With no votes to spare, Democratic senators moved health care reform past its first major hurdle Saturday night, with a party-line, 60-to-39 vote to begin consideration of the 2,000-plus page bill that Senate Majority Leader Harry Reid unveiled this week.
The fate of the measure came down to two moderate Democrats -- Blanche Lincoln of Arkansas and Mary Landrieu of Louisiana. Both women had withheld their support for debating the bill until the last hour, but announced in the afternoon that they would vote with Reid -- at least for now.
"My vote today should in no way be construed as an indication of how I might vote as this debate comes to an end," said Senator Landrieu. "After a thorough review, I have decided that there are enough significant reforms and safeguards in this bill to move forward, but more needs to be done."
Senator Lincoln echoed her colleague's skepticism, saying she would vote to move forward with the debate, but stressing that she wants changes to the legislation -- including striking the public option entirely -- before she would consent to vote for it on final passage. "I have concluded that it is more more important to begin debate rather than simply dropping the issue and walk away," Lincoln said.
The bill that senators will begin debating after Thanksgiving combines proposals passed by the Senate Finance Committee and the Senate Committee Health, Education, Labor and Pensions Committee (HELP), and is designed to make health insurance more accessible and affordable. The Congressional Budget Office estimates the bill would expand coverage to 94 percent of Americans at a cost of $848 billion over the next 10 years.
In addition to imposing new regulations on insurance companies, the legislation would create health insurance exchanges, which would function as a marketplace of last resort where Americans could choose between private insurance, non-profit cooperative insurance, and a government-run public insurance option. While Democrats differed in their levels of enthusiasm for the bill, Republicans were unanimous in their opposition, describing Reid's proposal as everything from a spending binge to a Ponzi scheme.
Sen. Olympia Snowe of Maine, who voted for the Democrats' bill in the Senate Finance Committee, voted against debating it Saturday night. She objected to many of the the policies in the version of the bill that emerged from the Majority Leader's office, including the public option. Mostly, Snowe was critical of the closed-door, partisan process used by Reid to combine the two committee bills.
Sen. Mike Enzi (R-Wyo.), the top Republican on the Senate HELP Committee and the only accountant in the Senate, warned of the bill's potentially catastrophic effect on the federal budget deficit. "Perhaps the best way to qualify this bill is to say it keeps me up nights," Enzi said, summing it up in one word: "Disaster."
Other Republicans, such as Sen. Orrin Hatch of Utah objected to the bill's abortion provisions, which are weaker than the House-passed bill, as well as the bill's estimated cost of nearly $1 trillion to the taxpayers over the next decade. Missouri Republican Sen. Kit Bond said there were so many objectionable elements to the proposal that his colleagues had a hard time choosing which ones to go after first. "We're like a mosquito in a nudist colony," he said. "We have so many targets to attack in this bill we don't know which one to hit."
Democratic leaders defended their bill, with Reid saying of Sen. Mitch McConnell (R-Ky.), "The facts he is talking about do not exist, except in the minds of people who do not understand this bill." Several Democrats also invoked the late Sen. Ted Kennedy before casting their votes, including Kennedy's close friend Connectucut Sen. Chris Dodd, who said "there is no greater compliment we could give to Ted Kennedy than to pass this bill."
In the minutes before the vote, Sen. Max Baucus, a leader for the Democrats in health care reform, said to his fellow senators, "History is knocking on the door. Let's open it."