Senators began debating the final piece of the landmark health care package Wednesday, with Republicans hoping to push Democrats into a quagmire of embarrassing votes over changes to the overhaul.
Lawmakers are expected to hold an afternoon vote on a laundry list of Republican amendments that could be awkward for Democrats to oppose — including a proposal by Sen. Tom Coburn (R-OK) to prohibit coverage of Viagra for sex offenders.
The package of amendments sought by House lawmakers needs only a simple Senate majority to become law. But if Republicans manage to change anything in the bill, it would have to go back to the House for another vote. Other modifications to the new health care law include scaling back a tax on high-cost insurance plans opposed by labor unions, closing the coverage gap in the Medicare prescription benefits, and higher taxes on upper-income earners.
Senate Democrats were hoping to finish work on the bill this week — right before Congress is scheduled for a two-week recess. They hope to use a procedure called budget reconciliation to quickly pass the changes to the plan that President Obama signed into law Tuesday. Reconciliation would allow the Senate to pass the modifications bill with 51 votes instead of a 60-vote supermajority.
But Republicans remained defiant. Rep. Mike Pence (R-IN) vowed that his Senate colleagues would use every possible approach to derail the bill.
"It wasn't so much that a Republican minority lost on Sunday night. The American people lost — but this fight is not over," he said.
Some Republican amendments include changes already approved by Democrats and signed into law by the president. Sen. Judd Gregg (R-NH) wants savings from Medicare cuts plowed back into the health care program for seniors, instead of being used to expand coverage to the uninsured. Sen. Mike Enzi (R-WY) wants to gut penalties on employers whose workers get taxpayer-subsidized coverage.
Republicans are pursuing other avenues to derail the overhaul law. Attorneys general in 13 states have announced that they'll file a federal lawsuit challenging the new law. Florida Attorney General Bill McCollum filed the lawsuit against the Departments of Health and Human Services, Treasury and Labor, saying it is unconstitutional to require Americans to buy health insurance.
"This law represents an unprecedented encroachment on the liberty of the American people, and I will pursue this litigation to the highest court if necessary," McCollum said.
In addition, the GOP is looking ahead to November. Senate Minority Leader Mitch McConnell (R-KY) promised that the fight against the health care overhaul would be a key election issue.
"The slogan will be repeal and replace, repeal and replace," McConnell said.
Under Senate rules, lawmakers will debate the reconciliation bill for 20 hours before holding a vote. The process could begin as soon as Wednesday evening.
The bill includes:
-- A $250 rebate for seniors who fall into the "doughnut hole" gap for Medicare prescription medications this year. It would close the gap by 2020.
-- An additional $60 billion cut from Medicare.
-- A delay on a tax on high-cost insurance policies until 2018.
-- The elimination of a special deal giving Nebraska 100 percent federal financing for newly eligible Medicaid recipients.
Senate Democrats have said the bill will pass, but it's less certain if changes will be made. If it passes as written, the bill will go straight to the president for his signature. But House Speaker Nancy Pelosi (D-CA) has warned members in her chamber that they could be needed to vote on any change.
White House press secretary Robert Gibbs said the Republican amendments are intended to be a political distraction. At an afternoon briefing, Gibbs said worthwhile changes not in the current bill can be addressed later on through the regular legislative process.
"I think it's pretty clear that there's a lot of game-playing going on," Gibbs said.
Meanwhile, Obama signed an executive order Wednesday that reaffirms existing laws against federal funding for abortions, except in cases of rape or incest or when the woman's life is in danger.
Obama agreed to issue the order last weekend to win the votes of a bloc of anti-abortion Democrats and push the overhaul legislation through the House.
The order was potentially awkward for Obama, who supports abortion rights, but his spokesman said the president has maintained that the health care overhaul should not stray into other issues.
Material from The Associated Press was used in this report
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