First test vote has Senate on cusp of health overhaul

WASHINGTON – The Senate early today took a giant step closer to enacting its sweeping health care bill – a watershed moment that united fractious Democrats after months of debate over President Barack Obama’s promise to provide universal health care coverage.

The move to break a Republican filibuster, which passed on a party-line 60-40 vote, capped months of work by Obama and Senate Majority Leader Harry Reid, D-Nev., who personally forged the necessary compromises on big issues such as abortion and taxes, as well as parochial deals for favored states and industries.

But with final Senate approval of the bill expected later this week, Democrats and the White House were moving to shift the focus away from the dozens of concessions made in writing the bill and toward the momentous changes it would bring: Bestowing access to insurance on 31 million Americans, cracking down on mercurial insurance practices and beginning to curb unsustainable medical inflation.

“I wish this bill were different,” Assistant Majority Leader Dick Durbin, D-Ill., said on the Senate floor Sunday, reflecting liberals’ unhappiness over some of the compromises with conservative members of their own party.

“But my disappointment … shouldn’t lead me to conclude that this bill is wanting or this bill is bad. Just the opposite is true. … We have to look at the positive side of what this legislation will do.”

The bill’s progress provides a needed shot of adrenaline for Obama and the Senate as opinion polls indicate the public’s support for the health care overhaul is waning substantially. Hoping to reverse that slide, Democrats and the White House are ramping up their efforts to reshape public perception of the bill as a glass half full, not half empty.

“This is a historic crossroads,” David Axelrod, senior Obama advisor, said Sunday on NBC’s “Meet the Press.” “Seven presidents have tried to pass comprehensive health insurance reform, seven presidents have failed. We’re on the doorstep of getting it done.”

Shifting the focus on how much change the bill would deliver – rather than the political sausage-making that preceded it – will be particularly important as senior lawmakers in the House and Senate begin another arduous round of compromising and deal-making to reconcile substantial differences between the health care bills developed in the two chambers.

The Senate’s dramatic first vote to shut down the Republican filibuster capped a weekend session that marked the third time in the last month the Senate has met on Saturday and Sunday. Two more procedural votes to close debate – on Tuesday and Wednesday – will be taken before the bill comes to a final vote.

Republicans conceded they were essentially powerless to derail the bill. But they vowed to force the debate to continue as long as possible – probably until Christmas Eve.

“We will fight until the last vote,” Sen. John McCain, R-Ariz., said on “Fox News Sunday.” “We must do everything. We must look back and say, ‘We did everything we can to prevent this terrible mistake from taking place.’ ”

In the death knell for Obama’s hope the bill would receive even token bipartisan support, Sen. Olympia Snowe, R-Maine, the one Republican who even considered supporting the bill, formally announced Sunday she opposed it.

Democrats hope that the more the public knows about benefits and consumer-oriented provisions of the bill, the more they will like it.

They have their work cut out for them. Public confidence in Democrats’ health care initiative has been sagging for months.

Today, just 45 percent of Americans believe the country will be better off with “reform,” down from 59 percent in February, according to a tracking poll by the nonprofit Kaiser Family Foundation, which surveys public opinion about health care. And just one in three Americans believe “health care reform” will leave them and their families better off, the lowest measure all year.

“People believe they will be paying more taxes,” said Robert Blendon, an expert on public opinion at the Harvard School of Public Health. “They are afraid about what is going to happen to Medicare. … They have just gotten very nervous.”