Senate Passes Historic Bill to Reform the U.S. Health Care SystemDecember 24, 2009 - by Donny Shaw
By a vote of 60 to 39, the Senate early this morning officially approved health care legislation designed to meet President Obama’s goals of reducing health care costs, increasing choices for consumers and guaranteeing access to quality, affordable insurance for all Americans. All 60 Democrats in the Senate, plus the two Independents, voted in favor of the bill. All 39 Republicans who were present voted “no.” Sen. Jim Bunning [R, KY] skipped the vote.
This morning’s vote ends 25 days of consecutive debate, the second longest such run in Senate history. It is the first time the Senate has been in session on Christmas Eve since 1985
The bill would require all Americans to obtain health insurance, provide new subsidies to help low and middle-income people purchase insurance, expand Medicaid coverage to millions more low-income Americans, create new “exchanges” for comparison shopping health care plans, ban insurance companies from denying coverage based on “pre-existing conditions” and, to pay for it all, tax the most expensive health care policies.
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The Senate has been working on versions of their health care bill since June. The story since then has been about the Democratic leadership shifting the bill to the right in order to find a sweet spot that could win 60 votes, the number needed to get beyond a Republican filibuster. The biggest concessions were made to conservative members of their caucus who were mainly opposed to a proposal in the bill to create a new government run insurance option (a.k.a. the public option). After trying out all sorts of ways to weaken the public option and make it more palatable for the conservative Democrats, the leadership decided the only way win over the conservatives was to drop the public option entirely. The final version that was passed today doesn’t include even a trace of the public option plan.
To balance it out a bit and retain the support of liberals, the leadership added a few sweeteners in the final version including more funding for Community Health Center and the Children’s Health Insurance Program (CHIP). The final bill also bulked up some of the consumer protections in the bill. For example, patients would be guaranteed the ability to appeal coverage denials and requiring insurance companies to spend at least 80 percent of premiums on actual health care. Only 20 percent of premiums max could be used for marketing, administration, underwriting and profit.
According to the non-partisan Congressional Budget Office (CBO), the bill passed today would expand health insurance coverage to 31 million more people over the next ten years who would otherwise not have insurance under the status quo. Fifteen million of those newly insured people would be covered under expansions to Medicaid and CHIP. The rest would either buy their insurance on the new Exchanges (with or without government subsidies) or get coverage through their employers. The CBO has also estimated that the bill would reduce federal deficits by $130 billion over the next ten years.
The Senate bill now has to be reconciled with the House’s health care bill (H.R. 3962), and the same final version needs to be passed once more in both chambers. The differences between the two bills are significant. The House bill contains a public option, for example. It also would use a tax increase on the wealthy as a revenue raiser instead of the Senate’s plan to tax expensive insurance plans. In January, a joint House-Senate conference committee made up of about a dozen committee chairman will start meeting to iron out the differences. It is expected that conference committee will keep the final bill close to the Senate bill in order to preserve the delicate 60-vote support that will be needed once again for passing the conference committee bill.