Washington, Dec 22: President Obama’s vision of near universal healthcare took a big step closer to reality yesterday when his plans secured a watertight majority in the Senate.
With Washington covered in 2ft of snow and some senators flown in on government jets to make sure they were there for the 1am roll call, all 58 Democrats and the chamber’s two independents held together to deliver the 60 votes needed to cut off Republican efforts to block the Bill.
The vote, which followed a frenzy of last-minute compromises to win over the last Democratic moderate, clears the way for a Senate Bill to win passage in a vote scheduled for 7pm on Christmas Eve. A final piece of legislation — the centrepiece of Mr Obama’s domestic agenda — is likely to reach his desk next month.
Republicans, who voted unanimously against the package, decried the $871 billion (£540 billion) ten-year Bill as a hastily crafted, fatally flawed partisan monstrosity that would raise taxes, increase healthcare costs and explode the already record budget deficit.
Yet after a century in which many US presidents have talked about universal health coverage — and with some, including the Republican Richard Nixon and Democratic Bill Clinton trying and failing — Mr Obama will rightly be able to claim that he has achieved something no other US president has managed.
The White House and Democratic leaders conceded that the Bill was far from perfect, but argued that failure to pass some form of sweeping legislation would have consigned efforts to reform the health insurance industry to the political wilderness, possibly for at least another generation.
Tom Harkin, a Senate liberal who had to swallow significant concessions to moderates, called his backing of the Bill “the defining vote of my career”.
Watching from the chamber’s gallery was Victoria Kennedy, the widow of Edward Kennedy — a staunch liberal who campaigned for health reform during his career.
Hours before the vote she argued in a piece written for The Washington Post that her husband would have voted for the Bill because “he said that it was better to get half a loaf than no loaf at all, especially with so many lives at stake”.
Obstacles remain, but yesterday’s vote was seen as the critical hurdle Mr Obama needed to clear to see a final piece of legislation emerge. If passed on Christmas Eve the Senate Bill will need to be merged, or reconciled, with a version passed by the House last month, and there remain significant differences between the two.
Unlike the $1 trillion House Bill, the Senate version contains no government-run health insurance programme, known as the “public option”. Liberals have seen this as a crucial test for any legislation because they claim that it is needed to provide competition to keep the costs of private insurers down.
Harry Reid, the Democratic Senate leader, dropped the public option to win over Joe Lieberman, the former Democrat turned independent, and the final Democratic holdout, Ben Nelson of Nebraska.
Mr Nelson also won restrictions on the use of federal money for abortions, and an extraordinary financial gift to his home state. Unlike every other US state, Nebraska will no longer have to share the cost with central government of providing Medicaid, the medical assistance programme for low income Americans — a concession condemned by Republicans as a blatant bribe. Because Mr Reid has no room for manoeuvre — one defection would doom the Bill — the Senate version is expected largely to prevail during negotiations with the House.
Under the legislation, an additional 30 million Americans, who are currently uninsured, would receive coverage.
The Bill will require nearly all Americans to obtain health insurance, or face a financial penalty for failing to do so. About half of those would be helped to do so by an expansion of Medicaid.
Small businesses would receive tax breaks to help them to provide coverage to employees. Big companies would face financial penalties for failing to do so. Insurance companies would no longer be able to decline coverage to people with pre-existing conditions.
To pay for the reform, the Bill would impose an array of taxes and fees, including tax rises for individuals earning more than $200,000 and couples earning more than $250,000. The most expensive health insurance coverage, known as “Cadillac plans”, will be taxed heavily.
The Bill would also slash government spending on Medicare, the government subsidy programme for the elderly.
–Agencies