It’s Done: Senate Approves Health Care Overhaul, 60-39

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Washington – The Senate Thursday voted 60 to 39 to overhaul the nation’s health care system — President Barack Obama’s top 2009 domestic priority — moving the nation closer to near-universal health care coverage early in the next decade.

It was a vote, said Senate Majority Leader Harry Reid, D-Nevada, “to live a healthy life.”

Fifty-eight Democrats and two independents — and no Republicans — voted to approve an $871 billion bill would require most Americans to obtain health care coverage, and would provide federal aid for those having difficulty affording it.

The bill, passed at 7:15 a.m. during the Senate’s first Christmas Eve session in 46 years, now has to be merged with a version passed last month by the House of Representatives.

Lacking the votes to stop the bill in the chamber, Senate Republicans vowed to continue their fight in the public arena and encouraged angry voters to let Congress know what they think of the health care bill.

“We must take this chance and deliver on a promise the American people have deserved for six and half decades,” said Majority Leader Harry Reid, D-Nevada, a reference to President Harry Truman’s initial bid to overhaul health care in the 1940s.

But Republicans would not relent.

“I guarantee you the people who voted for this bill are going to get an earful when they finally get home for the first time since Thanksgiving,” said Senate Minority Leader Mitch McConnell, (R-Ky.) “This fight isn’t over…My colleagues and I will work to stop this bill from becoming law.”

Negotiators are likely to begin closed-door talks next month, aiming to have a final compromise bill finished in time for Obama’s 2010 State of the Union address, probably in late January.

Democratic leaders and the White House are confident they can find common ground, and see plenty already. Insurers would be barred from denying coverage because of pre-existing conditions. Insurance exchanges, or marketplaces, would be created where consumers could easily shop for policies. And companies could no longer charge separate rates because of gender and would be limited to how much more they could charge older consumers.

But reaching agreement on contentious areas could be difficult, because the bills have stark differences on some of the major political flashpoints.

The House bill puts strict limits on federal funding of abortion. The Senate is less restrictive.

The House wants a government-run insurance plan, or public option. The Senate does not, opting to push a federally-supervised system of multistate, private run insurance plans..

The House wants to impose a 5.4 percent income tax surcharge on individuals earning $500,000 and couples making more than $1 million, starting in 2011, a change that would begin to restore some of the Bush era tax cuts.

But the Senate has other ideas, preferring a 40 percent excise tax on more expensive employer-sponsored insurance plans and a 0.9 percentage point increase in the 1.45 percent Medicare tax on the wealthy.

And there are less discussed differences, such as effective dates—the House wants to start major changes in 2013, the Senate, a year later.