Senate Debate Underway on Health Care Reform Bill

As the last month of the 2009 calendar year began, the goal of the Obama Administration to pass health care reform through the houses of Congress before the end-of-year recess seemed more remote than ever before. The process that began with campaign promises from then-candidate Obama and took tiny steps forward in the first months of his presidency did not truly move forward until he officially directed Congress in June to devise a framework for health care reform. And it took until November 30 to run its course in the House of Representatives and arrive on the Senate floor for debate.

The process started in June with disagreements and fundamental differences that were to set the tone for the past six months of health care reform discussions. Democrats and Republicans battled with traditional stances on the issue of governmental involvement in the health care system and basic party disparities, as well as influence from a sometimes misinformed public and a powerful organization of lobbyists.

After months of haggling and trying desperately to find middle ground, bills were introduced in late October. The Senate bill was brought into play by Majority Leader Harry Reid (D-NV) on October 26, and House Speaker Nancy Pelosi (D-CA) brought her bill to the House three days later. Both bills boasted of a public option, though they were watered-down versions of the initial hopes of the Obama Administration.

Members of the House looked to move the Affordable Health Care for America Act (H.R. 3962) forward quickly and brought it to a vote on Saturday night, November 7, where it passed by a vote of 220-215, only two votes more than necessary. Democrats provided the numbers necessary to pass the bill, with 219 voting for and 39 voting against it, and one lone Republican, Rep. Joe Cao (R-LA), crossed party lines to vote for it. The 2,000-page bill offered a public option and an expansion of Medicaid to extend coverage to 36 million people currently without it but also required Americans to pay penalties for not acquiring health insurance, and the reforms looked to be paid for through a payroll tax for employers, Medicare cuts, and other fees and taxes. And in order to secure the passage of the bill, Democrats had to concede to the passage of an amendment that prohibited federal funds for abortion services in the public option, which did pass by a vote of 240-194.

The focus then shifted to the Senate, and the 2,074-page piece of legislation was prepared to be displayed on the floor and opened for debate on Monday, November 30. Boasting of a public option that would insure 31 million people but cost $850 billion, the bill included provisions like taxes on cosmetic surgery and tax increases on insurers providing health plans worth more than $8,500 per year for individuals or $23,000 for families, all of which would combine to pay for the health reforms and reduce the deficit by $130 billion over the next decade.