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*Year-long fight ends as health bill clears Congress*
By: Carrie Budoff Brown
March 25, 2010 09:07 PM EDT

Congress completed its work Thursday night on the broadest social
legislation in almost a half-century, as the House capped the year-long
legislative saga over health reform by signing off on a package of fixes to
the newly minted law.

In the end, the titanic battle over remaking the American health care system
drew to a close on a pair of votes drained of suspense – after the Senate
approved the clean-up bill earlier Thursday. The House approved the same
bill, 220 to 207.

The votes deliver twin victories to President Barack Obama, the health-care
overhaul on which he staked the first year of his presidency and a
lesser-noticed provision that would carry out a major restructuring of the
student loan industry.

“The benefits for Americans start right now,” said Rep. George Miller
(D-Calif.), the chairman of the House Education and Labor Committee, who
also cited changes to the student loan system that Democrats included in the
health reform clean-up bill. “That’s the road to prosperity. That’s the road
to freedom for America’s families.”

But Republicans warned that Obama had overreached in his effort to pass the
bill, which employed fast-track rules to get around the possibility of a
Republican filibuster.

“The American people are asking, where are the jobs, but as we see today,
the issue of government-run health will continue to be the focus on this
body,” said House Republican leader John Boehner of Ohio. “We’re going to be
back here fixing the flaws in this very flawed bill.”

With Vice President Joe Biden presiding over the chamber, the Senate took
the first step Thursday, passing the package of fixes, 56 to 43. But the
work wasn’t done quite yet.

That’s because the last bit of drama on health reform had actually occurred
early Thursday morning, when Republicans succeeded in finding two parts of
the reconciliation bill that didn’t pass muster with the Senate
parliamentarian, both regarding Pell grants for low-income students.

So the version passed by the Senate had to be passed again by the House —
even though the House had already passed the landmark legislation Sunday
night that Obama signed on Tuesday. But since both houses must pass
identical versions of legislation to send it to the president’s desk, the
House had to return for one final vote, with members nervous over any
last-minute blow-ups that could endanger the reconciliation bill.

In the Senate, three moderate Democrats voted against the reconciliation
bill — Nebraska’s Ben Nelson and the two senators from Arkansas, Mark Pryor
and Blanche Lincoln. Lincoln faces a tough reelection fight this fall.
Republican Johnny Isakson of Georgia is ill and wasn’t in the chamber.

No Republicans voted for the reconciliation bill in the House or the Senate,
after just one Republican, Joseph Cao of Louisiana, voted in November for
the underlying health reform law. Sen. John McCain (R-Ariz.) criticized the
measure until the end, saying, “It is the most unsavory sausage-making,
Chicago-style bill I have ever seen.”

He said the GOP mantra would be to “repeal and replace” the bill going
forward. “We can’t just have the status quo,” McCain said.

The Senate vote happened just as Obama took the stage in Iowa City, Iowa —
his first stop since he signed the legislation Tuesday — hoping to promote
the bill to the American public, which polls show is deeply skeptical of
reform. He told Republicans he welcomed the chance to debate them on the
merits of the plan, particularly if they insist on pressing for a repeal of
the law.

“My attitude is: Go for it,” Obama said. “If these congressmen in Washington
want to come here in Iowa and tell small-business owners that they plan to
take away their tax credits and essentially raise their taxes, be my guest.”

The reconciliation bill makes a variety of fixes to the health legislation.
It removed controversial deals such as the Cornhusker Kickback and also
pushes off implementation of an excise tax on high-cost “Cadillac” health
plans until 2018.

The final vote on reconciliation in the Senate came with little drama — but
it followed weeks of tough negotiations between House and Senate Democrats
over what should be in it, and whether there would be the votes to pass it.

The top leaders in the Senate, Democratic Majority Leader Harry Reid and his
counterpart, Minority Leader Mitch McConnell, worked out a deal in the early
morning hours Thursday to hold the vote at 2 p.m. — and it went off on time,
with the final outcome not in doubt.

Sen. Robert Byrd (D-W.Va.), the longest-serving senator, was wheeled into
the chamber by an aide and shook hands with Reid before going to his place
and waiting for his name to be called in the roll. There was a humorous
moment when Reid’s name was called, and he said ‘no,’ before quickly
correcting himself. He made the same mistake when the Senate voted on the
overall health reform bill on Christmas Eve. The chamber broke out in
laughter.

The legislative path that brought the Senate to Thursday’s vote was tortuous
and politically risky.

The Senate spent months trying to write a bill that could win 60 votes.
Democrats succeeded on Christmas Eve, only to lose their filibuster-proof
majority a month later.

The White House and congressional leaders revived the bill after deciding on
a two-step process — the House passing the Senate bill, followed by both
chambers using fast-track rules known as reconciliation to pass a package of
fixes. This was the only way House members would agree to approve the Senate
bill and the only way the Senate could make changes that the House wanted.

Reconciliation was fraught with challenges. But Democrats successfully
scrubbed the bill of any potential procedural land mines, preventing
Republicans from stripping out any major policy pieces that would have
endangered its passage in the House or the Senate.

Democrats also held together during the more than 13 hours of amendments,
turning each one back. While Republicans implored their colleagues to make
changes, Democrats argued that any changes would send the bill back to the
House for another vote, an outcome they worked mightily to avoid before the
parliamentarian’s ruling early Thursday. That meant Democrats had to vote
against such campaign ad fodder as a provision barring sex offenders from
being given Viagra.

Once Republicans struck two minor provisions from the bill, sending it back
to the House, some liberals suggested that Democrats had one last chance to
fight for the public option. But no senators took the bait.

Democrats insisted on keeping the bill as clean as possible so the House
could give the measure swift approval — and then the party could be done
with the health care debate once and for all.

Senate Budget Committee Chairman Kent Conrad (D-N.D.) said, “Everybody feels
committed, feels we’ve done the right thing, knows that the things that are
required to go back to the House are insignificant and the House has already
told us, ‘No problem.’ So we don’t want to change that.”

The drama playing out on the Senate floor eventually became a battle of
wills between Republicans and Democrats, with each side trying to outlast
the other.

By the time senators filtered into the chamber Thursday afternoon, the final
vote felt almost anticlimactic to Democrats who had expended so much energy
to get to that point.
--
Eric D. Schwerin
Rosemont Seneca Partners
(202) 333-1880
eschwerin@rosemontseneca.co