WASHINGTON — Senate Democrats passed a landmark health care bill in a climactic Christmas Eve vote that could define President Barack Obama’s legacy and usher in near-universal medical coverage for the first time in U.S. history.
The 60-39 vote on a cold winter morning capped months of arduous negotiations and 24 days of floor debate. It also followed a succession of failures by past congresses to get to this point.
Vice President Joe Biden presided as 58 Democrats and two independents voted “yes.” Republicans unanimously voted “no.”
The tally far exceeded the simple majority required for passage, but clearly showed the philosophical split between Democrats and Republicans over how American health care should be delivered.
And that acrimony is expected to persist as the Senate’s bill gets merged with legislation passed by the House. That has to happen before Obama can sign a final bill in the new year.
There are significant differences between the two measures but Democrats say they’ve come too far now to fail. Both bills would extend health insurance to more than 30 million more Americans.
The bill’s passage will offer Obama a bright end to an often rocky year that began with huge hopes following his election victory. His public approval level now hovers around 50 percent as he copes with high unemployment, increasing violence in Afghanistan and the divisive health care debate.
Obama delayed his Christmas vacation in Hawaii until the Senate vote, a sign of its importance to his presidency. The legislation will likely shape the 2010 congressional elections and possibly Obama’s 2012 re-election bid.
Obama has signaled that he’s ready to go forward with the legislation.
In an interview with PBS broadcast Wednesday, the president sought to shift the focus from how the bills differ to how they are similar.
“I’m getting 95 percent of what I want,” Obama said. “Now, I might not be getting 95 percent of what some other folks want.”
Vicki Kennedy, the widow of the late Massachusetts Sen. Edward Kennedy, who made health reform his life’s work, watched the vote from the gallery.
“This morning isn’t the end of the process, it’s merely the beginning. We’ll continue to build on this success to improve our health system even more,” Majority Leader Harry Reid said before the vote. “But that process cannot begin unless we start today … there may not be a next time.”
At a news conference a few moments later, Reid said the vote “brings us one step closer to making Ted Kennedy’s dream a reality.”
After passage, House Minority Leader John Boehner assailed the bill.
“Not even Ebenezer Scrooge himself could devise a scheme as cruel and greedy as Democrats’ government takeover of health care,” the Ohio Republican said in a statement.
“Senator Reid’s health care bill increases premiums for families and small businesses, raises taxes during a recession, cuts seniors’ Medicare benefits, adds to our skyrocketing debt, and puts bureaucrats in charge of decisions that should be made by patients and doctors,” he said. “The bill also authorizes taxpayer-funded abortions, violating long-standing federal policy. It’s no coincidence that the more the American people learn about this monstrosity, the more they oppose it.
The legislation would ban the insurance industry from denying benefits or charging higher premiums on the basis of pre-existing medical conditions. The Congressional Budget Office predicts the bill will reduce deficits by $130 billion over the next 10 years, an estimate that assumes lawmakers carry through on hundreds of billions of dollars in planned cuts to insurance companies and doctors, hospitals and others who treat Medicare patients.
For the first time, the government would require nearly every American to carry insurance, and subsidies would be provided to help low-income people to do so. Employers would be induced to cover their employees through a combination of tax credits and penalties. The legislation costs nearly $1 trillion over 10 years and is paid for by a combination of taxes, fees and cuts to Medicare.
Some liberal Democrats have not been enthusiastic about the Senate bill because they don’t believe it goes far enough, leaving some 24 million people uninsured.
And there are no plans for a government-run national health care system that would cover all Americans. Even a more modest proposal to have a government-run health plan compete with private insurers had to be stripped from the Senate bill in the face of opposition from moderate Democrats.
Negotiations between the House and Senate to reconcile differences between the two bills are expected to begin as soon as next week.
Erica Werner/The Associated Press