The Senate is set to pass a landmark health bill early Thursday morning that would bring President Obama and Democrats a step closer to the most sweeping change in the nation's health system since Medicare was created more than four decades ago.
Despite unflinching Republican opposition and late carping by liberals that compromises to forge a 60-vote bloc went too far, Senate Democrats closed ranks behind legislation that would expand coverage to tens of millions of Americans, restrict the ability of private insurers to deny coverage and eventually trim the nation's budget deficit.
Senators voted 60-39 Wednesday to end debate on the health bill, clearing the way for the last vote on final passage, now set for 7 a.m. Thursday. Only a majority of 51 votes is needed to pass the bill, which isn't in doubt.
Sen. Max Baucus (D-MT), chairman of the Finance Committee, declared, "It is now only hours until this Senate will pass meaningful health care reform."
President Obama acknowledged that the road so far has been rough, during an interview with NPR's Robert Siegel and Julie Rovner Wednesday. The president made the case, however, that the struggle against what he called politically and ideologically driven opposition has been worth it.
Democrats assert that the Senate bill would fundamentally transform the health care system in the country, beginning with restrictions on private insurance companies. Obama told NPR that "a patient's bill of rights on steroids" lies inside the Senate bill.
Various provisions would prevent insurers from dropping ill patients and denying coverage to those with pre-existing conditions. The bill would also require that individuals buy insurance, if they don't already have it from their employers or existing government programs, such as Medicare.
Federal subsidies would be offered to help low-income people afford coverage. A financial penalty would be levied against people who skip coverage.
Republican remained steadfast in their opposition. "Tomorrow the Senate will vote on a bill that makes a bad situation worse," Sen. Charles Grassley (R-IA) said Wednesday. "This bill slid rapidly down the slippery slope to more and more government control of health care."
On Wednesday, the Democrats voted down a challenge led by Republican Sen. John Ensign of Nevada that questioned the constitutionality of the mandate for the purchase of insurance in the Senate bill. Ensign and his allies argued an insurance mandate would violate a Fifth Amendment ban on the government taking private property without appropriate compensation.
The vote on Christmas Eve is certain to make history, regardless of the outcome. The last time senators cast votes on that day was in 1895. According to the Senate Historical Office, legislators wanted to allow former Confederate officers to be employed by the United States Army.
