Sunrise votes in Senate on Tuesday push health care bill step closer to pre-Christmas passage

more images

more images

Sunrise votes nudge health care bill forward Tues.

WASHINGTON — Two down, one to go. President Barack Obama’s health care overhaul cleared its second 60-vote test in the Senate early Tuesday morning — moving it a step closer to passage by Christmas.

Senate Democrats remained united behind their compromise bill, over steadfast Republican opposition. The motion, to shut off debate and move to a vote on a package of changes by Senate Majority Leader Harry Reid, passed 60-39.

The final 60-vote hurdle, limiting debate on the bill itself, is expected Wednesday afternoon. That would start a 30-hour countdown to a night-before-Christmas vote on the legislation, which needs only a simple majority to pass.

The Senate has been voting at odd hours since Monday around 1 a.m., because Republicans have insisted on using all the time allowed them under Senate rules to delay the bill. Not to be thwarted, Reid, D-Nev., has refused to postpone action until after the holidays. Hence the unusual schedule. On Tuesday, they started voting at sunrise.

With long hours getting in the way of family obligations — and the outcome now seemingly preordained — senators are getting frustrated. Even Obama has put his planned vacation to Hawaii on hold, saying he wants to be in Washington in case there are last-minute problems in the Senate.

Reid appealed to his colleagues Tuesday to set aside acrimony and reach for some holiday spirit. “I would hope everybody will keep in mind that this is a time when we reflect on peace and good things,” he said. If Republicans agree, the schedule of votes could be shortened and senators would go home earlier.

There was still no sign partisan fires had cooled.

GOP Sen. Lindsey Graham of South Carolina denounced concessions won by conservative Nebraska Democratic Sen. Ben Nelson, whose support gave Democrats the 60th and final vote they need. Among other things, Nelson got an agreement that the federal government will pay to expand Medicaid services in Nebraska.

Said Graham: “That’s not change you can believe in. That’s sleazy.” He was interviewed on NBC’s “Today” show.

Democratic Sen. Tom Harkin of Iowa defended the concessions, saying: “The one that’s being talked about for Nebraska, it also benefits other states. It’s not just Nebraska.”

He also said he would vote for the package even if it didn’t contain concessions for Iowa. “The principle of this bill overrides everything,” Harkin told CBS’ “Early Show.”

Moderate Sen. Mary Landrieu, D-La., who has also been criticized after securing a boost in Medicaid for her state, defended the concessions she got, saying they benefited low-income families small businesses.

The Senate measure would still have to be harmonized with the health care bill passed by the House in November before final legislation would go to Obama.

There are significant differences between the two bills, including stricter abortion language in the House bill, a new government-run insurance plan in the House bill that’s missing from the Senate version, and a tax on high-value insurance plans embraced by the Senate but strongly opposed by many House Democrats.

Senate moderates have served notice they won’t support a final deal if government-run insurance comes back. And Democratic abortion opponents in the House say a Senate compromise on the volatile issue is unacceptable.

But there’s considerable pressure on Democrats to avoid messy negotiations over a final bill. Public support for the legislation continues to sink in opinion polls, even as the Senate advances.

The bills probably have more in common than differences. Each costs around $1 trillion over 10 years and installs new requirements for nearly all Americans to buy insurance, providing subsidies to help lower-income people do so. They’re paid for by a combination of tax and fee increases and cuts in projected Medicare spending.

Unpopular insurance company practices such as denying coverage to people with existing health conditions would be banned. Uninsured or self-employed Americans would have a new way to buy health insurance, via marketplaces called exchanges where private insurers would sell health plans required to meet certain minimum standards.

The American Medical Association announced its endorsement of the Senate bill Monday after Reid made some last-minute changes to please the doctors. A 5 percent tax on elective cosmetic surgery procedures was replaced with a 10 percent tax on indoor tanning services; a proposed fee on physicians to enroll in Medicare was dropped; and payment cuts to specialty and other physicians to pay for bonuses to primary care doctors in underserved areas were also eliminated, said the AMA’s president-elect, Dr. Cecil B. Wilson.

“America has the best health care in the world — if you can get it,” Wilson said at a press conference with Reid and other leaders. “For far too many people access to care is out of reach because they lack insurance. This is not acceptable to physicians.”