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Health Care Progress Report: November 9

The House of Representatives on Saturday took a momentous step toward overhauling the nation's health care system, passing a Democratic bill by just a slim margin of victory. Now the pressure is on Senate Democratic leaders to follow suit, as President Obama puts new pressure on Democrats in Congress to finish their work on health care before the year is up.

"Thanks to the hard work of the House, we are just two steps away from achieving health insurance reform in America," Mr. Obama said in a statement Saturday (The president, apparently, combines two of the steps below or considers the job done before his signing ceremony for the bill ). "Now the United States Senate must follow suit and pass its version of the legislation. I am absolutely confident it will, and I look forward to signing comprehensive health insurance reform into law by the end of the year." Special Report: Health Care

As Congress has been cobbling together the bill, has been tracking its progress for you. Below is a chart to track the six major steps Washington needs to take to accomplish health care reform. The House has accomplished three of six steps. Meanwhile, the Senate may finish the second step this week or next -- but moving past step three could prove to be much more difficult than it was for the House.


More on the progress of health care legislation in each chamber of Congress.

5571234HOUSE:Democrats in the House managed late Saturday night to pass their comprehensive health care bill by a vote of 220 to 215. After working for weeks behind the scenes to ensure she would have enough votes, House Speaker Nancy Pelosi (D-Calif.) told reporters Saturday morning she was confident the bill would pass. One Republican, Rep. Joseph Cao (R-La.) broke ranks with his party to support the measure. Cao represents New Orleans a heavily Democratic area in need of better health care services. Mr. Obama reportedly promised Cao more attention to New Orleans' health care issues in exchange for his support of the measure.

Meanwhile, 39 Democrats voted against the bill, even after adding to the legislation a strict anti-abortion measure that was intended to attract the support of more moderates. The vast majority of the Democrats who voted against the bill -- 31 of the 39 -- represent districts Sen. John McCain (R-Ariz.) carried in the 2008 presidential election, the New York Times reports. Most of them -- 22 -- represent southern states.

The House conducted about 12 hours of floor debate on Saturday before finally voting on the bill. The statements to come out of Saturday's activities reflected the nature of the health care reform dialogue that took place over the past year. Democrats and Republicans alike blasted their opponents with over-the-top rhetoric. Meanwhile, Rep. Jim Cooper (D-Tenn.), one of the moderate Democrats to raise the ire of the liberal "Netroots," put out an ambivalent statement explaining his vote in favor of reform.

CBS News' Capitol Hill Producer Jill Jackson lays out the key provisions of the legislation. It would expand health insurance coverage through subsidies and a new insurance marketplace, as well as through the creation of a government-run plan. It would mandate participation from individuals and employers and institute new consumer protections. It would pay for the reforms with cuts to Medicare and a new tax on the wealthiest Americans.

"For generations, the American people have called for affordable, quality health care for their families," Pelosi said before the vote. "Today, the call will be answered."

Of particular note in the debate Saturday night was an abortion provision offered as an amendment on the House floor by Rep. Bart Stupak (D-Mich.) and passed by a vote of 240 to 194, with 64 Democrats voting for it. Supported by only two Democratic women, the Stupak amendment represents "the greatest restriction of a woman's right to choose to pass in our careers," Rep. Diana DeGette (D-Colo.) reportedly said.

The provision would effectively keep private insurers from selling plans on the national health insurance exchange that cover abortion. It would also prevent women who receive subsidies to purchase insurance -- inside or outside of the exchange -- from purchasing plans that cover abortion. It would also explicitly ban abortion coverage from the government-run plan, or "public option."

The Senate health care bill currently includes less stringent abortion rules, and supporters of abortion rights are hoping the Stupak amendment will be stripped out of the legislation during the fourth step on the progress report -- conference committee.

(AP Photo/Haraz N. Ghanbari)
SENATE: Before the Congress can assemble the conference committee, the Senate must pass its own bill. Currently, Senate Majority Leader Harry Reid (D-Nev.) is waiting to receive a cost estimate of his legislation from the nonpartisan Congressional Budget Office before publicly unveiling it. The broad outlines of the bill are known, but many significant details have yet to be revealed, as discussed in last week's progress report.

Moderates and conservatives have warned that the Senate could not pass legislation as liberal as the House bill. Senator Lindsey Graham (R-S.C.) said on CBS News' "Face the Nation" on Sunday that the House health care bill would be "dead on arrival to the Senate."

While Pelosi could afford to lose as many as 40 Democrats and still pass a health care bill, Reid will have to win the votes of all 60 Senate Democrats in order to keep Republicans from filibustering the bill -- unless Reid chooses to use a procedural maneuver called reconciliation.

To complicate the matter, Republicans in the Senate could bring up any number of amendments to the bill on the floor and could keep the debate going for weeks. By virtue of congressional rules, the House debate was more restricted. Reid suggested last week the Senate may not pass a bill by his self-imposed Christmas deadline.

The president, however, pushed back against that idea over the weekend.

In an e-mail sent over the weekend to Mr. Obama's supporters from his political group Organizing for America, the president reiterated the need to finish reform this year: "Please donate to OFA's campaign to win this fight and ensure that real health reform reaches my desk by the end of this year," the message said.

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