WASHINGTON -- The Senate voted on party lines Saturday night to overcome a Republican filibuster and bring to the floor a bill that would overhaul the nation's health-care system.
After days of indecision, the two final Democratic holdouts - Sens. Blanche Lincoln of Arkansas and Mary Landrieu of Louisiana - voted with the rest of the 60 members of their caucus to support a procedural motion to begin debate. Though strictly parliamentary, the vote marks a milestone in the quest for health-care reform reignited by President Barack Obama's election.
The 60 to 39 vote set up weeks of debate. Senate Majority Leader Harry Reid, D-Nev., is aiming for final passage before Christmas.
New York Sens. Charles Schumer and Kirsten Gillibrand, both Democrats, each voted in favor of the motion.
The House passed a $1 trillion health bill two weeks ago; the $848 billion Senate version represents the work of two committees and hundreds of hours of hearings and deliberations, against a backdrop of fervent Republican opposition. But even as Democrats heralded their expected victory Saturday, they conceded that the vote represents the end of the beginning, not the other way around.
Like Sen. Ben Nelson, D-Neb., a holdout until Friday, Lincoln and Landrieu said they will press Reid for further changes to the bill before committing to its final passage.
Even to pass Saturday's hurdle, Reid agreed to a 72-hour review period that Lincoln had sought after the bill was introduced Wednesday night. He added a Medicaid clause worth up to $300 million for Landrieu's home state. Although many Democrats pressed Reid to include language to end a federal antitrust exemption for health insurers, he omitted the repeal to lock down Nelson's vote.
The weeks ahead are likely to bring many more costly concessions. Democrats are already requesting changes to the legislation, raising concerns related to Medicare, abortion and employer requirements.
But Democratic leaders said the Saturday vote provided a jolt of momentum that vastly improved prospects for a completed Senate bill before the Christmas break, leaving January for negotiations with the House. The goal now is to deliver final legislation to Obama in time for the 2010 State of the Union address in late January.
"There will be more procedural hurdles, more disagreements, more pressure from our opponents, more television ads, and many amendments," said Schumer, D-N.Y. "But I have no doubt that we will pass this bill."
Republicans portrayed the action Saturday night as considerably more consequential, tantamount to an endorsement of the underlying bill, or "a vote for higher premiums, cuts to Medicare, and more taxes," as Sen. Lamar Alexander declared.
"All those people who are concerned about the high cost of health care today aren't getting under relief under the Democrat plan," said Sen. John Thune of South Dakota.
The Senate bill would provide coverage to 31 million Americans by vastly expanding Medicaid and creating insurance "exchanges" for individuals who do not have access to affordable coverage through their employers. For the first time, it would require most people to carry health coverage, although families with incomes up to 400 percent of the federal poverty level would receive subsidies to buy policies.
The legislation would also force widespread changes to the insurance industry to end discriminatory practices, including the rejection of coverage based on preexisting conditions. It would provide new incentives to encourage disease prevention and to institute the most effective treatments for chronic conditions such as diabetes and asthma.
On the revenue side, the Senate bill would extract about $400 billion in cost savings from Medicare and Medicaid, and impose an excise tax on the most generous health-care policies, dubbed "Cadillac" plans.
It would raise payroll taxes for high earners and levy a new 5 percent tax on elective cosmetic surgery.
Posted in Local on Saturday, November 21, 2009 10:00 pm | Tags: Health Care
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