Senate Clears Procedural Hurdle To Begin Debate on Health Care
On Saturday, the Senate voted 60-39 along party lines to pass a procedural motion on the chamber's health reform bill, overcoming a GOP filibuster and clearing the legislation for floor debate, the Washington Post reports.
Sen. George Voinovich (R-Ohio) was not present for the vote (Murray/Kane, Washington Post, 11/22).
Senators will now depart for their home states for Thanksgiving break and return on Monday, Nov. 30, to begin floor debate on the legislation (Edney/Friedman, CongressDaily, 11/21).
Moderate Democratic Sens. Mary Landrieu (La.), Blanche Lincoln (Ark.) and Ben Nelson (Neb.), as well as independent Joseph Lieberman (Conn.), voted for the procedural motion but stressed that their support for the motion does not guarantee that they ultimately will vote for the bill (Herszenhorn/Pear, New York Times, 11/22). They contested several proposals, including a public plan option proposed by Senate Majority Leader Harry Reid (D-Nev.) that would allow states to opt out, Medicare reforms, abortion coverage and employer requirements.
Public Option Alternative
Reid said that Landrieu is working with Sens. Tom Carper (D-Del.) and Charles Schumer (D-N.Y.) to devise a public plan option "that is acceptable to all the Democrats." Reid said that although he did not request an alternative he is open to considering one, CongressDaily reports.
According to CongressDaily, the alternative proposal would establish the public plan option on the same day that the insurance exchanges in the legislation take effect. However, the public plan would be established only in states that do not meet a yet-to-be determined affordability standard for coverage.
Carper has said the alternative proposal would be managed by HHS at first, but eventually would have a not-for-profit board appointed by the president (CongressDaily, 11/21).
Roll Call reports that the senators also are working on the alternative with Sen. Olympia Snowe (R-Maine).
Snowe said last week that she has been discussing the proposal with moderate Democrats but has not finalized any language because Reid has made it difficult for her proposed compromises to succeed on the Senate floor (Pierce, Roll Call, 11/23).
Some Democrats Say They Have Compromised Enough
A challenge for Reid will be changing the legislation enough to mollify moderate lawmakers without alienating more liberal members of his party. Roll Call reports that some Democrats already have said that they have compromised enough on a public plan.
Sen. Sherrod Brown (D-Ohio) said on Sunday on CNN, "I think, in the end, I don't want four Democratic senators dictating to the other 56 of us and to the country, when the public plan option has this much support, that it's not going to be in it." He added, "I don't think" senators opposed to the public plan "want to be on the wrong side of history. ... So I think, in the end, we get them" (Roll Call, 11/23).
Other Issues Likely To Arise During Debate
According to the Post, the public option is just one of a host of issues among Democrats that could become hang-ups during the debate. Democrats are still undecided about the degree to which employers should be required to provide health coverage to their employees.
Nelson has said that he will seek to change the legislation to provide financial relief to small business (Murray/Kane, Washington Post, 11/23).
Meanwhile, Democrats from conservative states could be faced with an issue after gun-rights group Gun Owners of America in an alert to its 300,000 members wrote that provisions in the Senate bill would require physicians to provide "gun-related health data" to "a government database," including mental health issues, which they said could jeopardize some patients' ability to obtain a firearms license (Murray, Washington Post, 11/23).
Sen. Kit Bond (R-Mo.) said that another contentious issue that likely will arise is language that dictates insurance coverage for abortion. He said on "Fox News Sunday" that the Senate would "probably" adopt more restrictive proposals that match those contained in the House reform bill (HR 3962).
However, Sen. Michael Bennet (D-Colo.) said on CNN that he is hopeful the abortion language already appearing in the Senate bill will prevail (Bendery/Whittington, Roll Call, 11/22).
The GOP likely will offer several amendments related to abortion and undocumented immigrants. Republicans are expected to attempt to portray the legislation as "orchestrating a government takeover of the health care system," according to the Post (Washington Post, 11/23).
Senate Health, Education, Labor and Pensions Committee Chair Tom Harkin (D-Iowa) said the debates would last throughout the majority of December. He said, "We're going to have some long days, we're going to have weekends," adding, "We're going to have three weeks. That means we'll finish on the 23rd of December. And might, actually, a little before then -- actually the weekend before then" (Budoff Brown, Politico, 11/21).
According to the Post, if the Senate passes the bill before Christmas, lawmakers will use most of January to consolidate the House and Senate bills into a final overhaul package, with a goal of delivering a final bill to President Obama in time for the State of the Union address in late January (Washington Post, 11/22).
After Saturday's vote, Republicans elevated their criticisms of the Senate bill, saying the legislation eliminates jobs and will produce "excessive government control," The Hill reports (Johnson, The Hill, 11/22).
Sen. Lamar Alexander (R-Tenn.) on "Fox News Sunday" said a vote for the Senate bill is "a vote for higher premiums, cuts to Medicare and more taxes" (Washington Post, 11/22). He also said that the bill would enhance the "medical ghetto" of Medicaid. He added, "And we think if the American people know" the bill's shortcomings, it "will collapse of its own weight."
Alexander said that defeating the legislation would be the "best thing to do" in order to address the country's job shortage (The Hill, 11/22).
Sen. John Thune (R-S.D.) said, "All those people who are concerned about the high cost of health care today aren't getting relief under the Democrat plan," adding, "In fact, their lives are going to get much, much worse" (Washington Post, 11/22).
Senate Minority Leader Mitch McConnell (R-Ky.) on CNN said that the chamber will have an "extensive debate" on the bill and that the GOP favors a more incremental approach to an overhaul.In addition, Senate Minority Whip Jon Kyl (R-Ariz.) said that U.S. residents "have made it very clear that they want" the bill "aired out" (Roll Call, 11/22). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.