Obama Defends Health Bill as Passage Nears

Democrats are ready to push President Barack Obama's health care overhaul past one last procedural hurdle in the Senate Wednesday on the way to final passage of the landmark legislation.

Obama said the Senate legislation accomplishes 95 percent of what he wanted on health care. "Every single criteria for reform I put forward is in this bill," the president said in an interview with The Washington Post.

At the White House, spokesman Robert Gibbs declared: "Health care reform is not a matter of if. Health care reform is now a matter of when."

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The last of three procedural votes comes Wednesday afternoon, when Democrats will have to put up 60 votes one more time to cut off debate on the legislation.

Democrats are also expected to turn back points of order raised against the bill by Republicans, including one questioning the constitutionality of requiring almost every American to buy health insurance.

Final passage on the sweeping bill, which will extend health coverage to 30 million uninsured Americans, is set for 8 a.m. Thursday, Christmas Eve. It would mark the 25th consecutive day of Senate debate on health care.

That's 11 hours earlier than originally scheduled, thanks to a deal struck Tuesday between Majority Leader Harry Reid and Minority Leader Mitch McConnell. Republicans had been threatening to use all the time available to them, which would have kept the Senate in session late into the night before Christmas. But bad weather is forecast for later in the week, senators and aides are eager to get home to their families, and the outcome is preordained after Reid struck the final deals over the weekend to get his 58 Democrats and two independents in line.

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Washington Unplugged: Dean Tells Dems to "Toughen Up"
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Once passed, the Senate measure would still have to be harmonized with the health care bill passed by the House of Representatives in November. Both chambers would then have to approve the final legislation before it could be sent to Obama for his signature.

There are significant differences between the two bills, including stricter abortion language in the House bill, a new government-run insurance plan in the House bill that's missing from the Senate version, and a tax on high-value insurance plans embraced by the Senate but strongly opposed by many House Democrats who instead favor higher taxes on wealthy Americans.

Senate moderates have served notice they won't support a final deal if government-run insurance comes back. And Democratic abortion opponents in the House say a Senate compromise on the volatile issue is unacceptable.

But there's considerable pressure on Democrats to avoid messy negotiations over a final bill. Public support for the legislation continues to sink in opinion polls.

The bills probably have more in common than differences. Each costs around $1 trillion over 10 years and installs new requirements for nearly all Americans to buy insurance, providing subsidies to help lower-income and middle-income people do so. They're paid for by a combination of tax and fee increases and cuts in projected spending on the government-run Medicare program providing health care coverage for the elderly.

Unpopular insurance company practices such as denying coverage to people with existing health conditions would be banned. Uninsured or self-employed Americans would have a new way to buy health insurance, via marketplaces called exchanges where private insurers would sell health plans required to meet certain minimum standards.

Subsidies would be provided to help lower-income and middle-income people pay for the insurance, and more businesses would be encouraged to cover their employees through a combination of tax breaks and penalties.

Unable to prevent passage of the legislation, Republicans are stepping up their criticism of it, focusing in on the special deals some senators got.

South Carolina Attorney General Henry McMaster, a candidate for governor, said he and his counterparts in Alabama, Colorado, Michigan, North Dakota, Texas and Washington state - all Republicans - are jointly taking a look at whether the special provisions for Nebraska and other states are constitutional. The federal government is picking up the full tab for an expansion of Medicaid - the government-run health program that covers the poor - in Nebraska, where conservative Sen. Ben Nelson provided Democrats their crucial 60th vote.

"These negotiations on their face appear to be a form of vote-buying paid for by taxpayers," McMaster said.

Nelson vigorously defended the provision Tuesday, contending he didn't seek any special carve-out for Nebraska and hoped all states would get the same help.

Republicans are just seeking "an opportunity to mislead and distort," Nelson contended.

Reid has defended the dealmaking, asserting that every senator got something they were looking for in the health bill and if they didn't it speaks poorly of them.