At an August meeting in the Oval Office with the six leading Senate negotiators, three from each party, Grassley asked Obama if he would say publicly that he would be willing to sign a bill without a public option, according to Grassley aides. Obama demurred, knowing that would trigger a revolt among House Democrats. For his part, the president later told his own staff that he asked Grassley if he would support the health care plan if the president agreed to what the senator was asking for. As Obama later recalled the encounter, Grassley replied, “Probably not.” (Grassley aides dispute that Obama asked that question and they told me the senator said only that it would not be a bipartisan bill unless it had 70 or 80 votes.) Much later, both camps would cite this conversation as a turning point at which it became clear that there would be no significant bipartisan accord.

There is some fear because in the House bill, there is counseling for end-of-life," Grassley said. "And from that standpoint, you have every right to fear. You shouldn't have counseling at the end of life. You ought to have counseling 20 years before you're going to die. You ought to plan these things out. And I don't have any problem with things like living wills. But they ought to be done within the family. We should not have a government program that determines if you're going to pull the plug on grandma."