WITH THE US Senate’s approval of a motion to proceed on Saturday, US president Barack Obama’s chief domestic priority passed what the president’s office called “a critical milestone” on the road to healthcare reform.
The House voted its version of healthcare legislation on November 7th. Saturday night’s Senate vote was necessary because the Republican minority has triggered unending debates intended to delay legislation – standard practice for filibustering.
With the requisite filibuster-blocking 60 votes, the Senate will now begin debating the Patient Protection and Affordable Care Act after the Thanksgiving holiday recess. Senate majority leader Harry Reid hopes to bring the Bill to a vote before Christmas.
But Mr Obama’s goal of a healthcare Bill by the end of the year will not be met. Even if the Senate manages to vote before Christmas, House and Senate versions must then be merged in conference. Both houses of Congress would then have to vote on the resulting legislation before the text is signed by the president. Democrats now hope this can be achieved before the State of the Union address in late January.
The Senate voted along purely partisan lines, with all 58 Democrats and two Independents who usually side with the Democrats supporting Saturday night's motion, and 39 Republican senators opposing it. The 40th Republican senator, George Voinovich from Ohio, did not show up. The last two Democratic hold-outs were women senators from the south, leading the Washington Postto parody the session as a Tennessee Williams play, one of whose protagonists is even called Blanche.
Senator Mary Landrieu from Louisiana agreed to vote for the motion only after receiving $300 million in extra federal funding for her state – a deal that was quickly dubbed the Louisiana Purchase.
The vote was a cliffhanger until Senator Blanche Lincoln of Arkansas announced on Saturday afternoon that she would vote Yes – this time. “I will not vote in favour of the proposal . . . as it is written,” she warned.
Mr Reid had unveiled his Bill last Wednesday, but agreed to postpone the vote for 72 hours at the demand of Ms Lincoln, who insisted senators needed time to read its 2,000-plus pages.
Ms Lincoln insisted she was thinking about the 450,000 Arkansans who don’t have healthcare insurance – not about her re-election in a difficult race next year, nor “whether Democrats or Republicans are going to be able to claim victory in winning this debate”.
Mr Reid needs every single Democratic vote for the Bill to pass, yet at least four Democratic senators who voted Yes on Saturday have vowed to vote No unless provisions for a government-run public insurance option are removed in the course of the debate.
Three issues could still defeat healthcare reform: the public option, abortion and deficit spending. Democrats opposed to the public option say they could support a proposal by the Republican senator from Maine, Olympia Snowe, to include a “trigger” that would establish a government plan if private insurance still proved unaffordable.
The House Bill would ban private insurance companies on the new health insurance exchange from providing abortion coverage, while the Senate Bill would require at least one company to offer abortion coverage.
The Congressional Budget Office says the House and Senate Bills are budget neutral. But Republicans persist in portraying them as “budget-busters” that will raise premiums and taxes.
Mr Reid compared the debate on healthcare to historic laws on the GI Bills, social security, Medicare and abolition of slavery. Republican senator Sam Brownback dramatised his plea for just one Democrat to defect: “Do we choose life or do we choose death?”