While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
The Senate approved a landmark health-care bill early Dec. 24 that would provide coverage to more than 30 million people and begin a far-reaching overhaul of Medicare and the private insurance market, reports The Washington Post.
Vice President Biden presided over the 60-39, party-line vote, which brings Democrats closer than ever to realizing their 70-year-old goal of universal health coverage.
For the first time, most Americans would be required to obtain health insurance, either through their employer or via new, government-regulated exchanges. Those who can't afford insurance plans would receive federal subsidies. And Medicaid would be vastly expanded to reach millions of low-income children and adults.
The New York Times reported that the vote came on the 25th straight day of debate, and brings Democrats a step closer to a goal they have pursued for decades. It clears the way for negotiations with the House, which passed more liberal health reform legislation last month by a vote of 220 to 215.
If the two chambers can strike a deal, as seems likely, the resulting product would vastly expand the role and responsibilities of the federal government. It would, as lawmakers said repeatedly in the debate, touch the lives of nearly all Americans.
The bill would require most Americans to have health insurance, would add 15 million people to the Medicaid rolls and would subsidize private coverage for low- and middle-income people, at a cost to the government of $871 billion over 10 years, according to the Congressional Budget Office.
President Obama said after the vote that the health care bill is “the most important piece of social legislation since the Social Security Act” was adopted and that it represents “the toughest measure ever taken to hold the insurance companies accountable.”
When the roll was called at 7:05 a.m. on Thursday, it was a solemn moment. Senators called out “aye” or “no.” Senator Robert C. Byrd, the 92-year-old Democrat from West Virginia, deviated slightly from the protocol.
“This is for my friend Ted Kennedy,” Mr. Byrd said. “Aye!”
Sen. Harry Reid of Nevada, the majority leader, at first appeared to vote "nay" instead of "aye." He caught himself in time to vote in favor of the bill, as his colleagues in the senate laughed at his almost voting against a bill he has worked for so tirelessly.
Politico reported that after months of blown deadlines and political near-death experiences, the passage of the bill put President Obama within reach of a domestic policy achievement that has eluded Democrats for decades.
The vote sets the stage for difficult House-Senate negotiations during which Democrats will be forced to settle differences that have lingered for months, and there is no guarantee a bill will pass in the end.
Sen. Joe Lieberman (I-Conn.), one of the last Democratic holdouts, once again made clear that his vote isn’t assured when the bill returns to the Senate. In the hallway outside the vote, he told his fellow moderate, Sen. Ben Nelson (D-Neb.), “Our work is not over.”
"Splitting the difference here could well break the 60 vote consensus," Lieberman said to reporters.
With momentum at their back, Democrats believe they can craft a compromise that, in broad strokes, would expand coverage through subsidies to help Americans buy insurance and allowing more people into the Medicaid program. The Senate plan includes a new national health insurance program overseen by the government but offered through private insurers.
It would prevent insurance companies from dropping patients who get sick and create a new legal requirement that all Americans must own health insurance – a provision already under growing attack from conservatives.
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