Senate Passes Healthcare Reform Bill On Party Line With Jim Bunning AWOL (Absent Without Leave).

Senate passes health care reform bill
David Lightman

WASHINGTON — The Senate’s 60 to 39 vote Thursday to overhaul the nation’s health care system — President Barack Obama's top 2009 domestic priority--moves the nation closer than it’s ever been to a dramatic change in how people get medical care.

The $871 billion bill, approved on a party line vote, would require most Americans to obtain health coverage, and would provide federal aid for those having difficulty affording it.

“This notion that somehow the health-care bill that is emerging should be grudgingly accepted by Democrats as a half-a-loaf is simply incorrect. This is nine-tenths of a loaf. And for a family out there that right now doesn’t have health insurance, it is a great deal,” Obama told PBS’ “NewsHour” Wednesday.

The bill, passed during the Senate’s first Christmas Eve session in 46 years, passed just after dawn as lawmakers met for the 25th straight day.

It now has to be merged with a version passed last month by the House of Representatives. Negotiators are likely to begin closed-door talks next month, aiming to have a final compromise bill finished in time for Obama’s 2010 State of the Union address, probably in late January.

But reaching agreement could be difficult, because the bills have stark differences on some of the major political flashpoints.

The House bill puts strict limits on federal funding of abortion. The Senate is less restrictive.

The House wants a government-run insurance plan, or public option. The Senate does not, opting to push a federally-supervised system of multistate, private run insurance plans..

The House wants to impose a 5.4 percent income tax surcharge on individuals earning $500,000 and couples making more than $1 million, starting in 2011, a change that would begin to restore some of the Bush era tax cuts.

But the Senate has other ideas, preferring a 40 percent excise tax on more expensive employer-sponsored insurance plans and a 0.9 percentage point increase in the 1.45 percent Medicare tax on the wealthy.

And there are less discussed differences, such as effective dates — the House wants to start major changes in 2013, the Senate, a year later.

Democratic leaders and the White House are confident they can find common ground, and see plenty already. Insurers would be barred from denying coverage because of pre-existing conditions. Insurance exchanges, or marketplaces, would be created where consumers could easily shop for policies. And companies could no longer charge separate rates because of gender and would be limited to how much more they could charge older consumers.

Democrats, though, know they’re in for a fight among themselves, and have tried hard to read from the same script for weeks—that the final bill is only a start, one that can be expanded and refined in the years ahead.

What’s important, they say, is that, as Sen. Christopher Dodd, D-Conn., a key health care architect, said, “This is the beginning of a process, not the end.”

And, he and others say, it’s a huge step in a process that’s nearly a century old. The 1912 Progressive Party platform championed by former President Theodore Roosevelt urged “the protection of home life against the hazards of sickness, irregular employment and old age through the adoption of a system of social insurance adapted to American use.”

In 1945, ,President Harry Truman proposed what most historians view as the beginning of the serious legislative health care effort.

“Our new Economic Bill of Rights,” he said, “should mean health security for all, regardless of residence, station, or race — everywhere in the United States.”

For decades, presidents from both parties tried mightily. Medicare, the government’s insurance plan for people over 65 and some others with disabilities, began in 1965, but though it proved popular, still could not provide momentum for universal health care.

Democrats made the issue a cornerstone of the 2008 presidential campaign. With a popular president and control of 60 of 100 Senate seats and 258 of the 435 House seats, leaders saw 2009 as a rare opportunity to pass legislation.

But deadlines came and went—originally, Obama wanted a bill by August — as Republicans balked and Democratic centrists were wary of the public option and the bill’s cost.

The Thursday vote came only after Senate leaders agreed to last-minute deals with centrists. Sen. Ben Nelson, D-Neb., got tougher language limiting federarl abortion funding, as well as a pledge of more Medicaid help for his state. Sen. Mary Landrieu, D-La., and Blanche Lincoln, D-Ark., were pleased with additional help for small business.

Liberals weren’t happy, but went along.

“The bill still delivers meaningful reform,” said Sen. Russell Feingold, D-Wisc. “and the cost of inaction is simply too high.”

The negotiators, or conferees, are expected to meet early next month — probably in closed session.

Obama campaigned on a promise to televise health care negotiations on C-SPAN, but that generally hasn’t happened.

Lawmakers continue to meet privately to make deals, and the president and White House negotiators have themselves weighed in behind closed doors.

White House Press Secretary Robert Gibbs has defended the president against accusations he broke his promise, insisting Obama has kept the public abreast of developments and that Obama never promised that the entire legislative process would be conducted publicly.

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Editor's comment: OK, I cannot resist anymore. We must now have a new post label for members of CONgress to suggest what they do to the rest of us: CON us.