Senate Dems Get Needed Votes For Health Bill

A big breakthrough amid Saturday's blizzard on Capitol Hill: Nebraska Democrat Ben Nelson said he will support the health care bill, giving Senate Democrats the 60 votes they need to pass it. What did it take to win Nelson over? Changes in abortion language and in Medicaid money for his home state, Nebraska.

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GUY RAZ, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Guy Raz.

Few here in Washington will ever forget this day, one of the snowiest December days on record, but also a day Democratic Senator Ben Nelson agreed to back his party's health care bill after 13 hours of marathon negotiations.

Senator BEN NELSON (Democrat, Nebraska): I intend to vote for cloture and vote for health care reform.

RAZ: It's one of the final hurdles to getting a bill passed by the Senate before Christmas. And today, President Obama seemed relieved that his plan, or at least a version of it, now seems likely to become law.

President BARACK OBAMA: After a nearly century-long struggle, we are on the cusp of making health care reform a reality in the United States of America.

RAZ: In a few moments, we'll check in with former Senator Tom Daschle, who played a pivotal behind-the-scenes role in gathering those 60 votes needed to pass a health care bill.

But first, to NPR's David Welna, who's covering the story for us on Capitol Hill.

David, what did it take to win over Senator Ben Nelson, the last holdout in the Democratic caucus?

DAVID WELNA: Well, Guy, more than anything, it took a change in the health care bill's language regarding abortion coverage, which would be provided to people getting federal subsidies for buying insurance. He said he was satisfied with the new language in the bill that walls off any taxpayer funding for abortion.

But it didn't hurt as well that Nebraska got a pretty sweet deal, unlike other states that lose extra federal funds after three years to help pay for expanded Medicaid coverage. Nebraska now gets that federal aid indefinitely.

RAZ: So beyond that deal, what else did Harry Reid, the majority leader, have to do to get all the 60 votes?

WELNA: Well, quite a few things. In order to win over some other holdouts, Reid's so-called manager's amendment takes out a few things from his original bill. Most notably, a public option for people buying insurance on these exchanges that are to be set up. In its place, there will be a plan similar to what federal employees have operated by the Office of Personnel Management and carried out by private insurance firms on a not-for-profit basis.

There's also extra Medicaid money for Vermont, which helped lock in the vote of Bernie Sanders, the Senate's only self-declared socialist. Also new is a requirement that no child below the age of 18 can be denied health coverage due to a pre-existing condition starting immediately. For adults, that won't be the case until 2014.

And one other change is that they're dropping the proposed tax on voluntary plastic surgery, the so-called botax.

RAZ: Mm-hmm.

WELNA: And instead, they're going to slap a 10 percent surcharge on people using indoor tanning parlors.

RAZ: Indoor tanning parlors. Okay. Is there any chance for support now among Senate Republicans, David?

WELNA: Well, not one of those Republicans has expressed any intention to vote for the bill; not even Maine moderate Olympia Snowe, who did vote for the Finance Committee's version of the bill. Republicans are saying this revised bill is even worse than what Democrats had earlier proposed and they're trying to slow down what seems to be inexorable progress towards approval by doing things like demanding today that the entire nearly 400-page manager's amendment be read aloud.

RAZ: And Democrats say they want this bill finished in the Senate by Christmas. Is that going to happen?

WELNA: Well, things are on track for that to happen now. But it may take staying in session virtually nonstop until a final vote. The Democrats are hoping will happen by Christmas Eve. The big test of their unity comes on Monday at a vote at one o'clock in the morning on a procedural matter. That would show whether they really do have the 60 votes that they'll need to get this done.

And even if the bill passes, there's yet another big hurdle, reconciling it with the bill passed by the House. But Democrats are still aiming to do all that before President Obama delivers his State of the Union address.

RAZ: And I suspect you'll be staying up late to watch that vote, David.

WELNA: Absolutely.

RAZ: That's NPR's David Welna from Capitol Hill.

David, thanks so much.

WELNA: You're welcome, Guy.

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