Senate sends fixes bill back to House

The Senate on Thursday voted 56-43 to approve changes to the healthcare overhaul and send it back to the House for a re-vote on two tweaks that the Senate was forced to make to ensure the bill complied with reconciliation rules.

The House expects to vote Thursday evening, Majority Leader Steny Hoyer, D-Md., said, wrapping up a debate that has lasted more than a year on President Obama's signature issue.

The adjustments the Senate made to the reconciliation bill, which contains changes to the overhaul Obama signed into law Tuesday, are minor. Speaker Nancy Pelosi, D-Calif., characterized them as "technical." The Democrats voting no were Sens. Ben Nelson of Nebraska and Blanche Lincoln and Mark Pryor of Arkansas. Sen. Johnny Isakson, R-Ga., did not vote because he is hospitalized.

Both tweaks apply to the student loan section added to make the deficit reduction numbers add up to meet reconciliation requirements. The Senate parliamentarian ruled the provisions out of order because they do not have an impact on the budget.

One provision would have protected Pell Grants from shrinking if their appropriations decrease. The provision would not have affected the grant program until 2013, and Democrats are confident they can address the issue before then.

Senate Budget ranking member Judd Gregg, R-N.H., raised the points of order against the two provisions. His office said the provision would not affect Pell Grant spending in the bill.

"While that provision might mean something in a future Congress, it has no effect on the level of mandatory spending on Pell Grants in this bill," according to a statement from Gregg's office. "And even though the provision is struck from the bill, mandatory Pell spending in this bill remains unchanged."

The other provision would have eliminated obsolete language.

The reconciliation bill increases federal subsidies to help those without employer-sponsored insurance purchase coverage; closes the Medicare Part D doughnut hole; increases Medicaid funding for states; and pushes back implementation of a tax on high-cost health plans until 2018 while raising the threshold for plans eligible for the tax.

Savoring his big healthcare win on the first lap of a victory tour, Obama today dared Republicans to "go for it" and try to repeal the signature legislative accomplishment of his presidency. GOP leaders have promised to fight to repeal the new law.

Returning to Iowa City, Iowa, where he first promised to overhaul health care during his campaign for office, the president joked that "some folks in Washington are still hollering" about the bill he signed into law on Tuesday.

"Now that it's passed, they're already promising to repeal it. They're actually going to run on a platform of repeal in November," he said.

"Well, I say go for it. If these congressmen in Washington want to come here to Iowa and tell small-business owners that they plan to take away their tax credits and essentially raise their taxes, be my guest."

Noting that opponents will have to tell individual Americans to give up the new rights given them in the legislation, he said, "They can run on that platform. If they want to have that fight, I welcome that fight. Because I don't believe the American people are going to put the insurance industry back in the driver's seat."

George E. Condon Jr. contributed to this story.