What: All Issues : Health Care : Access to Health Insurance : HR 4872. (Health care overhaul) Motion to begin debating a bill that would revise a major new law overhauling health insurance and student lending laws/On the motion (2010 senate Roll Call 63)
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HR 4872. (Health care overhaul) Motion to begin debating a bill that would revise a major new law overhauling health insurance and student lending laws/On the motion
senate Roll Call 63     Mar 23, 2010
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This vote was on whether to begin debate on a bill that would revise a major health care and student loan overhaul law cleared by the House the night before. A bill is “cleared” when one chamber of Congress passes a bill that has already been passed by the other chamber; once a bill is “cleared” it is sent to the president.  The law being changed aims to expand the availability of health care coverage for some 31 million Americans that are not currently covered.  

Typically bills are brought to the floor through a procedural motion called a “motion to proceed,” which is usually approved by voice vote as a routine matter.  However, if a senator wants to hold up consideration, all he has to do is remove his consent – which was the case with this bill.  Instead, the Democratic leadership called a vote on beginning debate on the bill, which is what this vote was on.

This reconciliation bill made several changes to the new law, including increasing subsidies for some people and delaying the date when some new taxes and fees would start to pay for the expanded coverage.  It also removed some provisions in the health care law that benefit certain states, which Republicans decried as “sweetheart deals.”  These fixes were requested by wavering moderate Democrats in the House who in part based their vote for the health care law on the assurance that Congress would later pass the reconciliation bill.

A second bill was necessary because the Senate had already passed the bill, and if the House were to have changed it, the Senate woud have had to pass it again – a much more difficult calculus now that Democrats have fewer seats in the Senate.  Instead, Democrats decided they would clear the bill the Senate had already passed, and then pass another bill that contained changes to the law, which the Senate would then consider.

Democrats worried that even this smaller reconciliation bill could face significant obstacles and for that reason decided to use an expedited procedure known as “reconciliation” to consider it.  In essence, using reconciliation shields the bill from filibusters by only requiring 51 votes instead of 60 for it to pass, and limits total debate time to 20 hours.  However, it does allow for unlimited amendments to be offered to the legislation, all of which receive a vote.

“Today, we have before us a bill to improve the new law. We do not have before us the whole health care reform bill. We do not have to reopen every argument we had over the last 2 years. We do not have to say everything we said about health care one more time. Rather, we have a bill before us that will do a few good things,” said Max Baucus, D-Mont.  “We have before us a bill that will improve affordability by increasing tax credits to help pay for insurance premiums. We have before us a bill that will help with out-of-pocket costs for lower and middle-income families; that is, to raise the assistance. We have before us a bill that will increase aid to States to help them shoulder the costs of covering Americans under Medicaid. We have before us a bill that will give additional help to States that took extra steps to cover the uninsured before reform took place. Together, these improvements will level the playing field among States under health care reform.”

Judd Gregg, R-N.H., called the new health law an “atrocity” and bristled at the idea that the Senate must now consider a bill he said was designed to buy votes.

“This bill aggravates the fundamental problems of the bigger bill the President signed today. This bill adds more costs, creates more taxes, and will reduce Medicare’s viability in a more significant way. Yet it is called good policy. It is very hard to understand that,” Gregg said. 

“We know the record of the government around here on the issue of entitlements. We always underfund them. The promises are made, but they are never kept. So this will all end up rolling into a giant ball, like a huge, massive asteroid headed to Earth which is basically going to land on our children’s head as debt. That is what we have headed toward us here,” Gregg said.

By a vote of 56-40, the Senate voted to begin debating the bill.  All but one Democrat present voted to begin debating the bill.  Every Republican present voted against debating the bill.  The end result is that the Senate voted to begin debating a bill that made changes to a new, massive health care overhaul law, including increasing tax credits to pay for insurance premiums and other items.

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