Democrats approve health insurance bill: Christmas Eve vote is Senate’s first since 1895 [The Oklahoman, Oklahoma City]

Dec. 25--WASHINGTON -- Senate Democrats approved their health insurance reform bill on Thursday, ending a bitterly partisan debate for now and setting up what could be contentious negotiations with the House on a final version of legislation to ensure coverage for most Americans.

Democrats heralded the fact that both houses of Congress had approved major health care reform for the first time in generations, but Republicans said victory came only after payoffs to wavering senators.

The final vote was 60-39, but the suspense ended last weekend when Sen. Ben Nelson, a Nebraska Democrat, agreed to join 57 other Democrats and two Independents to get the bill past procedural hurdles that required 60 votes of approval. All 39 Republicans present voted against the bill.

President Barack Obama, who made passage of health care reform the top priority for his first year in office, hailed the vote on Thursday as one "that brings us toward the end of a nearly century-long struggle to reform America's health care system."

The president said: "Ever since Teddy Roosevelt first called for reform in 1912, seven presidents -- Democrats and Republicans alike -- have taken up the cause of reform. Time and time again, such efforts have been blocked by special interest lobbyists who've perpetuated a status quo that works better for the insurance industry than it does for the American people. But with passage of reform bills in both the House and the Senate, we are now finally poised to deliver on the promise of real, meaningful health insurance reform that will bring additional security and stability to the American people."

But even some supporters of the bill say special interests such as insurance companies, drugmakers and hospitals had a major influence on the Senate bill, and liberals and conservatives in both houses have expressed some disappointment.

Senate Majority Leader Harry Reid, a Nevada Democrat, had to placate the White House and senators in the Democratic caucus that had objections to certain proposals. The White House had cut a deal with the drug industry to cut prices and so opposed a bipartisan effort in the Senate to allow for the reimportation of prescription drugs; Independent Sen. Joe Lieberman, of Connecticut, and some conservative Democrats opposed a government-run health care plan, a so-called public option, and so that was dropped from the original bill.

And Nelson wanted tighter restrictions on federal funding of abortion, but what he got didn't satisfy U.S. Catholic bishops or other anti-abortion groups. Nelson also got a promise that the federal government would pay all of Nebraska's costs to expand Medicaid -- a key component of the Senate bill's expansion of health coverage to the uninsured.

Sen. Tom Coburn, R-Muskogee, said, "This process was not compromise. This process was corruption. This bill passed because votes were bought and sold using the issue of abortion as a bargaining chip."

And Senate Minority Leader Mitch McConnell, a Kentucky Republican, said, "This fight isn't over. My colleagues and I will work to stop this bill from becoming law. That's the clear will of the American people, and we're going to continue to fight on their behalf."

Republicans did as much as Senate rules would allow them to do in order to stall the final vote, making Democrats clear almost every procedural hurdle that could be erected. The Senate was in session for 25 straight days, and the Christmas Eve vote was the first in the Senate since 1895.

The Senate bill will require most Americans to buy health insurance or pay a fine, and it sets up markets, called exchanges, from which private insurance plans can be purchased. The federal Office of Personnel Management, which oversees the health insurance plan for federal employees, would be given the authority to supervise a system of private plans.

Low-income people would receive subsidies to help buy benefits; Medicaid, the health care program for the poorest Americans, would be expanded to include more people. About 30 million more people are expected to get coverage under the Senate bill, about 6 million fewer than under the House bill.

The bill's cost has been estimated at $871 billion over 10 years. It would raise the federal Medicare tax on individuals who make more than $200,000 a year and those couples who make more than $250,000 a year.

It also would assess a new fee on high-cost insurance plans, a change that could affect health care plans enjoyed by many state workers and other union members.

Insurance companies would not be allowed to deny coverage because a person has a pre-exisiting condition, and there could be no lifetime caps on pay-outs, as there are now in many private plans.

The Senate bill now must be merged with the House bill, which was passed in November and differs in some key respects. The House bill would establish a government-run insurance plan to compete with private plans in the exchanges. The abortion language also changed, as did the means of paying for the bill; the bill would levy an income tax on the wealthiest Americans.

House Speaker Nancy Pelosi, D-Calif., said Thursday that the Senate vote "brings us closer to providing quality, affordable health insurance to every American."

Pelosi said she is proud of the House bill and that she was looking forward to working with Obama and legislators in both houses to produce a final bill.

It will likely be February or later before such a bill is ready for a final vote in the House and Senate, and, at least for now, it would appear the Senate version will have to be closely adhered to since Democrats will again be forced to get 60 votes.

Obama said Thursday's vote meant "we are now incredibly close to making health insurance reform a reality in this country."

"Our challenge, then, is to finish the job," he said. "We can't doom another generation of Americans to soaring costs and eroding coverage and exploding deficits."

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