U.S. Senate Votes to Open Debate on the Overhaul of the U.S. Health Care System After Thanksgiving Break - 11/21/2009

On Saturday, November 21, 2009, with no Republican votes, and no votes to spare, the U.S. Senate voted to open debate on the overhaul of the U.S. health care system after the Thanksgiving break.  The Senate bill, a product of the merger of two separate measures that cleared the Senate Finance and Health, Education, Labor and Pensions Committees, promises to expand access to health care to some 31 million Americans at the cost of $848 billion dollars over the next 10 years and includes a public plan with a provision allowing states to opt out by passing legislation to that effect.  To pay for the coverage expansion, the bill includes various revenue raising provisions as well as measures designed to produce substantial savings in the Medicare program.

Like the House bill, the Senate legislation includes extensive insurance market reforms and a significant expansion of Medicaid.  One major area where the two health care reform bills differ, however, is in the provisions to offset costs. For example, the Senate legislation provides for a 40 percent tax on so-called high-cost “Cadillac” benefit plans that would kick-in at thresholds of $8,500 for individuals and $23,000 for families (up from $8,000 and $21,000 in the original Senate Finance Committee version).

Majority leader Senator Harry Reid acknowledged that Saturday night's 60-to-39 vote is only the first 60-vote hurdle in a long race to passing a bill in the Senate.  Comments by several moderate Democrats – Democrats without whom the bill has little chance of passing – suggest the shape of the debate ahead for the Senate health care reform bill in the next coming weeks: the existence of a public option and its size, ways to contain costs, and provisions about limiting access to abortion services, among other issues.  Their comments also highlight the enormity of the work that remains.

Senator Mary Landrieu (D-LA) was one of the last two Democrats on the fence to be persuaded to vote "yes" on Saturday, November 21, 2009.  In discussions with Senator Reid, Senator Landrieu reportedly gained promises of funds to help her state, and yet her support remained tepid.  "I have decided that there are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done," said Landrieu.  The last Democrat to publicly agree to vote to begin debate on the bill, Senator Blanche Lincoln (D-AK), announced her decision on the floor of the Senate with a significant caveat: "I am opposed to a new government administered public health care plan as a part of comprehensive health care reform, and I will not vote in favor of the proposal that has been introduced by leader Reid as it is written."  If Saturday’s vote is the model of how Democrats can get to 60 votes on health care reform – avoiding a filibuster – then Senator Reid will need Senator Lincoln and other moderate Democrats.  Yet, on the left wing of the Democratic caucus, other Senators went on record saying their vote is in doubt if the public option is weakened during debate.  Senators will begin debate on the bill next week. President Obama has called for the Senate to finish by the end of 2009.

If you have more questions about Health Care Reform, you can contact Greg Pemberton, Kevin Woodhouse or Sarah Cotterill, or any other member of Ice Miller's Health Law Practice Group.

This publication is intended for general information purposes only and does not and is not intended to constitute legal advice.  The reader must consult with legal counsel to determine how laws or decisions discussed herein apply to the reader's specific circumstances.