WASHINGTON – Without a vote to spare, Democrats pushed their health care overhaul legislation over its first obstacle on the Senate floor Saturday, as the chamber voted to begin formal debate of a sweeping measure to guarantee medical coverage for all Americans.
The 60-39 procedural vote – backed by all 58 Democrats and two independents, with Ohio Republican George Voinovich not voting – overcame a Republican-led filibuster designed to block consideration of the bill and kept up momentum behind President Barack Obama’s top legislative priority.
The vote also set the stage for a historic health care debate that is expected to begin after Thanksgiving and consume the Senate for the remainder of this year and into next.
“It is more important that we begin this debate to improve our nation’s health care system for all Americans, rather than just simply drop the issue and walk away,” Sen. Blanche Lincoln, D-Ark., one of the last Democratic holdouts, said Saturday in announcing her support for the high-stakes parliamentary vote. “That is not what people sent us here to do.” Democratic congressional leaders, who got a health care bill through the House two weeks ago, are laboring to move legislation through the Senate by Christmas so they can deliver on Obama’s top domestic priority by early next year.
Senate Democrats prevailed Saturday only after Lincoln and Sen. Mary Landrieu, D-La., two centrists from traditionally Republican states who had been withholding their support for the procedural vote, went to the Senate floor and announced they would vote with their party.
Not a single Republican backed the motion to proceed, which GOP lawmakers declared would pave the way for a government takeover of health care and drive up the national debt.
“We know that Americans oppose this bill,” Senate Majority Leader Mitch McConnell, R-Ky., said as debate on the cloture issue got under way Saturday. “They certainly don’t think it’s what we need at a time when … one out of 10 working Americans is looking for a job.”
The $848 billion measure that will now be laid before the full Senate is designed to expand coverage to an additional 31 million Americans over the next decade, while still restraining federal deficits and taking steps to make the nation’s health care system more efficient and reliable for patients.
The centerpiece of the bill is a series of new regulations to require insurers to offer coverage to all Americans, regardless of their health status, and to create new government-regulated insurance exchanges where people who do not get covered through work will be able to shop for plans.
Senate Majority Leader Harry Reid, D-Nev., has proposed to fund the measure with a politically delicate mix of cuts to the federal Medicare system and new taxes on parts of the health care industry, high-end “Cadillac” health plans and wealthy households.
Reid’s 2,074-page proposal almost certainly will undergo changes in the weeks ahead as Democrats and Republicans offer amendments challenging controversial elements of the legislation.
Liberal lawmakers have already warned that they will not brook any moves to further weaken the government insurance plan in Reid’s bill, which the nonpartisan Congressional Budget Office has estimated would provide coverage to about 3 million or 4 million people.
And Friday, the liberal grass-roots powerhouse MoveOn.org began running television ads in Arkansas and Maine attacking an alternative favored by some centrists that would “trigger” the creation of a government plan only in parts of the country where commercial insurers fail to meet benchmarks for affordability and quality.
A leading champion of this approach is Maine Sen. Olympia Snowe, a moderate Republican whom Democratic leaders still hope to convince to back the final health care package.
Reid will face other challenges if lawmakers try to expand aid to small businesses, as Landrieu has demanded, or to increase subsidies for low- and moderate-income workers to help them buy insurance policies, as other senators want.
That’s because Democratic leaders are under immense pressure to keep the 10-year cost of the bill under $900 billion and ensure that it does not exacerbate federal budget deficits in coming years, benchmarks set by the president.
The Congressional Budget Office has estimated that Reid’s proposal in its current form would lower the deficit by $130 billion by 2019.
Republicans are intensifying their argument that now is not the time to commit billions of dollars to ensuring that all Americans have access to health care.
“You don’t start new programs that are likely to spiral out of control,” Alabama Sen. Jeff Sessions said Saturday.
The GOP criticism has enraged many Democrats, who watched congressional Republicans turn a massive budget surplus they inherited from the Clinton administration into record deficits, in part by passing a $395 billion Medicare drug benefit in 2003 without any mechanism to pay for it.
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