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Senate Dems narrowly clear hurdle on health care

Erica Werner | 12/23/2009, 5:14 a.m.

The Senate measure still must be harmonized with the health care bill passed by the House in November before final legislation can be sent to Obama’s desk.

There are significant differences between the two measures, including stricter abortion language in the House bill, a new government-run insurance plan in the House bill that’s missing from the Senate version, and a tax on high-value insurance plans embraced by the Senate but strongly opposed by many House Democrats.

After Monday’s vote a number of Senate Democrats warned that the legislation could not change much and expect to maintain support from 60 senators. House Democrats are sure to want to alter it but may have to swallow it mostly whole.

“It took a lot of work to bring this 60 together and this 60 is delicately balanced,” Lieberman said.

In a statement Monday, Nelson said, “The Senate health care bill is not perfect. Yet it doesn’t include a public option or taxpayer funding of abortion I worked to exclude.”

Republicans are determined to give Democrats no help, eager to deny Obama a political victory and speculating openly that the health care issue will hurt Democrats in the 2010 midterm elections.

“There will be a day of accounting,” warned John Cornyn (R-Texas) accusing Democrats of pushing a health overhaul opposed by the public. “Perhaps the first day of accounting will be Election Day 2010.”

At their core the bills passed by the House and pending in the Senate are similar. Each costs around $1 trillion over 10 years and is paid for by a combination of tax and fee increases and cuts in projected Medicare spending. Each sets up new insurance marketplaces called exchanges where uninsured or self-employed people and small businesses can compare prices and plans designed to meet some basic requirements. Unpopular insurance practices such as denying people coverage based on pre-existing conditions would be banned, and young adults could retain coverage longer under their parents’ insurance plans –through age 25 in the Senate bill and through age 26 in the House version.

Reid cut numerous last-minute deals to get the votes he needed and powerful Democrats also inserted home-state provisions in a 383-page package of amendments Reid filed this weekend to the 2,074-page bill.

Among other items, Senate Finance Committee Chairman Max Baucus (D-Mont.) included a provision allowing residents of the town of Libby, Mont., who are suffering asbestos-related illnesses from a mining operation to get Medicare benefits. Nelson won a list of benefits for Nebraska including a commitment for the federal government to pick up the full tab of an expansion of Medicaid. And Sen. Christopher Dodd (D-Conn.) who faces a difficult re-election, inserted a $100 million item for construction of a university hospital that his spokesman said he hopes to claim for the University of Connecticut.

(AP Special Correspondent David Espo contributed to this report.)