By Alex Sange
Today marks the 15th straight day of floor debate on the Senate’s health reform bill and the next 48 hours could be some of most important yet. So far, the Senate has run into some significant road blocks to passing a reform bill and nearly a thousand amendments have been filed on the legislation. Through the eyes of C-SPAN and a pack of Washington-based journalists, we’ve seen the Senate deliver rhetoric, take votes, reach tentative compromises, and identify irreconcilable differences on this historic bill. But in order to meet Majority Leader Harry Reid’s (NV) intended timeline of passing the bill out of the Senate by Christmas, legislators will have to agree what reform should look like: what it will do, how much it will cost, and what specific changes must be made to the bill so it does the most good for the most people.
If Majority Leader Reid intends to meet his goal of passing a bill from the chamber by Christmas, he’ll need to start the process of ending the debate sometime this week. Essentially, he’ll need to line up 60 votes to support the bill through a series of votes in the next couple of days – including a vote for a Manager’s Amendment that will include the compromise provisions Senators have agreed on, and a set of procedural votes on cloture – or he can’t bring the legislation forward for final consideration.
But what are they waiting for? A handful of Democrats have held out their support of the Reid health reform bill so they can amend or adjust certain provisions in the bill. One issue is whether federal funding can be used to support abortion, another is whether the public option should be included in the bill. On the public option, the Senate may have a tentative agreement which would strike the public option in the Reid bill and replace it with a Medicare buy-in for those ages 55-64 and a government administered plan similar to the current Federal Health Employee Health Benefit Plan (FEHBP). Several moderates including Senators McCaskill (MO), Lincoln (AR), Landrieu (LA) and Collins (ME) are waiting for the Congressional Budget Office (CBO) to score the Medicare buy-in and others – Senators Lieberman (CT), Nelson (SD) and Snowe (ME) – have indicated they may not support it regardless of the CBO score.
Health centers have enjoyed some attention in the debate as well. Last week, Senator Bernie Sanders (VT) said his yes-vote on the bill is dependent on it including the House language for health center and National Health Service Corps funding. In addition, Senator Bingaman (NM) continues to make it a priority to remove caps and screens from health centers’ Medicare payments (the MATCH Act provisions), and Senator Menendez (NJ) is working on getting health centers’ reimbursed in all Exchange plans through a Medicaid-like Prospective Payment System (PPS).
When (or if) the bill does move out of the chamber, the Conference Committee process is anyone’s guess: the bill could go straight through the house with no changes, it could go through a full debate process on the house floor, or it could “ping-pong” between the chambers with a couple of key changes incorporated in the process. We’ll keep you posted on those details as we move forward. But for now, be sure to keep your eyes on your inboxes. As soon as the Senate moves toward ending the debate we’ll be looking to health center advocates nationwide to raise their voices in support of this landmark legislation.