Hurry Up And Wait: With Final Senate Vote on Health Care Complete, The Real Fun Begins

BlogHer Original Post

Vice President Joe Biden led the Senate this morning while his colleagues voted from their seats in favor of Senate Bill 3590 (aka "Senate Health Care Bill" aka "The Patient Protection and Affordable Care Act"). The vote was 60-39 along party lines, as expected. Republican Jim Bunning of Kentucky, who is retiring at the end of the 111th session of Congress, failed to show up or vote for the second day in a row but no explanation was forthcoming.

As you head into serious holiday mode, here's some calorie-less food for thought to put perspective on what we've gotten ourselves into:

If you haven't already heard, the last time a vote was taken in the Senate on the day before Christmas? 1895 per the Senate Historical Office.

The Los Angeles Times published an interesting article on the role played by Senate leader Harry Reid.  In part (but the whole piece is a very good read):

The quirky, taciturn majority leader had no background in health policy and a less-than-commanding public image. Yet today Reid delivered as the Senate moved to take its final vote on the most sweeping healthcare legislation to make its way through the chamber in nearly half a century.

Along the way, Reid's effort sometimes revealed an unseemly, if time-honored, side of congressional business as he struck bargains with senators who traded their votes for aid to their states or help for supportive interest groups.

"This bill is a mess, and so is the process that was used to get it over the finish line," Senate Minority Leader Mitch McConnell (R-Ky.) charged this week, encapsulating a new GOP line of attack.

But the process -- as described by senators, Capitol Hill aides and White House officials -- also revealed that oft-fractious Democrats could achieve remarkable unity under the guidance of a politician with an unparalleled understanding of the arcane institution he leads -- and a sure grasp of the particular needs of the individual lawmakers who serve there.

Swampland has the remarks given by Leader Reid and Minority Leader Mitch McConnell (KY) this morning just before the vote (which did start promptly at about 7am).  From McConnell and the opposition:

“This debate was supposed to produce a bill that reformed health care in America.

“Instead, we're left with party line votes in the middle of the night, a couple of sweetheart deals to get it over the finish line, and a public that's outraged.

“A problem they were told would be fixed wasn't.

“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."

In addition to commending his colleagues for their work and espousing the ways in which he sees this legislation as a leap forward for the country, Reid agreed with McConnell's prediction that they'll be hearing an earful, but that they will hear an "earful of wonderment and happiness."

The House reconvenes on January 12, 2010 and the Senate on January 19, 2010.  However, their staffs will begin negotiations over the differences between their two bills way before then and in preparation for the conference committee process.  Composition of the conference committee, according to McClatchy, looks like this:

While health-care [conference] committee members haven't been named yet, it's widely expected that they'll include Sen. Christopher Dodd, D-Conn., one of the Senate bill's architects, as well as: Majority Leader Harry Reid, D-Nev.; Senate committee chairmen Max Baucus, D-Mont., and Tom Harkin, D-Iowa; and House committee chairmen Charles Rangel of New York, and George Miller and Henry Waxman of California, according to Harkin.

Likewise, we should expect to see House Speaker Nancy Pelosi (D-CA) in the mix.

NB: The word "reconciliation" is sometimes used in connection with the process about to begin. That process does involve "reconciling" the differences between the House and Senate versions of health care bills, but it is not the reconciliation process which is a very specific process, unrelated to what will be happening with the health care bills and is described here.

For an excellent overview of the differences between the House and Senate version, I must refer to this New York Times' display - it's thorough, it's clear and you can view the differences via subject matter (i.e., abortion, public plan, Medicaid, etc.) and is a great starting point for battling it out in the comments as you vent your feelings about what's happened, what we've got, what we should have once the conferencing is complete and what you think we will have once the process ends (well, this time around anyway).

What's the buzz this morning from those who were up early enough to watch and comment?

I'll editorialize first: the news that it passed this morning isn't "breaking" or a news "alert." It became pretty obvious a few days ago, after Joe Lieberman and Ben Nelson were placated, that today's result would in fact be the outcome of the last several months of action on this legislation. What I do believe is "breaking" and should be an "alert" is that the Republicans have dug deeper into The Land of No and the Democrats have stuck their necks out further over the abyss of Who Really Can Know How It Will All Turn Out.

And in this regard, Mitch McConnell's comments this morning are extremely telling. Maybe he's under orders from Frank Luntz to speak this way, but grammatically, it's incredibly incorrect, since the bill has not yet become law.  Regardless, here's his anachronistic reflections:

The most obvious problem with the bill before us is that it doesn’t do what it was supposed to. The one test of success for any bill was whether it would lower costs. This bill fails that test.

We can't and don't know that. We have the Congressional Budget Office predictions, and scores of other predictions about all kinds of aspects related to the bills.  But predictions are all they are and all the hope/fear of legislation ever is until it's completed, signed, enacted, promulgated as rules and implemented. Try predicting when that will happen. 

So - for a spin around the sphere and a look at the spin in the sphere:

Karoli of Drums and Whistles (who supports health care reform) was up before I was from what I can tell. Her post, post-vote, reflects on what I know I see as a very odd collaboration between Jane Hamsher and Grover Norquist in an effort to fight the bill, but for very different reasons:

When Jane Hamsher defends her opposition to Ben Bernanke and the Senate health care reform initiative on the basis of principle, what she reveals is this: She will win at any cost, even the cost of her principles, if they were there to begin with.

Having a shred of commonality on one single cause does not a principled stand make, particularly when arriving on common ground via opposite directions.

...You should learn to take things less personally, too. Your crusade against the President and Rahm Emanuel appear to be wholly personal, staked in your petulant disbelief that you didn’t get exactly what you wanted when you wanted it. Welcome to the world.

What she said.

BlondeSense gives voice to that "do we really know what we're doing/have just done" sense I mentioned:

As of today, I still have no insurance even though the husband has money taken out of his paycheck every week to pay for it. I've shelled out over $1000 this month to pay for medications. There are medications I cannot afford and am trying to live without them although there's a chance I am going to get pretty sick if I have to go on without them.

As far as I'm concerned, if the government doesn't stop accepting blow jobs from big pharm, the health care bill can blow me. (Honestly, I can go on and on about how my family's been screwed over by corporate for-profit health care insurance, but I won't. Luckily NY State is on our side and helping us fight them... but I'll save that rant for another day. It's Xmas eve for gawd's sake.)

The Republicans suck more than the Democrats suck, but still, they both suck big time.

Taylor Marsh followed along this morning and blogged:

Can you just imagine what the traditional media would have done if the Senate had failed? Republicans would be dancing.

And Not Under The Bus re-emphasized the importance, now more than ever, for women to understand that they can drive the bus of health care reform - and not end up under the bus. They provide an array of links that underscore what is at stake for women as the bills head into conference.

Finally, from Lynn's Little Bit of Trivia-Lake Worth, another post that shows she "gets it" re: this bill is all about speculation and trust:

It was stated that the legislation would ban the insurance industry from denying benefits or charging higher premiums on the basis of preexisting medical conditions. My question is, will the insurance industry be charging premiums based on your health and your age?

Right now we know for instance that women are charged more than men for health insurance. We live longer. Will the health-care insurance companies rate the consumer like the car insurance industry does...the more accidents, the higher the rate? I break a toe, my rate goes up?

Although the government says that they must spend 85% of all premiums collected on health-care, we know that insurance companies are in collusion and they are here to make big bucks. They play games with people all of the time. When looking for auto insurance, you are forced to shop around to get a better rate. Is this what we will have to do with health-care? Is this all a game? Is this all about getting something passed by Christmas?

Good questions all.

My prediction is that there will be something worked out and something for President Obama to sign sometime before the Spring ends (before Easter I would guess).  My hope is that whatever that something is retains the focus on the three main goals - lowering costs, covering more people and improving quality - that should have been the focus at every step of the way (as opposed to the agendas of Bart Stupak, Joe Lieberman or Ben Nelson).


There's always more:

A Senate Bill By Christmas But No Health Care Reform in 2009

Health Care Reform As A Future Political Tool

The Senate Bill Saves Families Money


Jill Writes Like She Talks


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