Senate Democrats win overnight procedural vote; move one step closer to approving health bill by Christmas

The New York Times: "After a long day of acid, partisan debate, Senate Democrats held ranks early Monday in a dead-of-night procedural vote that proved they had locked in the decisive margin needed to pass a far-reaching overhaul of the nation's health care system." The vote, which followed party lines, was taken just after 1 a.m. The result is that the Senate will "cut off a Republican filibuster of a package of changes to the health care bill by the majority leader, Harry Reid of Nevada." The final tally -- 60 to 40 — "is expected to be repeated four times as further procedural hurdles are cleared in the days ahead, and then once more in a dramatic, if predictable, finale tentatively scheduled for 7 p.m. on Christmas Eve" (Herszenhorn and Pear, 12/21). 

The Washington Post: It was a "milestone victory" for Senate Democrats -- "approving a procedural motion to move the reform legislation to final passage later this week, and without a single vote to spare." But to get to this point, Senate Democrats worked through "a challenging closing round of negotiations, culminating in a series of compromises with moderates, [that] threatened to overshadow the significance of what Democrats believed they were close to achieving: the most significant health-care legislation since Medicare and Medicaid were created in 1965." The Post reports that Senators voted from their desks, which is "a formality observed only for the most important bills." Also, visitors watching the vote from the gallery included Victoria Reggie Kennedy, widow of Sen. Edward M. Kennedy (D-Mass.); Health and Human Services Secretary Kathleen Sebelius; and senior White House aides Jim Messina and Nancy-Ann DeParle. In the background, though, President Barack Obama and other Democrats struggled to contain growing dissatisfaction from the party's liberal flank, which has heightened in recent days as a result of compromises negotiated to get the Senate bill this far (Murray and Montgomery, 12/21).

Politico: "Less than two days after releasing a bill with 383 pages of changes, Senate Majority Leader Harry Reid (D-Nev.) corralled his politically diverse caucus and delivered the 60 votes necessary for the most crucial test vote in the legislative process so far — effectively assuring the reform package will clear the Senate later this week." Though a procedural vote, most Senators viewed it as a crucial vote on the bill itself, Politico reports. And just minutes after the roll call was completed, "two of the final Democratic holdouts, Sens. Ben Nelson (Neb.) and Joe Lieberman (Conn.) were already threatening to withhold their votes if the bill drifts closer to the House bill, which includes a public health insurance option and different ways to pay for reform" (Budoff Brown and Shiner, 12/21). 

The Wall Street Journal: "The more than 2,000-page Senate bill needs to be reconciled with House-passed legislation, but is likely to form the core of any final bill presented to President Obama for his signature."

"Months in the making, the Senate bill would sharply expand Medicaid -- the federal-state health program for the poor -- and create tax subsidies to help low- and middle-income people comply with a new mandate to carry insurance." The measure generally would "leave the existing employer-based health-insurance system intact. ... Larger companies would be required to pay a fee to the government if they didn't offer affordable insurance to employees and if the employees later sought government help paying for insurance. Last-minute additions toughened restrictions on insurers" (Hitt and Adamy, 12/21).

The Hill: "Had the bill derailed, it would have proved a major embarrassment for the leader, a setback drawing intense media scrutiny over the holiday." But, The Hill continues, "Monday's vote showed that Reid did just what his critics said he could not do. He kept all of his Democratic colleagues together, even though he had to make compromises that many disliked" (Bolton, 12/21).

CQ: "Much of the health industry either supports the bill or is not vigorously opposing it. The American Medical Association, Pharmaceutical Research and Manufacturers of America, Federation of American Hospitals and several other nursing and doctors' groups have partnered with a Democratic-aligned consumer interest group, Families USA, to run television ads in support of the bill. Business Roundtable ... sent a letter to Reid on Dec. 18 expressing concerns about the legislation but described it as an improvement" over the House-passed bill. "And Karen Ignani, president and CEO of America's Health Insurance Plans, a trade group, issued a statement Dec. 20 that contained both praise and criticism. ... A spokesman for AHIP noted that the group remains opposed to the bill." But such criticism "probably benefits Reid, who risked losing the votes of liberals when centrists forced him to jettison the public option" (Wayne, 12/21).

Kaiser Health News tracked events over the weekend in the run-up to the overnight vote, including the details of Majority Leader Reid's manager's amendment, the Congressional Budget Office analysis, reaction to the bill's abortion language, specifics of how the deal happened and coverage of the pre-vote politics.