Senate vote sets up health overhaul passage

The Senate early on Monday voted 60-40 to cut off debate on a manager's amendment to the healthcare overhaul bill, setting up final passage of the sweeping legislation on Christmas Eve and putting President Obama possibly a month away from achieving a major goal of his campaign.

Following final passage, Democrats would still need to merge the measure with a House-passed version before sending it to the president's desk. Democrats say they hope to get the bill to the president before his State of the Union address, which is typically in late January. The conference with the House could be difficult, given the fragile Senate balance and the interest of House lawmakers in trying to restore a public option.

The procedural victory came over the strenuous objections of Republicans, who had promised Sunday to fight to the bitter end Christmas Eve, when support by the same 60 Democrats would pass the final bill.

Majority Whip Richard Durbin, D-Ill., said after the vote he hopes "cooler heads will prevail" and that Republicans would allow a final vote sooner than Thursday. "What is the purpose," he said. "I don't see a purpose" in further delay.

The bill provides federal subsidies to help people buy health insurance, expands Medicaid, attempts to rein in insurance companies and remove barriers to coverage.

Democratic leaders originally sought to include a public option that would compete with private insurers, but could not garner the 60 votes to pass it. Instead, they tapped the Office of Personnel Management to oversee a national plan through private insurance companies and will require insurers to spend 85 percent of premiums in the large-group market and 80 percent of premiums in the small-group and individual markets on health services.

Senators on both sides agreed on the significance of vote, albeit for different reasons. Durbin called it "one of the most significant votes in the history of the United States Senate."

Minority Leader Mitch McConnell, R-Ky., attacking the bill, said "the impact of this vote will long outlive this one frantic, snowy weekend in Washington." He added: "Mark my words, this legislation will reshape our nation."

Democrats have two more cloture votes to go before final passage. Republicans have vowed to extend debate, claiming doing so will help inform Americans about the cost and impact of the legislation.

Republicans also took some heat for a comment Sen. Tom Coburn, R-Okla., made in wishing the vote failed. "The American people ought to pray that somebody can't make the vote tonight," Coburn said. Democrats immediately denounced the comment, suggesting Coburn was wishing ill on fellow senators.

"Calling on people to pray that a senator does not make it back for tonight's vote, as Dr Coburn did, is repulsive," said Jim Manley, a spokesman for Majority Leader Harry Reid, D-Nev.

Democrats had their 60 votes lined up Friday evening, after Reid worked out an agreement with Sen. Ben Nelson, D-Neb., on compromise language on federal funding of abortion. The manager's amendment made some changes to the bill Reid introduced last month, including a sweetener for Nelson, directing the federal government to pick up the tab for Nebraska's expenses under a Medicaid expansion. Republicans decried such deals, and even some Democrats seemed irked.

As she tried to move through a crowd of reporters around Nelson before the vote, Sen. Barbara Mikulski, D-Md., complained, "I know I'm not as important as Sen. Nelson. I didn't get the money for my state. I was too stupid."

Sen. Christopher Dodd, D-Conn., pushed to include a $100 million grant for construction of a university hospital in the overhaul bill, his spokesman confirmed following Republican complaints. The grant could go to about a dozen eligible universities but Dodd will push for the University of Connecticut to win the funding.

Nelson shrugged off attacks on the floor by Republicans and said he has heard no dissent from fellow Democrats. "You know, cheap shots are a dime a dozen in this town ... It's not my style and I have no opinion about them," he said.

While Democrats must win two more procedural votes before lawmakers can start working out differences in conference, some senators were already looking ahead. Senate Finance Chairman Max Baucus, D-Mont., said the two key differences between the House and Senate bills are the public option and pay-fors. The Senate pays for some of the measure with a tax on high-cost health plans and does not include a public option, two provisions Baucus said "have to be in the conference report for the bill to pass the Senate.