Archive for Sunday, November 22, 2009

Historic health care bill clears Senate hurdle

Sen. Tom Harkin, D-Iowa  speaks Saturday, Nov. 21, after the U.S. Senate voted to begin debate on legislation for a broad healthcare overhaul at Capitol Hill in Washington as Senate Majority Leader Harry Reid D-Nev., looks on.

Sen. Tom Harkin, D-Iowa speaks Saturday, Nov. 21, after the U.S. Senate voted to begin debate on legislation for a broad healthcare overhaul at Capitol Hill in Washington as Senate Majority Leader Harry Reid D-Nev., looks on.

November 22, 2009


— Invoking the memory of Edward M. Kennedy, Democrats united Saturday night to push historic health care legislation past a key Senate hurdle over the opposition of Republicans eager to inflict a punishing defeat on President Barack Obama. There was not a vote to spare.

The 60-39 vote cleared the way for a bruising, full-scale debate beginning after Thanksgiving on the legislation, which is designed to extend coverage to roughly 31 million who lack it, crack down on insurance company practices that deny or dilute benefits and curtail the growth of spending on medical care nationally.

The spectator galleries were full for the unusual Saturday night showdown, and applause broke out briefly when the vote was announced. In a measure of the significance of the moment, senators sat quietly in their seats, standing only when they were called upon to vote.

In the final minutes of a daylong session, Majority Leader Harry Reid, D-Nev., accused Republicans of trying to stifle a historic debate the nation needed.

“Imagine if, instead of debating whether to abolish slavery, instead of debating whether giving women and minorities the right to vote, those who disagreed had muted discussion and killed any vote,” he said.

The Republican leader, Sen. Mitch McConnell of Kentucky, said the vote was anything but procedural — casting it as a referendum on the bill itself, which he said would raise taxes, cut Medicare and create a “massive and unsustainable debt.”

'Beginning, not the end'

For all the drama, the result of the Saturday night showdown had been sealed a few hours earlier, when two final Democratic holdouts, Sens. Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, announced they would join in clearing the way for a full debate.

“It is clear to me that doing nothing is not an option,” said Landrieu, who won $100 million in the legislation to help her state pay the costs of health care for the poor.

Lincoln, who faces a tough re-election next year, said the evening vote will “mark the beginning of consideration of this bill by the U.S. Senate, not the end.”

Both stressed they were not committing in advance to vote for the bill that ultimately emerges from next month’s debate.

Of particular contentiousness to moderates is a provision for the government to sell insurance in competition with private companies, subject to state approval — a part of Reid’s bill expected to come under significant pressure as the debate unfolds.

Even so, their announcements marked a major victory for Reid and the White House in a year-end drive to enact the most sweeping changes to the nation’s health care system in a half-century or more.

At the White House, press secretary Robert Gibbs issued a statement saying the president was gratified by the vote, which he says “brings us one step closer to ending

This graphic shows the process of making the health care reform bill into law.

This graphic shows the process of making the health care reform bill into law.

insurance company abuses, reining in spiraling health care costs, providing stability and security to those with health insurance, and extending quality health coverage to those who lack it.”

What's in the bill

The legislation would require most Americans to carry insurance and provide subsidies to those who couldn’t afford it. Large companies could incur costs if they did not provide coverage to their workforce. The insurance industry would come under significant new regulation under the bill, which would first ease and then ban the practice of denying coverage on the basis of pre-existing medical conditions.

Congressional budget analysts put the legislation’s cost at $979 billion over a decade and said it would reduce deficits over the same period while extending coverage to 94 percent of the eligible population.

At its core, the legislation would create insurance exchanges beginning in 2014 where individuals, most of them lower income and uninsured, would shop for coverage. The bill sets aside hundreds of billions of dollars in tax credits to help those earning up to 400 percent of poverty, $88,200 for a family of four.

How they voted

The House approved its version of the bill earlier this month on a near party line vote of 220-215, and Reid has said he wants the Senate to follow suit by year’s end. Timing on any final compromise was unclear.

All 58 Senate Democrats and two independents voted to advance the bill. All 39 votes in opposition were cast by Republicans. GOP Sen. George Voinovich of Ohio was the only senator not to vote. Montana Sen. Max Baucus, the chairman of the Senate Finance Committee who has labored on health care for more than a year, flew in from his home state on a government plane for the vote and was returning afterward to be with his ailing mother.

While timing made Landrieu and Lincoln the final two Democrats to announce their intentions, Sen. Paul Kirk of Massachusetts had a clear claim as the 60th vote.

Appointed to office this fall after the death of Kennedy, who championed health care issues for decades, Kirk said he spoke for those “who for so many years revered and loved and elected and re-elected (him) ... that I think they’re all — they all, as we do, have him in our minds and our hearts tonight. ...”

Sen. Chris Dodd, D-Conn., echoed those sentiments later in the evening when he referred to Kennedy’s “lifelong quest” for national health care and said “tonight and in the days to come we will pay him the highest compliment by fulfilling that” goal.

At a post-vote news conference, Reid said he had telephoned Kennedy’s widow, Vicki, with the news.

Republican opposition

In hours of debate before the Saturday evening vote, a few Republicans piled copies of the 2,074-page bill on their desks while others criticized it as a government takeover of health care and worse.

“Move over, Bernie Madoff. Tip your hat to a trillion-dollar scam,” said Sen. Kit Bond, R-Mo., likening the bill’s supporters to the imprisoned investor who fleeced millions.

In her remarks, Landrieu said, “I’ve decided that there are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done.” She also touted the $100 million included in the legislation to help her state cover its costs under Medicaid, the state-federal health care program for the poor.

Lincoln referred repeatedly to the political controversy surrounding the issue. She said $3.3 million has already been spent by outside groups advertising either for or against health care legislation in her state, and said, “these outside groups seem to think that this is all about my re-election. I simply think they don’t know me very well.”

How to pay for it

To finance the expanded coverage, Reid proposed higher taxes as well as cuts totaling hundreds of billions of dollars in projected Medicare payments. Hardest hit would be the private insurance Medicare plans, although providers such as home health agencies would also receive significantly less in future years than now estimated.

The bill raises payroll taxes on incomes over $200,000 for individuals and $250,000 for couples. Reid eased the impact of an earlier proposal to tax high-value insurance plans, which has emerged as one of the principal methods for restraining the growth in health costs.

The bill includes tax increases on insurance companies, medical device makers, patients electing to undergo cosmetic surgery and drugmakers.


notajayhawk 8 years, 6 months ago

And all it cost us was $100,000,000 to buy off the last vote. A bargain these days.

Centerville 8 years, 6 months ago

And the Senators are exempt from enrolling in the for-the-little-people 'public' option.

Flap Doodle 8 years, 6 months ago

"Invoking the memory of Edward M. Kennedy..." They got drunk & drove off a bridge?

pace 8 years, 6 months ago

Thank god, working families will be free from Health industry theft and tyranny. Health care should not be designed to serve only the wealthy or to impoverise the middle class.

notajayhawk 8 years, 6 months ago

pace (Anonymous) says…

"Thank god, working families will be free from Health industry theft and tyranny."

Have another glass of kool-aid, pace.

leedavid 8 years, 6 months ago


I go to the doctor, they bill my insurance company and works just fine. Wife died of cancer several years back and the bills were all paid as they should. Now if you could explain how that was health industry theft and tyranny I would love to read that.

parrothead8 8 years, 6 months ago


It wasn't. You are someone who obviously has pretty decent insurance. Many, many Americans work their butts off and still can't afford insurance like yours.

zenmon 8 years, 6 months ago

Why don't we just end the false hoods. Instead of getting a paycheck, just send it to Washington and let them decide what you get. You'll get a card that allows you to buy only approved items, in limited quantities, and everyone will be better for it, right.... No more greed, no more responsibility, , no more prosperity, no more motivation, no more innovation, and no more choice. Ah bliss/sedation.

We won't have to be bothered to vote anymore because the press and the politicians know what we need and could care less about what we want. We are just cattle to be moved about, fed, cared for (at lowest possible cost), and finally slaughtered when we are no longer useful. Welcome to the land of opportunity,

LiberalDude 8 years, 6 months ago

It is so sad that the Republicans all voted to not even enter debate about health care reform. The Republican Senators only care about the money that they are getting from the health insurance lobbyists. They are getting rich while their constituents are suffering.

staff04 8 years, 6 months ago

Thanks for looking out for income earners, Tom. Nice of you to do that in your spare time.

Head for your bunkers everybody, the world is coming to an end...

Richard Heckler 8 years, 6 months ago

National Health Insurance Vs Public Option


The public option ain't what it used to be There's almost nothing left to give away in a healthcare compromise

By Robert Reich

Nov. 19, 2009 |

First there was Medicare for all 300 million of us. But that was a nonstarter because private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it was too much like what they have up in Canada -- which, by the way, cost Canadians only 10 percent of their GDP and covers every Canadian. (Our current system of private for-profit insurers costs 16 percent of GDP and leaves out 45 million people.)

So the compromise was to give all Americans the option of buying into a "Medicare-like plan" that competed with private insurers. Who could be against freedom of choice? Fully 70 percent of Americans polled supported the idea. Open to all Americans, such a plan would have the scale and authority to negotiate low prices with drug companies and other providers, and force private insurers to provide better service at lower costs. But private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it would end up too much like what they have up in Canada.

So the compromise was to give the public option only to Americans who wouldn't be covered either by their employers or by Medicaid. And give them coverage pegged to Medicare rates. But private insurers and ... you know the rest.

So the compromise that ended up in the House bill is to have a mere public option, open only to the 6 million Americans not otherwise covered. The Congressional Budget Office warns this shrunken public option will have no real bargaining leverage and would attract mainly people who need lots of medical care to begin with. So it will actually cost more than it saves.

But even the House's shrunken and costly little public option is too much for private insurers, Big Pharma, Republicans and "centrists" in the Senate. So Harry Reid has ......

Tom McCune 8 years, 6 months ago

Switzerland: Insurance provided by: private companies Insured can shop for and choose carrier: yes Denial for pre-existing conditions: prohibited by law Cancellation for getting sick: prohibited by law "Amenity upgrade" plans: available at additional cost Population covered: 100% Insuror profitability: non-profit by law Life expectancy: 11th in the world National total cost: 10.8% of GDP

United States of America Insurance provided by: patchwork of government agencies and private companies Insured can shop for and choose carrier: yes Denial for pre-existing conditions: commonplace Cancellation for getting sick: prohibited in some states, not others; insurors commonly lie and cheat to cancel policies "Amenity upgrade" plans: available at additional cost Population covered: 85%, but with many under-insured Life expectancy: 50th in the world Insuror profitability: very high National total cost: 16% of GDP

notajayhawk 8 years, 6 months ago

notwhatyouthink (Anonymous) says…

"Same with the insurance companies. The costs are always passed to the consumer."

And you wondered how they were going to get people to buy the public option when the CBO said it would cost more?

Pretty good plan, eh? The government competes with private business then taxes the competition to make their product cost more.

On the bright side, however, I was just listening to Lieberman on the radio. He voted to bring it to the floor for debate, but pretty sure you ain't gonna' see a public option in the final product. Especially since Obama/Reid/Pelosi only want to pass something so they can take credit for "reform" despite the fact that it won't solve anything. Pelosi already threw abortion rights under the bus, wait and see how quick Reid dumps the public option if it means he can be the hero passing a meaningless and empty bill.

Flap Doodle 8 years, 6 months ago

At least the Senate version doesn't have to provision of jail time for people who don't buy insurance..... at least for now.

notajayhawk 8 years, 6 months ago


Were the penalties actually spelled out in the House version? I thought they weren't explicitly mentioned, other than that the fines would be collected along with your taxes by the IRS, and there are possible jail sentences for tax fraud or deliberate non-payment. I could be wrong.

notajayhawk 8 years, 6 months ago

And in only slightly better news, Dennis Moore is supposed to announce today he will not run for re-election. Screw the people you were supposed to be representing to keep your political masters happy one last time then run, right, Dennis?

At least the dog will be gone.

a_flock_of_jayhawks 8 years, 6 months ago

Truth is that it probably won't pass and we can all thank the party of no. I plan to express my thanks at the polls.

Flap Doodle 8 years, 6 months ago

"Truth is that it probably won't pass and we can all thank the party of no." If the Democrats were united, they could pass this without a single Republican vote. The Feds had to bribe the LA senator to get her to go so far as to vote for opening debate. How much can they afford to pony up to get her to vote to pass the actual bill?

remember_username 8 years, 6 months ago

I really don't understand what the big deal was over this vote. As I understand it the bill now goes to debate before it can be voted to pass, or not. While the Democratic majority should have enough to get a simple majority of votes to pass, don't they require 60 passing votes to end a filibuster threat? If it was such a struggle to move the bill forward into the debate phase imagine the difficulty required to get 60 senators in line for a closure. Perhaps someone with better knowledge could correct me if I'm wrong but after a committee votes to introduce a bill to the floor, the bill is debated, more amendments tacked on for compromise, and it is voted on. A particularly contentious the bill might require 3/5ths majority to clear a filibuster during the debate phase and that's it. When did the a rule requiring 3/5ths majority simply to put a bill on the floor for debate come from? Has bipartisanship gotten so insanely rigid that 3/5ths majority is going to be required at every step of legislation?

pace 8 years, 6 months ago

Why respond with personal attacks and tantrums. I can only assume your oxygen level is choked from burying your head in the sand. A recent Harvard study found that medical debt contributed to 62 percent of U.S. personal bankruptcies in 2007 and that 78 percent of bankruptcy filers burdened by healthcare expenses had health insurance but “still were overwhelmed by their medical debt.”

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