US health reform clears first Senate hurdle


Washington : US health insurance reform, the top domestic priority of President Barack Obama, cleared a major procedural hurdle in the US Senate early Monday, ending months of work by majority Democrats to push through a historic bill.

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The Senate voted 60-40 along party lines to end debate on the bill, opening the way for its passage, expected by Thursday.

The bill would provide health insurance for an estimated 31 million people who now have no coverage.

The Senate version, when passed, would have to be reconciled with a version passed in November by the House of Representatives, a move that Obama is hoping would be completed by January or February.

Fifty-eight Democrats and two liberal independents have a 60-vote majority in the Senate for the first time in years, a number needed to end debate – a procedural rule designed to ensure a strong majority for passage of bills.

To secure the vote, the Democratic leadership had to make major concessions to two key senators.

The final wheeling and dealing provoked acrimony among Republicans, who months ago had vowed to undermine health care reform so as to undermine Democrats in the November 2010 elections, when all of the House and one-third of the 100-member Senate face voters.

Before the vote, Republican Minority Leader Mitch McConnell blasted the rush to vote in the middle of the night, referring to a “couple of cheap deals”.

“The final product is a mess and so is the process that brought us here to vote on the bill that the American people overwhelmingly oppose,” he said.

Democratic Majority Leader Harry Reid said the vote to close debate was a vote to make quality health care “a human right”.

“It demands for the first time in American history that good health will not depend on great wealth,” Reid said. “It acknowledges, finally, that health care is a fundamental right – a human right – and not just a privilege for the most fortunate.”

Monday’s vote represented the most progress for any administration in 45 years in reforming the US health care system, which consumes about 18 percent of the gross domestic product – one of the highest percentages in the industrialised world.

Obama had made it a keystone of his election campaign last year, noting often how his own mother had to fight for coverage from her health insurer even as she was dying from cancer.

Democrats wrestled down the key vote of a holdout senator late Friday amidst the worst snowstorm ever to hit Washington DC in December.

“After a nearly century-long struggle we are on the cusp of making health care reform a reality in the United States,” Obama told reporters, reacting to news that the final vote had been secured.

Health care reform has been among Obama’s top domestic priorities since he took office in January, but the issue has served as the most contentious debate of his presidency. “As with any legislation, compromise is part of the process,” he said.

The late senator Edward Kennedy, who died of brain cancer in August, had been a life-long champion of health care reform, and his name was mentioned by Reid and by Senator Chris Dodd, who took up the banner when Kennedy died.

Kennedy’s widow, Victoria Kennedy, was in the Senate for the vote.

Reid had asked for a so-called desk vote, which meant all the senators had to be in their seats. Normally, senators mill around during voting, and the unusual request was Reid’s way of signalling the high importance of the vote.

In the negotiations over the bill, Nebraska Senator Ben Nelson, a Democrat, had initially refused to support the legislation over concerns that federal money would be used to fund abortions. Independent Senator Joe Lieberman insisted that provisions for a public insurance plan – like that contained in the House of Representatives version – be dropped.

Both men traded their votes for the concessions.

In the late-Friday compromise, Reid also met Nelson’s demand for more aid to help Nelson’s state of Nebraska broaden coverage for the uninsured.

The $871 billion Senate bill is aimed at reducing soaring health care costs – in 2007, illness and medical bills caused 62.1 percent of all bankruptcies – and providing insurance to an estimated 31 million people of the 46.3 million the Census Bureau says are without coverage.

The House passed a $1 trillion version that scraped by with a 220-215 vote, with 39 of Obama’s centre-left Democrats voting against it, and includes an amendment that heavily restricts federal funding of abortion, except in rare cases.

Both the House and Senate bills require all Americans to get health care coverage or pay a penalty, expand the Medicaid programme for the poor, set up insurance exchanges or a purchasing marketplace and provide subsidies for those needing aid in buying policies.

“Because it’s paid for and gets rid of waste and inefficiency in our health care system this will be the largest deficit-reduction plan in over a decade,” Obama said.

He cited figures from the Congressional Budget Office that this bill will reduce the deficit by $132 billion over the first decade and more than $1 trillion in the following decade.