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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. 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, 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.


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 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.

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