Health Care Bill Progress Report: Dec. 21

In the wee hours of Monday morning, Democrats rallied the support of all 58 of their senators and their two Independent allies to overcome a Republican filibuster on the first procedural vote of their comprehensive health care reform bill.

To get to that vote, Democratic leaders in the past week have also overcome the concerns of moderate senators Joe Lieberman and Ben Nelson, while keeping the support of liberal senators like Bernie Sanders. But they have lost the backing of the liberal grassroots along the way.

Some liberal senators, however, are only begrudgingly agreeing to this week's big health care vote -- blaming President Obama for not sufficiently supporting liberal causes.

But the big news is that Democrats are now poised to officially pass the bill on Christmas Eve, Dec. 24.

CBSNews.com Special Report: Health Care

So what is the Senate doing in between now and Dec. 24? Well, Senate rules dictate that a cloture vote (a motion to end debate) can only take place one full day after the cloture motion was introduced, plus one hour after the Senate resumes business (thus, the 1 a.m. vote on Monday -- which was the next day the Senate resumed business after Senate Majority Leader Harry Reid's final changes to the bill were introduced in a "manager's amendment"). Even after that, however, the rules dictate 30 more hours of debate.

But now that the Senate has voted on cloture for the manager's amendment, they must actually vote on the amendment. Then, they must vote on cloture to add the manager's amendment to a dormant House bill, since constitutionally, the Senate cannot pass its own revenue-raising measures. Thus, more time must be spent "amending" a dormant House-passed bill entirely with the Senate health care bill language. After cloture is passed on that bill, it must actually be voted on.

At that point -- around Wednesday afternoon -- the Senate will finally be able to move for cloture on the final bill. Then, after the designated time has passed, the Senate will take its final vote. At that point, it will be around 7 p.m. on Dec. 24. Politico points out that Republicans could yield time during the "debate" and not filibuster to bring a final vote before Thursday, but they have no intention of doing that.

The chart below shows the progress Democrats have made toward their goal of passing a comprehensive health care reform package. As lawmakers have been working through the six major steps toward reform over the last few months, CBSNews.com has been tracking their moves. After the Senate passes the bill, Democrats will move onto step four and reconcile this reform package with the one passed in the House last month.

(CBS)

More on the how Senate Democrats got to this point: Senate Majority Leader Harry Reid (D-Nev.) triumphantly announced Saturday morning that the Democrats had 60 votes to pass health care reform. His party breathed a sigh of relief after a week of cajoling holdouts Democrat Ben Nelson of Nebraska and Independent Joe Lieberman of Connecticut. Lieberman's demands were met after Democrats dropped a plan to expand Medicare, and Nelson said Saturday he was satisfied with the compromise abortion language added to the bill.

With all 60 votes in place, Reid released the manager's amendment (PDF) on Saturday -- a complete replacement of the health care bill with all the final negotiated changes added to it. The 60 votes needed to pass the bill include those of liberals like Bernie Sanders (I-Vt.) and Roland Burris (D-Ill.), who were hesitant to support the bill after the number of concessions made to gain moderate votes.

Those votes are not coming easily, however. Sen. Russ Feingold (D-Wisc.) released a statement Sunday announcing he would vote for the bill but that he holds President Obama responsible for the fact that the bill does not include a plan for government-run insurance, or a "public option."

"The lack of support from the administration made keeping the public option in the bill an uphill struggle," Feingold said. "Removing the public option from the Senate bill is the wrong move, and eliminates $25 billion in savings."

The senator said he will urge House and Senate leaders to include a public option in the bill that comes out of conference committee, in which the two chambers' bills will be merged.

Feingold's position is similar to that of labor unions, which denounced the Senate bill but wanted to see it pass so it can be improved in conference. Meanwhile, other liberal grassroots groups sought to focus progressive anger against President Obama for his hands-off approach to the health reform package.

Other liberal advocates for reform like MoveOn.org took a stronger tack, urging liberal senators to completely oppose the current Senate bill, demanding a liberal bill like the House legislation. Former Democratic leader Howard Dean said he wants the current Senate bill thrown out in favor of passing a more robust reform package through a procedural maneuver called reconciliation.

The Senate package, however, has managed to win the endorsements of former President Bill Clinton and Jacob Hacker, the Yale professor credited with devising the idea for the public option.

As Democrats fended off liberal criticisms of the bill, they continued to fend off Republican attacks and tactical moves against the bill. In order to stall the health care debate, Republicans on Thursday night attempted to filibuster a defense spending bill, merely to waste time. Republicans also prompted Bernie Sanders to withdraw an amendment he introduced to the bill, after demanding all 767 pages of the amendment be read aloud.

[ProfElwood]

I'm afraid that it's going to hurt the people it was meant to help. The premiums are going to increase dramatically and the supplements aren't going to be enough. Just as the mortgage assistance bills only drove up housing prices and interest on low-income families, and student loan bills drove up college costs, insurance expansion will drive up healths costs more than expected.

This is just a wealth transfer -- from the middle class and poor to the medical industry.

[stn_sage]

Now, that they've stripped out everything that would have helped the public and made it a health care bill, they can get their "majority"
to vote for it! How grand!

And, they expect 'a big pat on the back' for this!?

What they deserve is their 'pink slip' in Nov 2010 for those whose "contract" expires! Good bloody riddance!!

[ohiopolitico]

Democratic Party - the Party of Lowered Expectations! What a disappointment. They didn't tackle any of the big issues that reduce costs. Instead, they demand that everyone has health insurance and us taxpayers will pay dearly for it. This is not bipartisan and its nothing
for Obama to be proud of. Can't wait for 2010.

[ohiopolitico]

Democratic Party - the Party of Lowered Expectations! What a disappointment. They didn't tackle any of the big issues that reduce costs. Instead, they demand that everyone has health insurance and us taxpayers will pay dearly for it. This is not bipartisan and its nothing
for Obama to be proud of. Can't wait for 2010.

[schlark]

Thumbs up to Sen. Ben Nelson, for doing the right thing & not succumbing to all the irrational, prefabricated outrage. The Dems, unlike the corpse of the GOP, might actually get some things accomplished.

[spotrunner]

You guys need to take a cold shower and relax. also, actually spend some time thinking about the the good things in this bill - not the abstractions that the fear-mongers have so successfully instilled in your minds. and by the way, if you dont actually think you know anything good about this bill, then this should be proof enough for you that you've been only listening to those who try to scare you to advance their own politic goals and you are having troubles keeping your objectivity. but it's not too late for that ;)

[spotrunner]

You guys need to take a cold shower and relax. also, actually spend some time thinking about the the good things in this bill - not the abstractions that the fear-mongers have so successfully instilled in your minds. and by the way, if you dont actually think you know anything good about this bill, then this should be proof enough for you that you've been only listening to those who try to scare you to advance their own politic goals and you are having troubles keeping your objectivity. but it's not too late for that ;)

[reason10000]

Are you even paying attention? What is your favorite item that will reduce the overall cost of health care in the US? Perhaps your costs will go down but at the expense of whom? Here in California the Pollyanna attitude you portray is wide spread and the self destruction by what is, essentially, a one party system is enormous. Your last line reminds me of the Borg: "resistance is futile".

[btrask3]

I have never been as disappointed in government as I am today. Just look at the success they have had running things over the years... The Federal Reserve, The Security Exchange Commission, Housing & Urban Development, Social Security, Feddie Mac, Fannie Mae, The United States Post Office, The Internal Revenue Service, control of Military Spending, and look at the dismal job government is doing educating our children. And NOW they want to take over my HEALTH CARE??? When I don't want them too??? It's not the Democrats, nor the Republicans... it's ALL OF THEM! What a bunch of corrupt men and women. It is clear that the GLOBALISTS have gained control of our government! They are not supporting and defending our United States Constitution... they are dismantling it! They are not protecting my 'Bill of Rights' they are usurping them! GLOBALISM WILL DESTROY AMERICA IF YOU AND I DON'T WAKE UP!! Take off your Red or Blue Jersey's this is not a high school game of us vs them... it is our children's future that we are pissing down the river of debt. And it is an outrage!

[Jason_Clearbrook]

You have to realize this is *not* by any stretch of the imagination, a 'bi-partisan' law, no matter how watered down it has to become. This will be the Democrats Bill, period. That they had the votes but had to make concessions *internally* to get their critical cloture vote is not lost upon the American Public. For better or worse, this bill will be heralded and despised as a Democrat only Vision. If it fails miserably, they will only have themselves to blame on this one. (although they are already trying to point the finger to others, unsuccessfully, I might add) The Reconciliation Bill is likely to have the *very* unpopular language about forcing everyone to buy health insurance, and since that has absolutely no *direct* bearing upon appropriations, that should be able to be challenged if it remains in the Reconciliation Bill, both procedurally now, and then in the Courts later, both as a Violation of Law and also under a Constitutional Challenge. I have a feeling that when it comes down to the wire, these issues will become bigger and force some support within the Democratic Party to be withdrawn. There is no compromise that will make everyone happy. There might not even be a compromise that will get the majority needed in both houses and be purely enough a qualify under the Congressional Budget Act of 1974 if it is held to the kind of scrutiny that it should. Joe Biden could invoke the "Nuclear" Option, by making a ruling on every single item as the bill being legitimately part of a Bugetary Reconciliation Bill. For their part, the Republicans can (and should) challenge any item, one at a time, that they feel should not be in any such Reconcilliation Bill. The only choice the Democrats have at that point is to either push items into a bill that could be challenged, or make it a purely budgetary bill, defeating its stated purpose. This will happen under the Byrd Rule, which allows any Senator may raise a procedural objection to any provision believed to be extraneous, which will then be ruled on by the presiding Senator. The bigger the bill, the more items that can be challenged that way. And if you understand the Rule as it is written, it was to prevent (then Repulicans, now Democrats) from using this Reconciliation Procedure to Circumvent the design of our legislative process for for dealing with items outside purely budgetary concerns. The worst case scenario for Demcrats? Biden opts for the 'Nuclear' Option. The Law is voted through, but is *very* unpopular. It triggers small business closures and worse economic chaos. It suffers exposure by some Federal Districts to rule the Law unconstitutional, leading to Supreme Court Review. The Supreme Court shows Partisan Leanings in what is becoming quickly even a more unpopular bill, and although upheld, erodes respect for the high court greatly reducing the cohesive fabric of society that requires that respect to maintain order. It gets really bad in many different ways and the Democrats are the sole holders of the bag.