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Health Care Reform Moves to the Senate

November 30, 2009 - by Donny Shaw

The Senate today comes back from Thanksgiving recess to begin their health care debate. Majority Leader Sen. Harry Reid [D, NV] has said that he plans to keep the Senate in session nights and weekends until the debate is over. With senators form both parties preparing amendments to change almost every aspect of the 2,074 page bill and Republicans vowing a “holy war” to prevent its passage, the debate that begins today is expected to be one of the longest and most contentious in decades.

Here’s where things stand: The Democratically controlled 111th Congress has passed health care legislation designed to reform the insurance industry and expand coverage through five congressional committees and the full House of Representatives. Right now, things are further along in the legislative process that any of the previous Administrations that have attempted comprehensive reform of the U.S. health care system (Carter, Clinton etc.) ever got. So far, in all the votes that have been taken, only one Republican – Rep. Anh Cao [R, LA- 2] – has voted in favor of the bill. The House passed their version of the bill on November 16 by a vote of 220-215, but passage in the Senate is still uncertain.

On Saturday November 21, Senate Democrats voted unanimously to defeat a Republican filibuster of beginning debate of their health care bill (which you can read in full at this link). However, before voting to defeat the filibuster, several centrist Democrats said that they intend to join with Republicans to filibuster the bill from ever coming to a final vote on passage if its provisions related to the public option are not changed by amendments.

“My vote today to move forward on this important debate should in no way be construed by the supporters of this current framework as an indication of how I might vote as this debate comes to an end,” said Sen. Blanche Lincoln [D, AR], one of the Democrats who has been most opposed to the public option, before voting to defeat the filibuster. The debate and amendment process to resolve all outstanding issues with the bill begins officially today at 3 p.m ET.

The centrists all have different takes on the public option. Some want it to be reduced to an opt-in plan for states to choose (or not choose), some want it attached to a “trigger” that would start it up if private insurers don’t expand coverage enough, and some want it to be scrapped altogether. Republicans are planning to delay the bill every step of the way, so it will take 60 votes for the Democrats to defeat a filibuster on ending debate and bringing the bill to a final vote. With the Democrats only controlling 60 votes in the Senate, their challenge is to find a compromise that holds their entire caucus together or wins the support of centrist Republicans like Sen. Susan Collins [R, ME] and Sen. Olympia Snowe [R, ME]. The Washington Independent is maintaining a public option scoreboard that includes key quotes from the eight senators considered to be on-the-fence on the issue.

The Hill’s Jeffrey Young has a great piece outlining all of the big issues the Senate will be taking up as they begin debating the health care bill. The public option is the most widely discussed issue in the bill, but other issues, like affordability and tax plans, are just as important and deserving of more attention.

More good preview coverage of the debate: WSJ, WaPo, Jonathan Cohn, The Caucus.

The whole debate and amendment process in the Senate could last anywhere from a couple weeks to several months. As Carrie Budoff Brown at The Politico reports, wrapping up the debate rests largely on the Democratic leadership’s ability to negotiate behind the scenes and strike a deal on the public option that can win 60 votes. Publicly, Harry Reid says still plans on finishing the bill by Christmas.

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