Health reform bill clears 60-vote hurdle in Senate

Last night the U.S. Senate voted 60 to 40 to move forward with debate on the health insurance reform bill. All senators who caucus with Democrats voted for cloture, and all Republicans voted against. The breakthrough came on Saturday, when Senate Majority Leader Harry Reid secured Senator Ben Nelson's support with extra money for Medicaid in Nebraska and new language on abortion.

At Daily Kos mcjoan published a good summary of what's in the latest version of the bill.

Reid reportedly promised Nelson a "limited conference" on this bill, meaning that very few changes will be made to the Senate version. However, it's far from clear that the House of Representatives will approve the Senate's compromise. About two dozen House Democrats plan to vote against health care reform no matter what, meaning that it will only take 15-20 more no votes to prevent supporters from reaching 218 in the House.

Bart Stupak, lead sponsor of the amendment restricting abortion coverage in the House bill, has been working with Republicans against the Senate's abortion language. Meanwhile, the leaders of the House pro-choice caucus have suggested the Senate language may be unconstitutional.

Even before Reid struck the final deal with Nelson, Representative Bruce Braley told the Des Moines Register, "I think the real test is going to be at the conference committee and if it doesn't improve significantly, I think health care reform is very remote based on what I'm hearing in the House."

Senator Tom Harkin has done several media appearances in recent days defending the Senate compromise. He seems especially pleased with the Medicaid deal for Nebraska:

The federal government is paying for the entire Medicaid expansion through 2017 for every state.

"In 2017, as you know, when we have to start phasing back from 100 percent, and going down to 98 percent, they are going to say, 'Wait, there is one state that stays at 100?' And every governor in the country is going to say, 'Why doesn't our state stay there?'" Harkin said. "When you look at it, I thought well, god, good, it is going to be the impetus for all the states to stay at 100 percent. So he might have done all of us a favor."

Ezra Klein has posted some amazing spin this morning about how the Senate bill is "not very close to the health-care bill most liberals want. But it is very close to the health-care bill that Barack Obama promised." Sorry, no. Obama campaigned on a health care plan that would control costs and include a public insurance option, drug re-importation, and letting Medicare negotiate for lower drug prices. Obama campaigned against an individual mandate to purchase insurance and an excise tax on insurance benefits.

Those of you still making excuses for Obama should listen to what Senator Russ Feingold said yesterday:

"I've been fighting all year for a strong public option to compete with the insurance industry and bring health care spending down," Feingold said Sunday in a statement. "Unfortunately, the lack of support from the administration made keeping the public option in the bill an uphill struggle."

Republican Senator Olympia Snowe was about as unprincipled and two-faced during this process as White House officials were. She voted for the Senate Finance Committee's bill in October and had suggested her main objection to Reid's compromise was the inclusion of a public health insurance option. Yet Snowe remained opposed to the bill even after the public option was removed last week. Because of her stance, Reid cut the deal with Nelson. The supposedly pro-choice Snowe could have prevented the restrictions on abortion coverage from getting into the bill if she had signed on instead.

Speaking of Republicans, the Iowa Republican posted this rant by TEApublican: "Nebraska And Huckabee Respond To Ben 'Benedict' Nelson's Christmas Senate Sellout." If you click over, be prepared to encounter mixed metaphors and misunderstandings about what this "reform" does. Still, the rant is a good reminder of how Republicans will still scream about government takeovers even though corporate interests got everything they wanted out of the bill.

  • Saw Harkin's quote;

    About how this realization of Universal Health Coverage is such an homage to the memory of Ted Kennedy.

    And I am not happy with Rahm at all.

    If this kind of "reform" is going to be the benchmark of this administration?

    McCain is looking pretty good to me about now.

    • no, McCain would be worse

      in any number of ways. But I am not celebrating the passage of this bill. Women's rights and union benefits are getting shafted while the drug and insurance companies get a free ride. I believe many supporters of this bill will later regret it when they see it does nothing to control costs and allows companies to keep delaying and denying coverage.

    • Ok Fill me in.

      How is this bill so bad?

      1. The CBO projections do actually predict this to reduce the deficit.

      2. We are getting all the insurance reforms we wanted such as outlawing denials for pre-existing conditions etc.

      3. We are still getting a national insurance exchange that will allow anyone of us to buy into with or without employment. This in itself makes it easier for independent contractors, self employed and small businesses get coverage a good price.

      So we do not have a public option. So what it was only going to effect 5% of the insured people anyways! It was only meant for those that absolutely could not afford coverage. I see the point of it being there to compete with private insurance but do you really believe that in a few years when insurance companies do not lower rates and stop the nasty business tactics we will not add a PO then?

      Bottom line is this...ready...OBAMA DID NOT WRITE THE BILL!!!! He gave set of parameters and goals and let congress create a means to the end. Sure he helped along the way but he did not give them a specific set legislative items. Why/ Well first of all they would have been the first thing the REPUGS fought against. Just like when they found out that Obama would take heat for if the PO was not in the bill. Second, Bill tried that remember, did not work well with him in 93 did it. And third if he would have gave them a detailed road map they just would have said he was micromanaging anyways.

      You cannot blame him for everything. In the end all we can do if remove Steve King, Chuck Grassley and the like from office and vote in people who will do what the people want them to.    

      • there are loopholes

        and weak enforcement provisions for the insurance reforms. I believe denials for pre-existing conditions and rescission will continue, especially since no meaningful competition will be provided. Remember, in most insurance markets one or two companies have a monopoly.

        The bill is projected to reduce the deficit, but the subsidies will not be adequate to make insurance affordable for millions of families. I would rather have a more "expensive" bill that actually solves the problems.

        You can keep making excuses for Obama, or you can listen to the growing number of Congressional Democrats who say their fight to keep a public option in the bill was undermined by the White House. Obama was meeting with the key senators on health care and he was not even trying to pressure them to support the public option. All the pressure was on liberals to drop the public option.

        do you really believe that in a few years when insurance companies do not lower rates and stop the nasty business tactics we will not add a PO then?

        People who believe we will add a public option in a few years (when we have fewer Democrats in Congress and less of a mandate for change) are deluding themselves.

        Obama made a political decision to do this without arousing the anger of the drug and insurance industries. Millions of Americans will pay the price for his calculus.

        • What?

          Again how is this Obama's fault? If Ben Nelson and the other "blue dogs" were not voting for a PO then what was the man to do? He saw that in order to get anything done we need the PO. If you are mad at anyone it should be the so called Blue Dogs not Obama. At least Obama could see that in order to have a reform bill at all we may need to drop the PO.

          Would it be better to have nothing at all?

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