Health Care Overhaul On Track For Final Passage
Senate Democrats pushed the health care bill past its final major procedural test Wednesday, voting 60-39 to end debate and putting the $871 billion overhaul on track for final passage Thursday morning.
Majority Leader Harry Reid (D-Nev.) kept his caucus together for the third time in three days, delivering the 60 votes necessary to break a Republican filibuster on the bill.
Reid also announced he’s moving up the time of the Christmas Eve vote by one hour, to 7 a.m. Thursday.
After the vote, congressional Democrats will turn to reconciling the House and Senate bills, which include different approaches to restrictions on abortion coverage, the role of government in health care and the mandates placed on employers to provide insurance.
Sen. Ben Nelson (D-Neb.), the last holdout on Senate passage, threw what could be a complication into the mix Wednesday, saying he didn’t want to see the overall cost of the bill grow much beyond the $871 billion in the Senate version.
"I am going to be much very aware of what goes into the conference committee and what comes out of the report and watching it very closely," said Nelson.
His ceiling on spending? "The current number — $871-ish," Nelson said.
House leaders have already indicated they want to make changes in the Senate bill, including possibly increasing tax credits to help people buy insurance and moving up start dates for some programs. But both steps would boost the cost of the overall bill, so Nelson’s comments signal there could be tough negotiations ahead.
The White House privately anticipates health care talks to slip into February — past President Barack Obama’s first State of the Union address — and then plans to make a “very hard pivot” to a new jobs bill, according to senior administration officials.
Obama has been told that disputes over abortion and the tight schedule are highly likely to delay a final deal, a blow to the president, who had hoped to trumpet a health care victory in his big speech to the nation. But he has also been told that House Democratic leaders seem inclined, at least for now, to largely accept the compromise worked out in the Senate, virtually ensuring he will eventually get a deal.
Democrats originally hoped to finish before Obama’s speech to Congress to allow Democrats to turn their focus to the nation’s economy ahead of the 2010 elections. But by Wednesday, they weren’t so sure anymore that they could do it.
"I'm not making any promises on that one," Iowa Sen. Tom Harkin said about finishing before the speech. "We will have it to him, I would hope, before the end of January, but I don't know before the State of the Union. There are a lot of differences between the Senate and the House."
On the Senate floor Wednesday, the partisan sniping over the bill continued, with Republicans continuing to hit Democrats for last-minute changes to the bill designed to secure Democratic votes, such as a fix to win over Nelson that would save Nebraska nearly $100 million in state Medicaid spending in the first 10 years.
“There has been growing public concern that earmarks were used to buy votes for this legislation,” said Sen. Jim DeMint (R-S.C.). “It has been argued by some that this practice is acceptable because it’s necessary to get things done in the Senate. I reject that argument, and I urge my colleagues to put an end to business as usual here in the United States Senate.”
The Senate rejected a proposal from DeMint to prohibit earmarks for the explicit purpose of obtaining votes. Democrats objected, saying the idea sounded good in theory but would be unworkable in practice.
DeMint said he expected Democratic support because Majority Whip Dick Durbin (D-Ill.) co-sponsored a similar measure in 2007.
"Not anymore," Durbin said, waving off DeMint from the Senate floor.
Democrats made a last-minute attempt to recast the focus of the debate, away from the growing tensions between the parties and toward the people whom the majority leader said the bill would help.
“Each has been a party-line vote, and much of this debate has focused on politics,” Reid said shortly before the vote, pointing to a stack of letters. “But the health care debate is not about procedure … but about people.”
Health and Human Services Secretary Kathleen Sebelius and White House health reform director Nancy-Ann DeParle were on hand at the Capitol for the vote, as they had been Monday and Tuesday.
The only suspense in recent days had been when the Senate would take the final vote. Republicans were prepared to run out the entire clock on the procedural motions — a move that would have forced senators to vote at about 10 p.m. Christmas Eve. But Reid and Minority Leader Mitch McConnell (R-Ky.) worked out a deal Tuesday to have the final vote at 8 a.m. Thursday, and then Reid bumped it one hour earlier.
Unlike the three procedural motions, which required 60 votes, the vote on final passage requires only 51 votes.
Even though final passage is still hours away, Senate Democrats planned to celebrate early. The entire caucus was invited to a news conference at 4 p.m. Wednesday.
The Senate bill would extend coverage to 31 million uninsured Americans by expanding Medicaid, creating new insurance subsidies, setting up a national insurance marketplace and offering private plans nationwide administered by the same federal agency that oversees federal employee benefits. No longer could firms deny insurance over pre-existing conditions or set a lifetime limit on benefits.
But the plan falls far short of Obama’s initial vision for reform in one key regard — Democrats stripped out a government-run insurance option after several moderate Democrats said they’d block the bill if it remained.
That decision has drawn sharp fire from the party’s liberals, who have said the Senate plan isn’t true reform and would merely enrich private insurers — setting up a showdown with moderates, who have threatened to walk if liberals try to force it back in.
Sources: Politico
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