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It took months of deliberation, presidential prodding and a last-minute, $300 million deal to start Senate debate on the health care bill.

A day after the Senate voted along party lines Saturday to bring President Obama's 10-year, $848 billion health care proposal to the floor, familiar fissures reopened over unresolved issues such as a proposed government-run health insurance program. Though the vote gave Democratic leaders the ability to claim momentum, it also underscored difficult decisions that have been looming for months and that must be resolved if the Senate is to take a final vote by year's end. To secure the 60 votes he needed to overturn the threat of a filibuster, Reid bowed to requests by wavering Democrats such as Sen. Blanche Lincoln, D-Ark., who wanted 72 hours to review the bill before voting. Sen. Mary Landrieu, D-La., scored a provision that would increase Medicaid funding to her state by as much as $300 million in 2011.

Hours after the vote, dissention remained on display over more fundamental issues, such as how to pay for the legislation, whether the bill goes far enough to control costs and whether Congress should include some form of a government-run health plan, known as the public option. Currently included in the bill is a government insurance plan similar to Medicare. The non-partisan Congressional Budget Office says up to 4 million people would enroll in that plan by 2019. The measure goes too far for Republicans and some Democrats, even though Reid crafted it to allow states to opt out in an attempt to attract more votes. Other senators had already made demands.

Similar negotiations unfolded in the days before the Senate approved Obama's $787 billion economic stimulus package. Some Democratic senators such as Sherrod Brown of Ohio bristled at the idea of making significant changes to the health care bill for a handful of votes. The Senate bill, which would offer insurance to 31 million people who wouldn't otherwise have it, requires most Americans to buy coverage and provides subsidies to help low  and moderate income families pay premiums. The House passed its version of the bill Nov. 7. Senators will begin debate on the bill next week. Obama has called for the Senate finish by the end of the year.

Source – USA Today

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