Health Care Moves To The Senate

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On health care, all eyes have turned to the Senate, which has to pass the reconciliation bill — or "fixes" — to the health bill. It promises to be arduous, with Republicans throwing up roadblocks and forcing uncomfortable votes for Democrats. But the bill cannot be filibustered, and Democrats expect to have the 51 votes (or 50, plus Vice President Biden) they need for final passage.

ROBERT SIEGEL, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

MELISSA BLOCK, host:

And I'm Melissa Block.

Now, it's the Senate's turn. The House, of course, passed the Senate's health care overhaul last night. President Obama is expected to sign the bill into law tomorrow. The House also went on to pass a package of fixes to the legislation, and it's up to the Senate to approve those revisions.

That approval is being done under special budget rules that do not allow Republicans to filibuster. Still, as NPR's David Welna reports, the end of the health care saga could get even more complicated.

DAVID WELNA: Democrats are ready to wrap things up on health care and move on, but they don't want to do that without first getting the Senate to agree to the bill of corrections the House passed last night. This afternoon, House Speaker Nancy Pelosi staged a send-off at the Capitol for the health care bill, a bill she and many other Democrats see as good but flawed.

Representative NANCY PELOSI (Democrat, California; Speaker of the House): Today, I will sign and roll the Senate bill, which will go to the president immediately for his signature. And it will enable the Senate now to take up the corrections that we passed last night.

WELNA: So, the elaborate legislative dance on health care continues. On the Senate floor today, Majority Leader Harry Reid said that reconciliation, as the expedited budget process being used is known, is about making a good law even better, if the Republican minority lets that happen.

Senator HARRY REID (Democrat, Nevada; Senate Majority Leader): I hope they finally learned that a strategy of delay, myths and fear might slow progress, but it cannot stop it. I hope that this week, when we take up the final revisions of what will soon be a long-overdue law, our Republican friends will finally act in the interest of their constituents, and not just the interests of the insurance industry or their political party.

WELNA: The reconciliation bill would change a number of things in the bill on its way to the White House. A million more people would get health care coverage under it. It would strip out a controversial provision that exempted Nebraska from paying for expanded Medicaid coverage. It would close a gap in prescription drug coverage for those on Medicare.

But Senate Minority Leader Mitch McConnell today seemed to be betting on at least some Senate Democrats siding with his Republicans.

Senator MITCH McCONNELL (Republican, Kentucky; Senate Minority Leader): Democratic leaders may have gotten their votes, they may have gotten their win, but today is a new day. Already, we're seeing Democrats in the Senate distancing themselves from this effort to make a bad bill worse. So we already know that reconciliation is guaranteed to have bipartisan opposition.

WELNA: The only Senate Democrat who's pledged not to vote for the package of fixes is Arkansas' Blanche Lincoln. But other Democrats are unhappy with the separate piece of legislation on student loans rolled into this bill. It would eliminate private banks as the middleman for federally insured college loans.

Washington University congressional expert Stephen Smith says Republicans want to alter the corrections bill so that it has to be sent back to the House for another vote. They can do that either by amending it, he says, or by raising points of order that require 60 votes the Democrats don't have, to be overruled.

Professor STEVEN SMITH (Political Science, Washington University): I can't imagine that there would be an amendment that would attract enough votes in the Senate to pass in the first place. I think that's very much a long shot. Less clear is whether there would be some point of order on which the presiding officer - could be Vice President Biden - would feel obligated to play it straight upon the advice of the parliamentarian, and to rule that some provision in the reconciliation bill was out of order.

WELNA: Further complicating things is the fact that because an unlimited number of amendments can be offered, voting on them could take a long time. Democrats are confident they'll have the votes to prevail, but they're not saying how soon that will be.

David Welna, NPR News, the Capitol.

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