Obama hails 60th Senate vote for health care

Jubilant US Senate Democrats secured the 60th and decisive vote for historic health care reform legislation, putting President Barack Obama’s top domestic policy issue firmly on a path for Christmas Eve passage.

At the White House yesterday, Mr Obama swiftly welcomed the breakthrough, saying: “After a nearly century-long struggle, we are on the cusp of making health care reform a reality.”

In the Capitol, Senate Majority Leader Harry Reid smiled when asked if Nebraska Senator Ben Nelson’s decision gave him the 60-vote majority necessary to overcome solid Republican opposition. “Seems that way,” he said.

The Nevada Democrat agreed to a series of concessions on abortion and other issues demanded by Mr Nelson in day-long talks on Friday, then informed Mr Obama of the agreement in a late night phone call as the president flew home from climate talks in Copenhagen.

The Congressional Budget Office said the Senate bill would extend coverage to more than 30 million Americans who lack it. It also imposes new regulations to curb abuses of the insurance industry, and the president noted one last-minute addition would impose penalties on companies that “arbitrarily jack up prices” in advance of the legislation taking effect.

Analysts also said the legislation would cut federal deficits by $132bn (€92bn) over 10 years and possibly much more in the subsequent decade.

The developments unfolded on a day of improbables – a snowstorm enveloped the Capitol, creating whiteout conditions outside; while inside senators staged duelling news conferences as if their presence on the Saturday before Christmas was the rule rather than the rarest of exceptions.

At its core, the legislation would create a new insurance exchange where consumers could shop for affordable coverage that complied with new federal guidelines.

Most Americans would be required to purchase insurance, with federal subsidies available to help defray the cost for lower and middle income individuals and families.

In a concession to Mr Nelson and other moderates, the bill lacks a government-run insurance option of the type that House Democrats inserted into their version of health care reform legislation.

In a final defeat for liberals, a proposed expansion of the federal Medicare program for the elderly was also jettisoned in the past several days as Mr Reid and the White House manoeuvred for 60 votes. The rejected proposal would have allowed Americans between the ages of 55 and 64 to buy into Medicare.

Outnumbered Republicans unleashed a new series of attacks against the legislation and vowed to delay its passage as long as possible. The next – and most critical – test vote was set for about 1am local time (6am Irish time) on Monday.

To secure passage, Democrats will need to show 60 votes on two additional occasions, and in the meantime, Mr Reid made sure Republicans would have no additional chances to seek changes to the measure.

In place of a government-run insurance option, the estimated 30 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for national plans overseen by the same office that manages health coverage for federal employees and members of Congress. Those plans would be privately owned, but operated on a non-profit basis.

Insurance companies would be barred immediately from denying coverage to children because of a pre-existing health condition. The prohibition on denial of coverage for adults would not take effect in the Senate bill until 2014.