US President Barack Obama’s signature drive to remake US healthcare barely cleared a key Senate hurdle in a narrow party-line vote the White House immediately hailed as a “historic” victory.
Senators voted 60-39 on Saturday to formally start debate on legislation aimed at extending coverage to some 31 million Americans who lack it in what would be the most sweeping overhaul of its kind in four decades.
But Obama’s Democratic allies mustered the bare minimum 60 votes needed to take up the bill, rallying two wavering colleagues and two independents to defeat 39 of the chamber’s 40 Republicans, one of whom was absent.
“Tonight’s historic vote brings us one step closer to ending insurance company abuses, reining in spiraling healthcare costs, providing stability and security to those with health insurance and extending quality health coverage to those who lack it,” White House spokesman Robert Gibbs said.
The debate was expected to begin next Monday, after Thanksgiving break, and to last at least three weeks as senators battle over possible changes to the legislation.
The measure — which includes a government-backed insurance program to compete with private firms and restrictions on dropping care for pre-existing ailments — is estimated to cost US$848 billion through 2019, but cut the sky-high US budget deficit by US$130 billion over the same period.
A successful final vote — expected a month away at the earliest — would force the Senate and the House of Representatives to reconcile their rival versions of the bill and vote again on whether to send it to Obama.
Democratic Senate Majority Leader Harry Reid faced three possible defectors, any one of whom could deprive the majority of the 60 votes necessary to break Republican parliamentary delaying tactics in the next procedural vote.
Those senators — Mary Landrieu of Louisiana, Blanche Lincoln of Arkansas and Ben Nelson of Nebraska — have signaled a willingness to join Republicans if their proposed changes to core provisions of the bill are defeated.
Nelson has said he wants tougher restrictions on federal monies subsidizing abortions, mirroring language the House of Representatives added to its version of the bill when it approved it in a 220-215 squeaker on Nov. 7.
“There are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done,” Landrieu, who opposes the government-backed “public option,” said hours before Saturday’s vote.
“I’m promising my colleagues that I’m prepared to vote against moving to the next stage of consideration as long as a government-run public option is included,” Lincoln said.
Reid acknowledged intra-party tensions meant “the road ahead will be the toughest stretch” and that after Saturday’s vote “we can only see the finish line; we have not yet crossed it.”
Republicans, one of whom has vowed a “holy war” against the bill, hope to kill the bill or delay the battle into next year with the expectation that next year’s midterm elections may make it harder for centrist Democrats to support it.
Republican Senate Minority Leader Mitch McConnell said the bill under consideration would result in a US$500 billion cut in the Medicare program for US seniors, massive tax hikes and an unsustainable expansion of new government programs.
“It may be a lot of things, but it’s sure not reform,” he said.
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