Senate Health Bill Faces Saturday Showdown

Published November 20, 2009 11:42 AM

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Senate Democrats will need to vote in lockstep to overcome GOP opposition to the $848 billion health care bill in a crucial vote Saturday that would move it to the floor for debate. But it's not yet clear whether Majority Leader Harry Reid can round up enough support.

Every member of the Democratic caucus is vital to reach the 60 votes needed to push the bill forward.

All eyes have been on three moderate Democrats. Two of them, Ben Nelson of Nebraska and Louisiana's Mary Landrieu, said Friday they will vote with the party.

That leaves Arkansas' Blanche Lincoln in the questionable column.

If the bill passes Saturday, that merely begins a debate on the Senate floor that could last until Christmas. If the full chamber ultimately approves the legislation, the House and Senate versions would then need to be reconciled.

The Congressional Budget Office says the Senate version of the 2,074-page bill would provide coverage to 94 percent of people in this country and cut the deficit by $130 billion in the first decade. Republicans, however, condemn the bill's price tag, which they say will wind up being more along the lines of $1.5 trillion.

Sen. Tom Harkin (D-IA) has been a big cheerleader for the bill, saying Thursday that he was "very confident that not only will the [Democratic] caucus unite around this bill, but that the American people will unite around it also."

The showdown vote — set to stay open until 8 p.m. Saturday to accommodate out-of-town senators — is a major hurdle for the health care overhaul. A failure at this stage would be a significant defeat for President Obama, who has put the issue at the top of his policy agenda.

"It's the same turkey you didn't like in August, and it's not going to taste any better on Thanksgiving," Sen. Lamar Alexander (R-TN) said of the bill, which has been wending its way through the Senate for months.

The legislation includes a so-called public option that has generated much Republican opposition. But the states would be allowed to opt out of the government insurance program, which the CBO estimates would attract 3 million to 4 million people. The House also bill also contains a public option.

That's not the only issue that has proved divisive. The Senate bill's $848 billion price tag and its language in regard to abortion have threatened to dilute Democratic support.

As written, the measure bars federal funds from being used to pay for abortions, except in certain cases, and forbids including abortion coverage as a required medical benefit. However, it would allow coverage through the public option and allow private insurers that receive federal subsidies to offer plans that include abortion coverage — in both cases, as long as no government money is used.

The U.S. Conference of Catholic Bishops opposes the compromise. Richard Doerflinger, associate director of the organization's Secretariat of Pro-Life Activities, said Reid's legislation "is actually the worst bill we've seen so far on the life issues." He called it "completely unacceptable."

The bishops were instrumental in getting the House to adopt tough anti-abortion language, forcing Speaker Nancy Pelosi (D-CA) to accept restrictions to gain the needed support, which nonetheless outraged liberals.

The House narrowly passed its version of the health care overhaul earlier this month in a 220-215 vote, with nearly all Republicans and 39 Democrats opposed. Advocates say the House bill would cover 96 percent of Americans at a cost of $1.2 trillion. To pay for the expansion, the House bill would cut Medicare's projected spending by more than $400 billion over the next 10 years.

From NPR staff and wire reports

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