Landmark health care legislation backed by US President Barack Obama passed its sternest Senate test in the pre-dawn hours early today, overcoming Republican delaying tactics on a 60-40 vote that all but assures its passage by Christmas.
The bill would extend coverage to more than 30 million Americans who now lack it, while banning insurance company practices such as denial of benefits on the basis of pre-existing medical conditions.
The atmosphere was intensely partisan, but the outcome preordained as senators cast their votes from their desks, a practice reserved for issues of particular importance. Administration officials who have worked intensely on the issue watched from the visitor's gallery despite the hour. So, too, Vicki Kennedy, the widow of Sen. Edward M. Kennedy, D-Mass., who championed health care across a Senate career that spanned more than 40 years.
Nebraska Sen. Ben Nelson's announcement on Saturday that he had decided to support the bill - in exchange for a variety of concessions - cemented the Democrats' 60-vote majority behind a bill assembled at the direction of Majority Leader Harry Reid of Nevada.
Republicans conceded Democrats had the votes, but said they hadn't heard the end of it.
The House has already passed legislation, and attempts to work out a compromise are expected to begin in the days after Christmas.
The Congressional Budget Office has estimated the legislation would reduce deficits by about $132 billion over a decade, and possibly much more in the 10 years that follow. Republicans counter those figures are illusory, because they depend on cuts to Medicare that will never take place.
At its core, the legislation would create a new insurance exchange where consumers could shop for affordable coverage that complies with new federal guidelines. Most Americans would be required to purchase insurance, with subsidies available to help families making up to $88,000 in income afford the cost.
In a bow to Senate moderates, the measure lacks a government-run insurance option of the type that House Democrats placed in their bill. Instead, the estimated 26 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for privately owned, nonprofit nationwide plans overseen by the same federal agency office that supervises the system used by federal employees and members of Congress.
AP