A Senate Health Care Bill By Christmas?

Early Monday morning, the senate voted 60-40 along straight party lines to defeat the initial attempt to filibuster the health care reform bill. Yesterday, it passed the second of three procedural votes, bringing the Senate one step closer to a final vote on the health care reform bill. Majority Speaker Harry Reid (D-NV) is on schedule to vote on the bill before Christmas.

In the last-minute negotiations leading up to these votes, Reid made stiff concessions to conservative Democrats, eliminating the public option and the expanded Medicare buy-in to placate Sen. Joe Lieberman (I-CT). Sen. Ben Nelson (R-NE) got tougher restrictions on abortion funding, though not as tough as those spelled out in the Stupak amendment to the House bill.

Sen. Bernie Sanders (I-VT), a socialist who caucuses with the Democrats, has apparently given up his threat to filibuster a bill with no public option. Instead, he's taking his turn as "the 60 vote," reports Katrina Vanden Huevel in The Nation. Sanders is using his leverage to push for waivers which would allow states to develop their own health insurance systems, possibly including single payer. Canada's celebrated Medicare program began in a single province and eventually went national.

In AlterNet, Zaid Jilani argues that President Barack Obama failed his progressive base by all but abandoning the public option. As Jilani points out, Obama is even trying to rewrite his own record on the issue. Now he says he didn't campaign on a public option. Jilani reminds us that the Obama-Biden campaign platform promised that "any American will have the opportunity to enroll in [a] new public plan.” Obama was promising a sweeping public option. Even the House bill would only make a tiny fraction of the population eligible for the public option.

It's not surprising that the health care bills before us favor vested interests in the health insurance sector. Health care companies spent $635 million on lobbying over the past two years, and 166 former congressional aides who used to work on health care legislation have registered as lobbyists, reports Amy Goodman of Democracy Now!.

Rachel Larris reports in RH Reality Check that many pro-choice groups will not back the final bill if it contains Sen. Nelson's abortion funding restrictions. Elsewhere on the Hill, the 190-member House Pro-Choice Caucus is huddling with attorneys and insurance companies to plan their next move.

The Senate bill seems destined to pass. Then the negotiations to merge the House and Senate bills will begin. The House bill has a public option and draconian abortion funding restrictions. The Senate bill has no public options and slightly milder restrictions on abortion. Realistically, the conservative Democrats have most of the leverage at this point. If even one joins the filibuster, the final bill will die. Sen. Nelson has already threatened to filibuster the conference report if substantial changes are made to the bill in conference.

At the end of the day, health care reform seems likely to eliminate discrimination based on preexisting conditions, offer subsidies for the purchase of private insurance, and set up some insurance exchanges that might bring down costs some day. These are real gains, but have been won at the cost of subsidizing the insurance companies who caused the problem the first place and leaving women's rights by the wayside.

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