Senate Health Care Bill Passes Without GOP Votes

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Senate Democrats passed a historic health care bill early Christmas Eve. The 60-39 vote ended months of negotiations and 24 days of floor debate. Not one Republican voted for the measure. The Senate bill must now be reconciled with a version passed by the House of Representatives last month.

LINDA WERTHEIMER, host:

The U.S. Senate has just passed a massive piece of legislation that would overhaul health care policy and extend coverage to more than 30 million uninsured Americans. The Senate bill must now be reconciled with the version passed by the House of Representatives last month.

Vice President Joe Biden, in his capacity as president of the Senate, was in the chair, and he announced the vote.

Vice President JOE BIDEN: The ayes are 60. The nays are 39. HR3590 as amended, the Patient Protection and Affordable Care Act is passed.

WERTHEIMER: The vote was on strict party lines. NPR's congressional correspondent David Welna joins us now. David, not a single Republican voted for the bill. What does that say about how the bill has been handled by both parties, and what it's prospects are now?

DAVID WELNA: Well, Linda, Republicans seem to have made a political decision to force the Democrats to go it alone on this landmark legislation, which the GOP hopes will redound to their benefit, since polls have been showing lately considerable skepticism about the Democrat's health plan.

And that forced Majority Leader Harry Reid to win the support of every one of the 60 members of his caucus. And that took some last-minute deal making that Republicans have seized on right before senators marked the gravity of this vote by taking the pretty unusual step of voting from their seats.

Reed, on the Senate floor, lamented the Senate's deep, political polarization over health care.

Senator HARRY REID (Democrat, Nevada; Senate Majority Leader): For the first time in American history, a political party has chosen a stand on the sidelines rather than participate in great and greatly needed social change.

WELNA: Of course, Republicans run a certain risk here of ending up on the wrong side of history if this does become law and gains the kinds of stature that Medicare now has, which many Republicans also opposed when it was passed in 1965.

WERTHEIMER: Well, aside from the Republican opposition, there was a considerable amount of grumbling on the part of Democrats about how the bill ended up.

WELNA: There certainly was. There were many Senate Democrats who wanted very much a public option in the bill. There was one, a government-run insurance plan, originally, but it had to be taken out to win the vote of Senator Joe Lieberman, an independent from Connecticut. Abortion was another bone of contention. More restrictive abortion language had to be put in to win the vote of Nebraska Democrat Ben Nelson. There was also a lot of division over taxing so-called gold-plated health care plans, something that many union members have and that they gave up wages for to get, and they don't want to give that up. And there was also a lot of dissent over expanding Medicare eligibility. In the end, the Senate didn't do it to win over centrists.

WERTHEIMER: But David, this bill has been declared dead over and over again, and it's somehow keeps soldering on. The next step is the - was reconciling the House and Senate bills. What - is that going to be - how is that going to be?

WELNA: I think it's going to be a tough row to hoe, but I think that the House is going to have to move probably more towards the Senate bill just because they barely got the 60 votes with the Senate's version right now. The House has a different plan for financing its bill. Its bill is more expensive. It covers more people. It starts one year earlier for many of its features than the Senate bill does.

There may be some concessions made to the House to appease those who wanted a public option, which is in the House bill and will probably have to come out. But there's going to be a lot of horse-riding going on in the next few weeks to get there.

WERTHEIMER: They're looking at a target date of February. In one word, do you think that's workable?

WELNA: Well, I think they're going to aim for - before the state of the union address, whenever that happens.

WERTHEIMER: Thanks very much. NPR's David Welna.

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