The leader of the US Senate, Harry Reid, was ready last night to move ahead at last with a draft healthcare reform bill amid hopes that he can muster the necessary minimum of 60 votes for a motion to begin debate by the full Senate by this weekend.
The way was cleared after the Congressional Budget Office, or CBO, formally estimated last night that the law, if enacted, would cost $849bn over ten years, well shy of the $900bn limit previously set by President Barack Obama and other Democrat leaders. It would meanwhile extend health insurance to 31 million Americans who don't currently have it, aides to Mr Reid said. "We have better coverage, we pay for it all, and we cut the deficit," Senator Tom Harkin, an Iowa Democrat who heads the chamber's health committee, told reporters. While securing support from wavering moderate Democrats and one independent, Joe Lieberman, remains a delicate task, Mr Reid has been under intense pressure to move the process forward in the Senate in the wake of the House of Representatives passing its own reform legislation 10 days ago.
The White House has made plain that it would like Congress to produce a final bill for signature by President Obama before Christmas. That remains a tall task, however, because even if Mr Reid successfully pushes a bill through Senate it must still then be combined with the version passed by the House.
"Of all the bills we've seen, it'll be the best: saves more money, is more protective of Medicare, is a bill that's good for the American people," Mr Reid said. "I think if you're not impressed, you should be." It was said to include a slightly diluted version of the "public option" – a public entity offering insurance in competition with private insurers.
There are important differences between the legislation that emerged from the House and the version now coming through the Senate, notably to do with paying for the subsidies that will allow millions of uninsured Americans to gain coverage. The House envisages new taxes on the rich while the Senate would prefer to raise most of the cash from excise taxes on the most expensive of existing insurance policies.
Mr Reid will hope also to navigate himself around perilous questions about abortion. Many Democrats are hoping that an amendment further restricting women's access to abortion that found its way into the House bill at the eleventh hour can be massaged out before a final bill is signed by Mr Obama.Reuse content