Health care reform bill clears Senate hurdle for opening debate

WASHINGTON -- Democrats united Saturday night to push historic health care legislation past a key Senate hurdle over the opposition of Republicans.

The 60-39 vote cleared the way for a full-scale debate beginning after Thanksgiving on the legislation, which is designed to extend coverage to roughly 31 million who lack it, crack down on insurance company practices that deny or dilute benefits and curtail the growth of spending on medical care nationally.

The spectator galleries were full for the unusual Saturday night showdown, and applause broke out briefly when the vote was announced. Senators sat quietly in their seats, standing only when they were called upon to vote.

Republican Sen. George Voinovich of Ohio missed the vote.

In the final minutes of a daylong debate, Majority Leader Harry Reid, D-Nev., accused Republicans of trying to stifle a debate the nation needed.

"Imagine if, instead of debating whether to abolish slavery, instead of debating whether giving women and minorities the right to vote, those who disagreed had muted discussion and killed any vote," he said.

The Republican leader, Sen. Mitch McConnell of Kentucky, said the vote was anything but procedural -- casting it as a referendum on the bill itself, which he said would raise taxes, cut Medicare and create a "massive and unsustainable debt."

For all the drama, the result of the Saturday night showdown had been sealed a few hours earlier, when two final Democratic holdouts, Sens. Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, announced they would join in clearing the way for a full debate.

"It is clear to me that doing nothing is not an option," said Landrieu, who won $100 million in the legislation to help her state pay the costs of health care for the poor.

Lincoln, who faces re-election next year, said the evening vote will "mark the beginning of consideration of this bill by the U.S. Senate, not the end."

Both stressed they were not committing in advance to vote for the bill that ultimately emerges from next month's debate. Even so, their announcements marked a major victory for Reid and the White House in a year-end drive to enact the most sweeping changes to the nation's health care system in a half-century or more.

The legislation would require most Americans to carry insurance and provide subsidies to those who couldn't afford it. Large companies could incur costs if they did not provide coverage to their workforce. The insurance industry would come under significant new regulation under the bill, which would first ease and then ban the practice of denying coverage on the basis of pre-existing medical conditions.

Congressional budget analysts put the legislation's cost at $979 billion over a decade and said it would reduce deficits over the same period while extending coverage to 94 percent of the eligible population.