US Senate passes sweeping healthcare reform Bill - but tough talks lie ahead

The US Senate has approved landmark legislation today that would extend healthcare for tens of millions of uninsured Americans.

After weeks of partisan bickering, horse-trading and tense negotiation, senators voted for the Bill along party lines - 60-39 - ensuring passage for the upper chamber's version of the historic reform.

President Obama hailed the Bill, describing it as the most important piece of social legislation for the country since the 1930s.

"We are now finally poised to deliver on the promise of real, meaningful health insurance reform," he said. "With today's vote, we are now incredibly close to making health insurance reform a reality in this country."
The unusual timing on the vote - the first on Christmas Eve since 1895 - reflected its importance.

As senators called out "aye" or "no" to register their vote, Robert C. Byrd, the 92-year-old Democrat from West Virginia, deviated from the protocol with a short speech.

“This is for my friend Ted Kennedy,” Mr Byrd said, referring to the Democratic patriarch who died earlier this year, and was a champion of healthcare reform. “Aye!”

Once the legislation passed, after a vitriolic debate, representatives of both parties gave their differing reactions. "This is a victory for the American people," said Senate Democratic leader Harry Reid.

The man who ushered the bill through its final stages almost fluffed his lines when he called on to vote for the Bill. Mr Reid said: "No. I mean, aye. Yes!", then shaking his read and giving a palms-up shrug. The chamber erupted in laughter.

"This fight is long from over," warned Republican Senate leader Mitch McConnell. "My colleagues and I will work to stop this bill from becoming law."

Many expressed regret at the partisan nature of the vote, as not a single Republican supported the Bill. Senator Olympia Snowe, a moderate Republican who has worked for years with Democrat colleagues on developing healthcare legislation, said that she was "disappointed".

She said the atmosphere in the house had not encouraged collaboration. "There was zero opportunity to amend the Bill or modify it, and Democrats had no incentive to reach across the aisle," she said.
Significant hurdles await the legislation. Work will begin in the new year to reconcile the Senate legislation with a House of Representatives Bill that was passed last month. Potentially tough negotiations are expected throughout January as the two Bills have significant differences.

The Senate Bill does not include the "public option" - a government-backed insurance programme - which is a key part of the House legislation. The provision is expected to be hard fought for by liberals in the House, but any public option risks losing the key votes of moderate Democrats in both the House and Senate.

Another dividing line between the two bodies is how the reforms will be financed. The House Bill would impose a surtax on high-earning individuals and couples, whereas the Senate Bill applies a 40 per cent tax to be paid by insurance companies on so-called "Cadillac plans" - health insurance premiums that cost more than $8,500 a year for individuals and $23,000 for families.

White House officials said yesterday it is unlikely that Mr Obama will be able to sign a final Bill before his State of the Union address, which is expected to be on January 26 or February 2.
Mr Obama and senators delayed their Christmas holidays for the vote today, defying snowstorms to travel to Capitol Hill. The President is due to fly to Hawaii now the vote has passed.

The new Senate Bill would extend health coverage to more than 30 million people who have no health insurance - covering 94 per cent of all Americans - and halt industry practices such as refusing insurance to people with pre-existing medical conditions.

Yesterday, Democrats gathered the 60 votes needed to keep the Bill on track for approval, over the unified opposition of Senate Republicans. Today’s vote requires a simple majority of the 100-member upper chamber.

Mr Obama's support for the legislation has angered his own supporters. Some Democrats believe that every last American should be covered and the “public option" should be included in both Bills.

Buying the Bill:

One section is thought to solely benefit Louisiana - and may have won the vote of the State’s Democratic senator Mary Landrieu. Estimates suggest the provision will cost the American taxpayers anything between $100-$300 million in additional aid for Medicaid recipients in her state.

Senator Ben Nelson, a Nebraska Democrat, won a provision exempting his state from paying part of the cost of expanding the Medicaid programme. The measure would cost the federal government an estimated $100 million over 10 years.

Mr Nelson also obtained a compromise that will allow individual states to choose whether to ban abortion coverage in certain health plans that receive government subsidies.

Senator Bernie Sanders, from Vermont, was given $10 billion to increase community health centres across America. Critics pointed out the provision will benefit two such facilities in his state, with Vermont also in line to receive additional Medicaid funding as well.

Senator Joseph Lieberman, from Connecticut, an independent that votes with the Democratic caucus, demanded the removal of the “public option” from the Senate Bill. Other moderate Democrats are also believed to have helped kill the measure.

Source: The times