With Deals Done, Senate Moves One Step Closer to Health Reform

The Senate voted Tuesday morning to pass the manager's amendment (the last-minute package of changes) to its health reform bill, and to limit debate on a substitute amendment. Both measures were approved by party-line votes of 60 to 39, and marked the second time in as many days that Majority Leader Harry Reid kept his sprawling Democratic caucus together on health reform after months of wrangling his members to support the effort.

At least one procedural vote remains before the Senate takes a final vote on the bill, which will require the votes of 51 senators to pass. That vote is now scheduled for 7:30 p.m. Christmas Eve.

In the hours leading up to the Tuesday morning vote, Republicans lambasted Reid's manager's amendment as the result of secretive dealmaking with the sole purpose of winning and keeping Democratic votes. Republicans zeroed in on the changes negotiated by holdout Sen. Bill Nelson (D-Neb.), now known among the GOP as "the Cornhusker Kickback."

Sen. Kay Bailey Hutchison (R-Tex.) said her own state will struggle to pay its share of the Medicaid expansion in the bill, but Nebraska will not, because of the deal Nelson stuck for his state. "I think people are looking at this issue in America today and saying 'What has gotten into the people who are voting for this bill?' " Hutchison said.

Sen. David Vitter even mocked concessions in the bill for his own state won by Sen. Mary Landrieu, a Democrat, and said the $300 million she secured for Louisiana will still leave their state $1 billion short of paying for the Medicaid expansion required in the legislation. "Rather than 'the Louisiana Purchase,' I think the bill could be very accurately called the 'Louisiana sellout,' " Vitter, a Republican, said.

Just as Vitter was speaking, Landrieu was appearing as a guest on C-SPAN's Washington Journal, when the host asked Landrieu to respond to his comments. "Sen. Vitter has not lifted a finger to help pass this bill, and he'll have to live with those consequences," Landrieu said.

After Vitter spoke, Sen. Max Baucus (D-Mont.), a primary author of the bill, asked him to remain on the Senate floor to discuss the statements he had just made, but Vitter left the chamber. "He's fleeing the floor because he knows I'm going to mention facts in total refutation to the assertions he's making," Baucus said angrily, pointing at the departing Vitter. "He leaves the floor. He will not stay with me to talk about what's going on. He makes these statements -- they're misrepresentations -- then he leaves the floor."

Following the morning votes, Reid acknowledged the tensions in the Senate, and said he hoped senators could get through the next two days and "go back to their gentlemanly ways."

"I've said to a number of people, just like Rodney King, 'Let's just all try to get along,' " Reid said. "This is a very difficult time in the next day or so; let's try to work through this." He added that as Christmas approaches, "I would hope everyone would keep in mind it's a time to reflect on peace and the good things in life."