a good bit but accomplishing little beyond degrading our nation in the eyes of his peer group. His recent return from Asia even anticipated our next major holiday - Christmas - he came back with an empty stocking.

Democrats in Congress also have a bag full of goodies awaiting our nation but the majority of Americans are not pleased with the offerings from our 'wise men' in D.C. In fact most would like to sack these elves.

Then we have the recent decision to try terrorists, who want to destroy our nation and who were captured on the field of battle, being tried in a civilian court and thus entitled to all the legal rights and privileges of an American citizen. In this instance the Obama Administration is not even seeking the death sentence for a terrorist who killed over 3,000 Americans.

A conviction is not a certainty though the terrorist being tried has acknowledged his guilt. Why? Because he was water-boarded, ie tortured, and not read his Miranda Rights. In other words, it is possible this terrorist could walk if our system of justice recognizes the legitimacy of his defense arguments. He could then apply for American Citizenship and maybe move to Michigan whose many mosques are a potential breeding ground for domestically bred terrorists.


So why did Obama and Atty General Holder choose this route? One can only speculate but it appears the reason is to show the world what evil things GW resorted to in keeping our nation safe, ie. GW allegedly trashed our laws in order to protect and defend our nation. GW was a bad person according to Obama and Obama is committed to remind us of this fact as often as circumstances permit.

I suspect four years from now when Obama runs again for his second term he will still be bashing Bush.

It is not a very HO HO HO TIME! (See 1 and 1a below.)

A former Israeli Ambassador expresses his thoughts regarding Abbas. (See 3 below.)

A comprehensive analysis of Pelosi's health care proposals and prospective legislation, a thumb nail on Reid's Senate plan and the Republican response. (See 4, 4a and 4b below.)


Dick

1)Remember When
By Matt Spivey

President Obama has meant a lot of things to a lot people this year.

After a bumpy year with our new president, it seems appropriate to reminisce about the many labels he assumed for himself and was granted by his admirers. At first, being anyone not named Bush was enough to get him pretty far. But then Obama became a promise of a refreshing future as well as the potential reincarnation of some of our history's most influential leaders.

Remember when we elected the next Lincoln?

Our first black president was going to transcend race and bring racial harmony to a scarred America. He was the answer to all our questions about how far our nation has come since our tainted past. He was a wiry lawyer from Illinois with a knack for eloquent speeches and a high-minded vision for our country.


In fact, CBS News ran entire piece about the similarities between the two men.

Obama rode Lincoln's famous train route to Washington, D.C. and was sworn in on Lincoln's Bible. Obama even vowed to surround himself with tough thinkers who would not necessarily follow his beliefs, much like Lincoln's "team of rivals." And he promised to bring unity to our partisan nation, much like Lincoln holding the union intact through America's deadliest war.

However, a new Gallup poll shows that optimism in race relations has actually decreased since Obama's election. Turning on any news channel at any time of day clearly shows that our nation seems to be more politically partisan than ever. And the advisers with whom Obama has surrounded himself seem to be either tax-evaders or Communist sympathizers.

A train ride and a well-crafted speech do not a great leader make.

Remember when we elected the next Kennedy?

Barack Obama was so elegant, so stylish, so...cool. He was young and attractive, yet real and accessible. He was everything we had been waiting for to help us forget the stodgy white guys who had been dominating our government since JFK.

Democrats overwhelmed newsstands for months.


However, Kennedy's comparatively conservative economic policies and his ardent fight against Communism stand in stark contrast to Obama's impending tax hikes and inability or unwillingness to firmly stand against terrorism. Under Kennedy, the GDP expanded, inflation remained steady, and unemployment decreased. Kennedy believed the best stimulus package of all was to lower taxes. In foreign policy, Kennedy fought Communism in Cuba, Latin America, and Vietnam. Obama seems unable to decide whether more troops would help us win a difficult war, and he refuses to condemn Islamic extremists as terrorists, even after one murders thirteen soldiers on American soil.

A nice suit and a handsome family do not a great leader make.

Remember when we elected the next FDR?

With intentions of creating public projects and ensuring entitlement programs, Obama was every Keynesian's fantasy. He was the candidate with the answers to the failing economy and the toughness to discipline Wall Street. He would pull us out of a recession with shovel-ready jobs while providing for the nation's poor and elderly.

Democratic strategists still repeatedly say, "Obama is the greatest economic president since Franklin Roosevelt."

But he has fudged his job creation numbers. He has brought the deficit to record levels. And he has taken over financial institutions, car companies, and soon health care entities. Where will his long arm of government influence reach next? While vaguely defining "saved" jobs may have impressed some, those of us actually living in the real world tend to rely on hard evidence and economic freedom.

In the first year of Obama's reign, the economy remains stagnant, inflation will soon spike as the dollar continues to plummet, and the unemployment rate he vowed would not reach 8% has now soared past 10%. And his stimulus package -- the meager portion that has actually been spent -- has turned out to be decidedly "unstimulating."


Massive spending and big promises do not a great leader make.

So now, here we are. Unemployment is higher, confusion about the war is greater, and division in our country is fiercer. The platitudes of hope and change are gradually being replaced by the pragmatism of liberty and responsibility. While of the real hope for America lies in the nation's people, too many people in this nation have put their hope in one man. Someday, we will look back on this administration, quizzically scratch our heads, and with an embarrassed grin, ask, "Remember when we elected Barack Obama?"


1a)Obama’s Popularity Is Higher Than His Policies, Poll Finds
By Jeff Bliss

President Barack Obama is more popular than his policies, according to a poll released today.

Almost three-quarters of American voters, 74 percent, surveyed in a Quinnipiac University poll liked Obama as a person while 47 percent agreed with most of his policies.

Fifty-three percent disapproved of his handling of health care compared with 41 percent who backed the president.

Most Americans “might like to have a beer” with Obama, said Peter Brown, assistant director of the Quinnipiac University Polling Institute. Still, many who voted for him “aren’t crazy about the kind of change he is trying to bring.”

Voters opposed by 51 percent to 35 percent health-care legislation that was supported by Obama and passed by the House of Representatives on Nov. 7, the poll showed. At the same time, voters favored allowing people to be covered by a government-run insurance plan, a part of the House measure, and are against provisions that would make it harder to get the option, according to the poll’s findings.

Quinnipiac University released a poll yesterday that showed Obama’s approval had fallen below 50 percent for the first time.

Voters in the latest poll backed a so-called public option program to compete with private insurances by 57 percent to 35 percent. Forty-nine percent were against letting states opt out of the public option while 43 percent supported the idea.

Respondents opposed 47 percent to 38 percent a trigger provision, which would let people get the public option only if private insurance didn’t cover enough Americans.

The poll, taken from Nov. 9 to Nov. 16, has a margin of error of plus or minus 2 percentage points.


2)Iran is advancing on dual nuclear bomb track: uranium plus plutonium

Military sources report that the UN inspectors' October visit to Iran turned up dual-track progress in support of its nuclear weapons program: Feverish activity was registered in the production of plutonium at Isfahan as an alternative to the Fordo enriched uranium plant near Qom which starts up in 2011.

The IAEA experts discovered 30 metric tons-IS of heavy water hidden in 600 tanks, each holding 13 gallons, according to the report they handed in last week to agency headquarters in Vienna.

From the shape of the tanks and other indications, the experts concluded that this stock had not come from the heavy water plant at Arak but was imported.

Metric tons-IS measure the amount of energy a given quantity can release. The force and types of nuclear bombs are gauged in kilotons or megatons. The American nuclear bomb dropped on Hiroshima in World War II was equal to 20 kilotons of TNT. By this standard, the amount of heavy water discovered at Isfahan would be enough to make at least one plutonium bomb when the plutonium reactor under construction near the Arak heavy water facility is finished.

Other than its civilian uses, heavy water may be used to produce tritium, which intensifies the explosive force of nuclear warheads. The discovery of quantities of heavy water at Isfahan confirms the suspicions surrounding Iran's nuclear program in three respects.

1. The long concealment of the Fordo site suggested to the UN inspectors that Iran has more hole-in the-corner nuclear facilities in the country. The discovery of a stock of heavy water further confirmed that Tehran is working hard to attain a nuclear weapon capacity on more than one track and at additional covert sites.

2. The IAEA wants to know who is selling Iran heavy water in violation of Security Council resolutions banning the sale or export of nuclear materials to Iran.

The very fact that some government or outside entity is willing to flout UN resolutions demonstrates that any further international sanctions would be ineffective for halting Iran's nuclear drive, even assuming that President Barack Obama gained Russian and Chinese backing for such penalties. This backing has so far been withheld.

Sources report from Vienna that on November 10, IAEA director Mohamed ElBaradei sent a request to the Iranian Nuclear Energy Committee asking it to confirm the presence of the heavy water and document its origin with a full explanation. Tehran has yet to reply.

3. The presence of the heavy water tanks at Isfahan is additional proof that the reactor at Arak is designed for military purposes, not a peaceful installation as Tehran claims.

3) A wheelless cart before a lame horse
By Zalman Shoval

One should never underestimate the propensity of the Palestinians for shooting themselves in the foot, to wit, the situation Palestinian Authority President Mahmoud Abbas has put himself in with regard to the peace process. True, this may not have been entirely his fault - mixed signals from abroad also had something to do with it, but Abbas seems to be bent on doing everything to get himself into an even deeper hole by adopting ever more intransigent positions. Then there was his zigzagging on the Goldstone Report, after first having asked Israel during the Gaza war to "smash" Hamas.

Now someone has come up with the idea of unilaterally declaring Palestinian statehood. Palestinian Prime Minister Salaam Fayad had earlier broached the idea of building up Palestinian governance - a plausible concept in itself - but what the Palestinian functionaries around Abbas intend now is something completely different, amounting to putting a wheelless cart before a lame horse.

They had tried it before; back in 1999 Yasser Arafat, who as a result of the Oslo agreement was back in the country, announced that the Palestinians would forthwith declare their independence - only to be quickly disabused of this idea when the US and most of the Europeans made it clear to him that the declaration would not be recognized by the international community.

In the present case, there will probably be a replay of this scenario, there being indications that neither the US nor most members of the European community as well as others would legitimize a unilateral declaration by according it recognition. Even the support of Russia and China is in doubt, given that the former has not recognized the unilateral declaration of independence by Kosovo, and that the latter is facing the threat in its own backyard of the Muslim community in Xinjiang declaring independence.

Someone should have explained to Abbas that this plan would in effect annul all past agreements including those which had granted legitimacy to the Palestinian Authority as part of the Oslo agreement. Also, any unilateral act regarding borders and territory could immediately trigger parallel annexations in the territories on the part of the State of Israel. In essence, a unilateral declaration of statehood would be in violation of international law and might be deemed an act of aggression, giving Israel the right to act in response, militarily or otherwise.

SO WHY does the official Palestinian leadership still threaten to go ahead with an act which so obviously goes against its own interests? It could be to pave the way towards a new wave of violence, as Arafat had planned and acted upon after the failure of the Camp David conference. But there may also be another, more immediate reason, namely, to bring about the elimination of UN Security Council Resolution 242. This resolution, which is the only agreed basis for all the agreements and initiatives to bring about a settlement of the conflict between Israel and its neighbors, including the Palestinians (and of course, Syria), also determined that Israel was not required to withdraw from all the territories it holds as a result of repulsing Arab aggression in 1967, and that furthermore, future borders should be based on considerations of security. In other words, the dividing line between a future Palestinian state and Israel would not necessarily be commensurate with the former temporary armistice line called the "Green Line."

This then, as senior PLO and Fatah official Yasser Abd Rabbo has confirmed, is their real and immediate agenda: get the Security Council of the UN to adopt a resolution to say that the future Palestinian border would be the Green Line - thus, in effect, replacing Resolution 242 and making the latter null and void. Israel's diplomacy thus has its job cut out for it in coming months, but one trusts that the US and others too are aware of the Palestinian stratagems and that they will not lend a hand to an initiative which would seriously exacerbate the political situation in the Middle East and return any chance of peace to square one.

The writer is the former Israel Ambassador to the US, and currently heads the Prime Minister's forum of US-Israel Relations.

4)Roadmap to Victory: Providing a contrast would best expose the weaknesses of the Democratic health bills.
By Tevi Troy & Jeff Anderson

By proposing a health-care bill of their own, Senate Republicans can throw the extraordinary weaknesses of the Democratic bills into stark relief. In the wake of the Congressional Budget Office’s recent scoring of aspects of the House Republican bill, there is now an opening for Republicans to provide a clear contrast with the proposed Democratic overhaul.

The Democratic bills are polling badly, even though they’ve been running largely unopposed in the eyes of most Americans. But continuing to let them run without competition would be a major political error, in both the short and long term. Republicans need to show how health-care reform should be done, improving on the unsustainable status quo while reflecting the political realities of the moment.

The House Republican bill, while imperfect and incomplete, provides a roadmap to victory. Even the New York Times recognizes as much, writing that “a ‘cheaper’ alternative” (the Times puts it in quotes) could scuttle the passage of the proposed Democratic agenda. The Wall Street Journal strikes a similar theme, writing that in the aftermath of the New Jersey and Virginia gubernatorial elections, Republicans “have an opening” to “give obviously anxious voters an alternative.”


The Democrats are attempting to decrease the number of uninsured through mandates and requirements — at the tradeoff of raising costs. Americans recognize this. As a recent poll in the Economist shows — by the overwhelming margin of 50 to 9 percent — Americans think they would personally have to pay more if the Democrats pass a bill.

That is why the CBO’s evaluation of the House Republican alternative is so encouraging. The Republican approach is to focus on lowering costs, which in turn would make coverage easier to afford — and the CBO says this approach would succeed. It estimates that the Republican bill would lower Americans’ insurance premiums — by 5 to 8 percent in the small-group market, up to 3 percent in the large-group market, and 7 to 10 percent in the individual market — while increasing the number of insured by 3 million.

The House Republican bill also has an obvious weakness, as the New York Times and Washington Post were quick to note. While it would reduce the number of uninsured by far more per dollar spent than the Democratic bills would, it would not lower the total number of uninsured by nearly as much.

But the CBO score for the House GOP bill was also extremely positive in another way: It said that the bill would reduce deficits by $68 billion. This, in tandem with the verdict that the bill would lower premiums, provides a prime opportunity for Senate Republicans to advance a proposal that does a better job of reducing the number of uninsured.

Here’s how: Senate Republicans should take the House Republican bill and add a $2,000 per person ($4,000 per family) tax credit — refundable, advanceable, and usable only to buy insurance — for those without employer-based health coverage. Currently, those who buy health insurance on the open market have to buy it with income that’s already had taxes taken out of it, while those who get insurance through their employer get it tax-free. This inequality is unfair, and it makes no sense when trying to solve the problem of the uninsured.

Elsewhere, Senate Republicans should more or less mirror the spending proposals of the House Republican bill, though they would be wise to spend more on state-run high-risk pools and less on incentives for innovations by states. They should save money by putting their legislation into effect no sooner than 2014 (just like 98.3 percent of the Senate Democrats’ bill). Importantly, while adding a tax-credit for the uninsured, the Senate proposal should leave the tax status of those with employer-provided insurance entirely untouched. (Millions of Americans are worried that their employer-provided insurance will be jeopardized by the Democrats’ proposed “public option,” and they want to know that their employer-provided insurance will remain secure.)

The CBO has already scored such a tax credit, albeit with somewhat different terms. Based on that prior CBO scoring, this proposal would likely reduce federal revenues by about $190 billion by the end of 2019, while increasing the number of insured by about 12 million. (If it were to insure more, it would reduce revenues by more, and the inverse is also true.) These 12 million people would largely be in addition to the 3 million newly insured from the House Republican bill, and would put a significant dent in the number of uninsured.

According to the Census, there are 28 million uninsured Americans — 46 million, minus 9 million non-citizens, minus 9 million Medicaid recipients that the Census admits were falsely tallied as uninsured. (Note: The CBO has consistently been using the wrong number on this, failing to adjust for the Census’s admitted Medicaid undercount.) President Obama seemingly agrees with this analysis, having said in his address to a joint session of Congress on September 9 that there “are now more than 30 million American citizens who cannot get coverage.” This proposed Senate Republican bill would cut that number in half.

So, how to pay for this? The CBO has already floated and scored the idea to convert Disproportionate Share Hospital (DSH) payments into block-grant payments to each state. DSH payments help compensate private hospitals for losses from treating the uninsured. With fewer uninsured, DSH payments need not expand at the same rate. Following the basic outlines of the CBO’s proposal, the Republican bill should set the block grant at 80 percent of each state’s current level of federal DSH funding and index it to the consumer price index minus one percentage point. Based on CBO scoring of a very similar proposal, this would increase revenues by about $135 billion from 2014-19.

Between this $135 billion and the net $68 billion surplus from the other provisions of the House Republican bill, $203 billion would be available to cover the $190 billion tax-cut for the uninsured, leaving a small surplus.

So, let’s compare the results.

The Senate Democratic bill — as passed by the Senate Finance Committee and now in the hands of Senator Reid — would raise taxes and fines on Americans by over half a trillion dollars. A Republican bill along the lines of the one proposed here wouldn’t impose any new taxes or fines.

The Democratic bill would provide strong incentives for people not to buy insurance until they are already sick or injured, raising premiums for everyone else in the process; the Republican bill would provide strong incentives and opportunities for people to buy insurance, letting them shop across state lines for the best values from coast to coast.


The Democratic bill would fail to end runaway medical-malpractice suits, which cause doctors to practice costly defensive medicine, stop practicing in certain areas, and pass along expensive malpractice premiums to patients; the Republican bill would end such runaway suits, saving the federal government $54 billion over ten years, according to the CBO, and likely saving Americans many times that in health costs.

The Democratic bill would funnel those without employer-provided insurance into government-run exchanges, where plans would look similar because the government would tell companies how they have to look; the Republican bill would keep alive and even expand the private market. The Democratic bill would perpetuate the federal government’s counter-productive limits on allowing private companies to offer lower premiums for healthier lifestyles; the Republican bill would welcome these Safeway-style cost-cutting efforts.

The Democratic bill would require younger Americans to subsidize the premiums of older Americans, banning private companies from offering plans to younger people at their true price; the Republican bill would not impose this heavy burden on young adults. The Democratic bill would limit the use of Health Savings Accounts (HSAs), making it harder for people to control their own health-care dollars and forcing them to pay money to their insurance companies rather than directly to their doctors; the Republican bill would encourage HSAs, private control, and price-consciousness.

The Democratic bill would result in an additional 27 million Americans (29 million people) having insurance, at a cost of $31,000 per newly insured American; the Republican bill would result in about 15 million more Americans having insurance, at a cost of less than $15,000 per newly insured American. Otherwise stated, the Republican bill would newly insure about 15 million Americans per $200 billion spent, compared to fewer than 7 million per $200 billion under the Democratic bill.

The Democratic bill would siphon over $400 billion out of already-barely-solvent Medicare; the Republican bill wouldn’t touch Medicare (aside from the proposal regarding DSH payments). The Democratic bill says that it would cut doctors’ Medicare payments by 25 percent and never raise them back up — making it harder for Medicare patients to find doctors willing to see them; the Republican bill would leave doctors’ payments alone.

If Congress doesn’t follow through on the Democratic bill’s Medicare cuts — and the CBO is plainly skeptical that it will — the CBO says the bill would increase our deficits by over $300 billion, as dealing with doctors’ payments alone would cost roughly $250 billion; the Republican bill would be deficit-neutral and would even provide a slight surplus.

Finally, the Democratic bill would likely raise Americans’ insurance premiums substantially; the Republican bill would lower Americans’ insurance premiums significantly — according to the CBO.

The Republican bill would have no obvious weaknesses. Aside from inefficiently and expensively increasing the number of insured, the Democratic bill would have no obvious strengths.

By taking the House Republican bill, adding a tax cut for the uninsured, and adopting a variation on the CBO’s proposal to convert DSH payments into block grants, Senate Republicans could offer an extraordinary — and extraordinarily popular — health bill. This bill would meet both widely stated goals of health-care reform: lowering costs and decreasing the number of uninsured. And it would do so sensibly, affordably, and unobtrusively.

In comparison, the Democratic bill would appear all the more plainly irresponsible, profligate, and counterproductive.

The Republican bill could help convince some centrist Democrats that there in fact is a better way. If not, if would help further convince the American people of this fact. It would provide an important alternative for Americans to consider all the way through the 2010 and 2012 elections — where the fate of any legislation that the Democrats dare to pass on a near-party-line vote would ultimately be decided.

— Tevi Troy, a visiting fellow at the Hudson Institute, was the deputy secretary of health and human services (HHS) from 2007–09. Jeffrey H. Anderson, director of the Benjamin Rush Society, was the senior speech writer for Secretary Mike Leavitt at HHS from 2008–09.

4a)Reid lays out $849B Senate health care bill
By John Fritze


Senate Majority Leader Harry Reid unveiled an $849 billion health care bill Wednesday that advanced President Obama's broad vision to revamp the health insurance market but left key moderate Democrats uncommitted.

Introduction of the bill — which Reid said represented "the last leg of this journey we've been on for a long time" — cleared the way for a vote this week on whether to start debate on health care as Senate leaders race to finish a bill by year's end.


Obama called the bill, which combines separate legislation passed by two Senate committees, "another critical milestone" and said he looked forward to getting legislation "to my desk as soon as possible."

The latest iteration of the massive health care legislation, which Reid said would cost $849 billion over the first 10 years, came after weeks of behind-the-scenes negotiations. It would provide coverage to 31 million Americans who wouldn't otherwise have it and would cut federal budget deficits by $127 billion, Reid said.

Largely similar to a bill narrowly passed by the House on Nov. 7, the legislation would require virtually every American to buy a health insurance plan, would expand Medicaid enrollment by millions and would provide subsidies to help low- and moderate-income families afford premiums.

Among the provisions included in the Senate bill:

•A government-run insurance program similar to Medicare that would compete with private insurers. Individual states could opt out of offering the public plan, and the government would negotiate, rather than dictate, how much to pay for medical services.

•Prohibitions against using taxpayer money to pay for abortions. Insurance companies would be required to segregate private premium money from government subsidies and to use only private money to pay for abortions. The same rule would apply to the public option.

•A half-percentage-point increase in the Medicare payroll tax for individuals who earn more than $200,000 and couples who take in more than $250,000 a year. Insurance plans that exceed $8,500 for individuals and $23,000 for couples would be taxed 40%, and elective cosmetic surgeries would be taxed 5%.

•Companies with more than 50 workers that do not offer insurance would pay $750 for each employee that receives a government subsidy for insurance.

"What's not to like about this bill?" asked Sen. Tom Harkin, D-Iowa, who is the chairman of the Senate's health committee.

Hours before the bill was unveiled, Reid was courting moderate Democrats he will need to bring the bill to the floor for debate — a procedural effort that in this case will require 60 votes.

Emerging from a rare evening meeting of Democratic senators to review the proposal, Sen. Ben Nelson, D-Neb., said he is reserving judgment. "It's one thing to talk about it," he said. "It's another thing to actually have the legislation in your hands." Democratic leaders posted the text of the legislation late Wednesday.

Republicans were critical of the legislation. Senate Minority Leader Mitch McConnell, R-Ky., called the bill "another trillion-dollar experiment."

4b)Republicans blast 'bait and switch' health bill
By DAVID ESPO

Digging in for a long struggle, Republican senators and governors assailed the Democrats' newly minted health care legislation Thursday as a collection of tax increases, Medicare cuts and heavy new burdens for deficit-ridden states.

Despite the criticism, there were growing indications Democrats would prevail on an initial Senate showdown set for Saturday night, and Majority Leader Harry Reid crisply rebutted the Republican charges. The bill "will save lives, save money and save Medicare," he said.

The legislation is designed to answer President Barack Obama's call to expand coverage, end industry practices such as denying coverage on the basis of pre-existing medical conditions, and restrain the growth of health care spending.

Republicans saw little to like.

"It makes no sense at all and affronts common sense," said Sen. Judd Gregg of New Hampshire, one of several Republicans to criticize the measure. He added that a plan to expand Medicaid, the state-federal program for the poor, was a "bait and switch" with states as the victims.

GOP governors, meeting in Texas, agreed. "We all know a sucker play when we see one," said Mitch Daniels of Indiana. The bill would expand the Medicaid program, which provides health care for the poor, and leave the states with part of the additional cost beginning after three years.

In the Capitol, Reid answered Republican delaying tactics with an initial test vote set for Saturday evening. A 60-vote majority is required to advance the bill toward full debate, expected to begin after Thanksgiving.

Counting two independents, Democrats control 60 Senate seats. Three moderate Democrats have been cagey about their intentions, although none of them has announced a plan to defect. Officials disclosed during the day that Reid had included in the bill a political sweetener for one of the three, Mary Landrieu of Louisiana, in the form of $100 million to help her state cover health care costs for the poor.

While the struggle was forming, there were limits. Sen. Tom Coburn, R-Okla., backed off his threat to force the 2,074-page bill to be read aloud in the Senate chamber, a move that would have eaten into the Senate's Thanksgiving-week vacation.

Given the political stakes, there was disagreement even about the bill's cost.

Democrats put the price tag of the 2,074-page measure at $979 billion, higher than the $849 billion figure they had cited Wednesday as the cost of expanding coverage to 31 million who now lack insurance. Republicans calculated it at more like $1.5 trillion over a decade, and said even that was understated because Reid decided to delay implementation of some of the bill's main features until 2014.

Officially, the Congressional Budget Office said the measure would reduce deficits by $130 billion over the next decade with probable small reductions in the 10 years that follow — forecasts that cheered rank-and-file Democrats. Among the cost-cutting provisions would be creation of an Independent Medicare Advisory Board which could be required to recommend steps limiting the growth of the program that provides health care to millions of seniors. The recommendations would go into effect automatically unless Congress blocked them.

CBO Director Douglas Elmendorf has said previously that type of arrangement would be one of the most potent weapons Congress would have to restrain the growth of Medicare, a fast-expanding program supported in part by a trust fund that is dwindling.

But CBO also cautioned the bill includes "a number of procedures that might be difficult to maintain over a long period of time."

The Democrats' cost estimates of slightly below $1 trillion was considerably smaller than a House-passed bill's price tag of between $1.2 trillion to $1.3 trillion.

In part to reduce costs, the legislation would delay until Jan. 1, 2014, creation of so-called insurance exchanges in which individuals and small businesses could shop for affordable coverage. The House would set up its version of the exchange one year earlier.

Both bills would allow consumers to choose between private insurance policies and coverage sold by the government.

The two bills also include billions of dollars in subsidies to help lower-income Americans afford the cost of coverage.

Under the Senate measure, CBO figures show about 19 million people would receive subsidies averaging $5,500 in 2019, at the end of the decade. By comparison, the House bill is projected to provide subsidies to 18 million, an average of $6,800.

Republicans said little if anything about subsidies during the day, instead focusing much of their criticism the bill's tax increases and its curbs in Medicare spending.

Democrats included a new tax on high-value insurance policies, an attempt not only to raise money but also to dampen the appetite for costly coverage. In addition, Reid included a payroll tax increase of .5 percentage point on income greater for $200,000 for individuals and $250,000 for couples. Medical device manufacturers, insurance companies, drug makers and recipients of elective cosmetic surgery would also face new or higher taxes.

About half of the bill Reid unveiled Wednesday would be financed by curbs in projected Medicare spending. While providers such as home health care agencies would absorb some of that, the biggest blow would fall on private Medicare plans. Studies show the government pays about 14 percent more to cover patients enrolled in those plans than in the traditional Medicare program.

Associated Press writers Ricardo Alonso-Zaldivar and Erica Werner in Washington and Liz Sidoti in Austin, Texas, contributed to this story.

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