published Monday, December 21st, 2009

Democrats push to pass health care by Christmas

ERICA WERNER, Associated Press Writer

WASHINGTON — A crucial, middle-of-the-night test vote behind them, Senate Democrats on Monday remained on track to pass historic health care legislation by Christmas, preparing for more votes at odd hours to overcome unanimous Republican opposition.

All 58 Democrats and the Senate's two independents held together early Monday to advance President Barack Obama's health care overhaul, which would extend coverage to 30 million people now uninsured and try to slow ruinous increases in medical costs. The 60-40 margin was exactly the number needed to shut down a threatened GOP filibuster. The next vote is expected around 7:20 a.m. EST Tuesday.

Obama called the vote "a big victory for the American people," and challenged critics who say it will increase, not reduce costs.

"For all those who are continually carping about how this is somehow a big spending government bill, this cuts our deficit by $132 billion the first 10 years, and by over a trillion in the second," Obama said. "That argument that opponents are making against this bill does not hold water."

Monday's Senate vote came shortly after 1 a.m. with the nation's capital blanketed in snow, the unusual timing made necessary in order to get to a final vote by Christmas Eve presuming Republicans stretch out the debate as much as the rules allow.

The outcome was preordained after Senate Majority Leader Harry Reid, D-Nev., wrangled his fractious caucus into line over the course of the past several months, culminating in a frenzy of last-minute deals and concessions to win over the final holdouts, independent Joe Lieberman of Connecticut and conservative Democrat Ben Nelson of Nebraska.

Obama's oft-stated goal of a bipartisan health bill was not met, despite the president's extensive courtship of moderate Sen. Olympia Snowe of Maine, the only Republican to support the bill in committee. Obama called Snowe to the White House for lengthy in-person meetings both before he left for climate talks in Copenhagen and after his return on Saturday. In the end Snowe said she was "extremely disappointed" in what she called a rushed process that left scant time for her to review, much less amend, the bill.

Sen. John McCain, R-Ariz., criticized the side deals needed to win key votes, calling them "Bernie Madoff gimmicks." McCain, appearing Monday on ABC's "Good Morning America," complained that "Republicans were never brought in to the negotiations."

Still, the vote represented a major victory for Democrats and Obama, who's now clearly in reach of passing legislation extending health coverage to nearly all Americans, a goal that's eluded a succession of past presidents. The legislation would make health insurance mandatory for the first time for nearly everyone, provide subsidies to help lower-income people buy it, and induce employers to provide it with tax breaks for small businesses and penalties for larger ones.

Two more procedural votes await the Senate, each requiring 60 votes, the first of these set for Tuesday morning. Final passage of the bill requires a simple majority, and that vote could come as late as 7 p.m. on Thursday, Christmas Eve.

The Senate measure still must be harmonized with the health care bill passed by the House in November before final legislation can be sent to Obama's desk.

There are significant differences between the two measures, including stricter abortion language in the House bill, a new government-run insurance plan in the House bill that's missing from the Senate version, and a tax on high-value insurance plans embraced by the Senate but strongly opposed by many House Democrats.

After Monday's vote a number of Senate Democrats warned that the legislation could not change much and expect to maintain support from 60 senators. House Democrats are sure to want to alter it but may have to swallow it mostly whole.

"It took a lot of work to bring this 60 together and this 60 is delicately balanced," Lieberman said.

Republicans are determined to give Democrats no help, eager to deny Obama a political victory and speculating openly that the health care issue will hurt Democrats in the 2010 midterm elections.

"There will be a day of accounting," warned John Cornyn, R-Texas, accusing Democrats of pushing a health overhaul opposed by the public. "Perhaps the first day of accounting will be Election Day 2010."

At their core the bills passed by the House and pending in the Senate are similar. Each costs around $1 trillion over 10 years and is paid for by a combination of tax and fee increases and cuts in projected Medicare spending. Each sets up new insurance marketplaces called exchanges where uninsured or self-employed people and small businesses can compare prices and plans designed to meet some basic requirements. Unpopular insurance practices such as denying people coverage based on pre-existing conditions would be banned, and young adults could retain coverage longer under their parents' insurance plans — through age 25 in the Senate bill and through age 26 in the House version.

Reid cut numerous last-minute deals to get the votes he needed and powerful Democrats also inserted home-state provisions in a 383-page package of amendments Reid filed this weekend to the 2,074-page bill.

___

AP Special Correspondent David Espo contributed to this report.

PDF: Side-by-side comparison of major health care reform proposals

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