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Nelson Agrees, Senate Poised To Pass Health Care Bill

Early this morning, Ben Nelson signed off on health care legislation, securing what the Senate leadership believes is the 60th and final vote needed for passage.

Nelson’s changes are reflected in a manager’s amendment, which can be found here. Early reports are that they changed the abortion language, secured more federal funding for Medicaid, and lowered a tax on non-profit insurance companies. Surely more revelations will come as we go through the amendment.

On abortion, the major change to the language is that states can opt out of it, and create their own Stupak-like prohibition on abortion services in the exchange. Beyond that, there’s the same kind of segregation of funds, et al, that basically were present in the Lois Capps compromise language in the House.

Obviously that, and all of the changes between the House and the Senate, have to be acceptable to both chambers after a conference committee. But Ben Nelson has already laid down a marker on substantive changes:

But he also sent a stark message to his counterparts in the House and on the left: If, after passage, negotiations with the House change the terms of his compromise substantially, he’s fully prepared to vote against final passage. Specifically, he called for a “limited” conference proceeding and warned:

If there are material changes in that caucus, changes that advesrely affect the agreement, I reserve the right to vote against the next cloture vote… I will vote against it if that is the case.

This was expected, but with so many stakeholders seeking changes, as well as the House, that conference committee will become another protracted negotiation.

On the Senate bill, however, the die appears to be cast. The Republicans are forcing a reading of the manager’s amendment on the Senate floor right now, but once that is completed, Democrats will begin one of three cloture votes on the bill, and once you get through them, should the Republicans force the taking up of the entire time frame, the final passage should be secured right around Christmas Eve.

Democratic Senate leaders are about to have a press conference.

Here’s Harry Reid. He starts by saying “What day is this?”

…Reid and the rest of them look tired. He’s thanking Max Baucus, Chris Dodd and Tom Harkin for their work. Says that the revision on the floor makes the bill stronger, and talks about it in very broad strokes. We have a lot of controls to make sure the insurance industry doesn’t go wild. Creates a level playing field between people and insurance industry. Progressives feel this bill didn’t go far enough, and wanted a public option. But this bill will do so many things for so many people. The right thinks the bill goes too far. They have a lack of understanding of the problems that go on in America today. Read our mail.

The broken system cannot continue, and it will not continue. Will end the era when insurance companies win when patients lose. Lots of tax incentives and tax credits in the bill – almost $500 billion (I assume that includes the subsidies). We have succeeded. At 1:00 today there’s a briefing with staff.

Sen. Baucus: We came to the floor with a good bill. Our bill is fully paid for and will reduce debt. Will protect consumers. Will provide billions in tax incentives, largest tax cut since 2001. Extend coverage to 30 million Americans. Hold companies accountable. Provide more insurance choices. More access to quality health care for seniors and children.

Sen. Dodd: Thanks the Majority Leader. Work to be achieved, but this is a major hurdle we will overcome in the coming days. We stand ready to pass a bill that makes access to quality health care a right and not a privilege. FDR outlined four freedoms. One of the great fear Americans have lived with is unaffordable sickness. This bill doesn’t guarantee you won’t get sick. We will try to guarantee that you’re never have that fear that you’ll lose your job or your house if you or a family member gets sick. In a nation founded on freedom, this bill is critically important. Our path has been illuminated a long time a go and sustained by good men who carried the torch. The man who carried the torch was Ted Kennedy. (Dodd’s tearing up.) He saw our efforts fall short. But Kennedy never stopped believing that everyone should be guaranteed access to health care. That day is upon us.

Sen. Harkin: We’re not building a mansion, but a starter home. But it’s got a great foundation. It has room for expansion and additions in the future. This is not the end of health care reform, it’s the beginning.


Q: What did Nelson get? Reid: I worked with every Democratic Senator to come up with the bill. There were negotiations with everyone. Ben Nelson was like the rest of them. We worked with things on him over a period of weeks. There are a number of different interests Senators have.

Q: Doc fix removed? Reid: Doctor’s fix was done because the doctors felt that was the best way to move forward. We believe it should be permanent. There was a 1-year fix, but they didn’t want that. We’ll work on it later.

Q: Nebraska one state that gets federal help from Medicaid? Reid: A number of states treated differently from other states. With Nelson, that was a minor part of the issues.

Q: Do you have 60? Reid: Seems that way.

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David Dayen

David Dayen