Senate Dems clear hurdle on health care

All58 Democrats and the Senate's two independents held together earlyMonday against unanimous Republican opposition, providing the exact60-40 margin needed to shut down a threatened GOP filibuster.

Thevote came shortly after 1 a.m. with the nation's capital blanketed insnow, the unusual timing made necessary in order to get to a final voteby Christmas Eve presuming Republicans stretch out the debate as muchas the rules allow. Despite the late hour and a harshly partisanatmosphere, Democrats' spirits were high.

"Today we are closer than we've ever been to making Sen. Ted Kennedy's dream of universal health insurance coverage a reality," Sen. Tom Harkin, D-Iowa, said ahead of the vote, alluding to the late Massachusetts senator who died of brain cancer in August.

"Vote your hopes, not your fears. Seize the moment," Harkin urged colleagues.

Kennedy'swidow, Vicki, watched the vote from the visitor's gallery along withadministration officials who have worked intensely on the issue.Senators cast their votes from their desks, a practice reserved forissues of particular importance.

The outcome was preordained after Senate Majority Leader Harry Reid,D-Nev., wrangled his fractious caucus into line over the course of thepast several months, culminating in a frenzy of last-minute deals andconcessions to win over the final holdouts, independent Joe Lieberman of Connecticut and conservative Democrat Ben Nelson of Nebraska.

Obama's oft-stated goal of a bipartisan health bill was not met, despite the president's extensive courtship of moderate Sen. Olympia Snowe of Maine,the only Republican to support the bill in committee. Obama calledSnowe to the White House for lengthy in-person meetings both before heleft for climate talks in Copenhagen and after his return on Saturday.In the end Snowe said she was "extremely disappointed" in what shecalled a rushed process that left scant time for her to review, muchless amend, the bill.

Sen. John McCain, R-Ariz., criticized the side deals needed to win key votes, calling them "Bernie Madoff gimmicks."McCain, appearing Monday on ABC's "Good Morning America," complainedthat "Republicans were never brought in to the negotiations."

Still,the vote represented a major victory for Democrats and Obama, who's nowclearly in reach of passing legislation extending health coverage tonearly all Americans, a goal that's eluded a succession of pastpresidents. The legislation would make health insurance mandatory forthe first time for nearly everyone, provide subsidies to helplower-income people buy it, and induce employers to provide it with taxbreaks for small businesses and penalties for larger ones.

Twomore procedural votes await the Senate, each requiring 60 votes, thefirst of these set for Tuesday morning. Final passage of the billrequires a simple majority, and that vote could come as late as 7 p.m.on Thursday, Christmas Eve.

The Senate measure still must be harmonized with the health care bill passed by the House in November before final legislation can be sent to Obama's desk.

Thereare significant differences between the two measures, includingstricter abortion language in the House bill, a new government-runinsurance plan in the House bill that's missing from the Senateversion, and a tax on high-value insurance plans embraced by the Senatebut strongly opposed by many House Democrats.

AfterMonday's vote a number of Senate Democrats warned that the legislationcould not change much and expect to maintain support from 60 senators.House Democrats are sure to want to alter it but may have to swallow itmostly whole.

"It took a lot of work to bring this 60 together and this 60 is delicately balanced," Lieberman said.

Republicans are determined to give Democrats no help, eager to deny Obama a political victory and speculating openly that the health care issue will hurt Democrats in the 2010 midterm elections.

"There will be a day of accounting," warned John Cornyn, R-Texas, accusing Democrats of pushing a health overhaul opposed by the public. "Perhaps the first day of accounting will be Election Day 2010."

Attheir core the bills passed by the House and pending in the Senate aresimilar. Each costs around $1 trillion over 10 years and is paid for bya combination of tax and fee increases and cuts in projected Medicarespending. Each sets up new insurance marketplaces called exchangeswhere uninsured or self-employed people and small businesses cancompare prices and plans designed to meet some basic requirements.Unpopular insurance practices such as denying people coverage based on pre-existing conditionswould be banned, and young adults could retain coverage longer undertheir parents' insurance plans — through age 25 in the Senate bill andthrough age 26 in the House version.

Reid cut numerous last-minute deals to get the votes he neededand powerful Democrats also inserted home-state provisions in a383-page package of amendments Reid filed this weekend to the2,074-page bill.