President Barack Obama’s planned reform of health care, his top domestic goal, cleared a key Senate hurdle Monday with no room to spare and seemed set to pass by his self-imposed Christmas deadline.
After hours of bitter debate, all 58 Democrats and their two independent allies closed ranks in a vote shortly after 1:00 am (0600 GMT) to get exactly the 60 senators needed to end debate on a landmark compromise bill.
“What’s really killing more and more Americans every day is complications from our health care system,” Democratic Senate Majority Leader Harry Reid said in the final speech before the ballot.
All 40 Republicans voted against the measure.
While acknowledging that for the moment, they lacked the power to kill the sweeping proposal, they warned that Democrats would pay a price in the November 2010 mid-term elections.
“It’s not too late. All it takes is one. Just one. All it takes is one. One can stop it — or every one will own it,” Republican Senate Minority Leader Mitch McConnell said in a vain last-ditch appeal for a Democratic defector.
Senators were scheduled to hold two more procedural votes a day apart and then a final ballot on Thursday — Christmas Eve — on passing what would be the most sweeping overhaul of its kind in four decades.
Passage would set up tough negotiations for the Senate and the House of Representatives — which approved its version of the bill on November 7 — to craft a compromise version they could send to Obama to sign into law.
Democratic leaders hope to do so before his State of the Union speech in late January or early February.
Intra-party Democratic feuds were expected over tough new restrictions on federal monies going to subsidize abortions and the Senate’s decision to strip out a government-backed “public option” to compete with private insurers.
But the White House defended the watered-down bill, saying it would still accomplish the president’s goal to overhaul the troubled US health care system.
“This is a very, very strong bill,” David Axelrod, a senior adviser to Obama, told CNN on Sunday.
“It’s going to help give security to people who have insurance today, and it will help people who can’t afford insurance, and small businesses who can’t afford insurance get insurance,” he added.
The bill would help prevent people with pre-existing health conditions from being denied insurance, he said.
“That is the change the president promised. That’s the change we’re close to delivering.”
The highly unusual overnight vote came after a day of often bitter debate inside the Capitol as Washington dug out from under the worst winter storm in years.
The underlying legislation would extend coverage to 31 million of the 36 million Americans who currently lack insurance.
It would require most Americans to buy insurance and offer subsidies for low-income families to do so, while forbidding insurers from denying coverage because of pre-existing medical conditions.
Democrats said the bill met Obama’s targets of costing less than 900 billion dollars and not adding to the deficit.
They cited findings from the non-partisan Congressional Budget Office that it will cost 871 billion over the next 10 years and cut the deficit by about 132 billion dollars.
Several Democrats invoked the memory of the late senator Ted Kennedy, who had made fixing US health care a main cause of his life. His widow Vicki Kennedy was in the visitors gallery as the vote took place.
Although the United States is the world’s richest nation, it is the only industrialized democracy that does not provide health care coverage to all of its citizens.
Washington spends more than double what Britain, France and Germany do per person on health care — but it still lags behind other countries in life expectancy and infant mortality, according to the Organization for Economic Cooperation and Development (OECD).
