Health bill advances with Lincoln’s vote

WASHINGTON — In a Saturday night showdown, Arkansas’ Sen. Blanche Lincoln cast the decisive vote to open the Senate’s health-care debate.

In a 60-39 party-line decision, Lincoln’s was the necessary 60th vote on a procedural motion to head off a Republican filibuster. The vote’s outcome had been unclear until Arkansas’ senior senator took the floor mid-afternoon to declare that launching debate was the beginning of the process, not the end.

“Although I don’t agree with everything in this bill, I have concluded that I believe it is more important that we begin this debate to improve our nation’s health-care system for all Americans rather than just simply drop the issue and walk away. That is not what people sent us here to do,” she said.

In an interview after her20-minute speech on the Senate floor, Lincoln elaborated on the decision she arrived at Friday night. “I’ve searched my soul and thought about what Arkansans would want,” she said. “I’ve heard certainly from enough Arkansans to know that they do think we need to reform health care.”

Sen. Mark Pryor, who didn’t speak on the floor, also voted for the measure.

In her floor speech, Lincoln foreshadowed the difficult legislative process ahead with a pair of warnings: that she wouldn’t support the bill as it now stands with a public health-insurance option and she wouldn’t support future procedural motions requiring 60 votes.

Lincoln, who is seeking a third term in 2010, had been under increasing scrutiny in the days leading up to the vote to commence debate on the bill estimated to cost $848 billion over 10 years. With Republicans united in opposition, Democratic leaders needed every one of their 58 members plus two Independents to head off a filibuster.

In the end, only Republican Sen. George Voinovich of Ohio missed the vote.

Although several centrist Democrats had expressed concerns over the bill and its costs, they gradually agreed to allow debate to begin. By Saturday, only two were left uncommitted: Lincoln and Louisiana Sen. Mary Landrieu, who announced her support earlier in the afternoon.

Because the bill itself would need only a simple majority of 51 votes to pass, Republicans have portrayed Saturday’s procedural vote allowing debate to begin as tantamount to voting in favor of the current bill. But Lincoln repeatedly disputed that point, contending it was a procedural motion, “nothing more or less.”

Lincoln has been targeted by critics on the right who oppose the health-care legislation and critics on the left who support the public health-insurance option. So far, she has drawn seven Republican challengers in a state that voted against Obama, while liberal groups have threatened to fund a primary opponent.

Lincoln lashed back at those who have “assigned various motives to my deliberations on health care.” She said more than $3.3 million had been spent on political ads in Arkansas aimed at influencing her.

“These outside groups seem to think that this is all about my re-election,” she said. “I simply don’t think they know me very well. I am focused on my opportunity to influence the final version of health-care reform legislation in a way that most helps my state.”

After her floor speech, Lincoln’s Republican challengers immediately issued statements criticizing her position. The National Republican Senatorial Committee’s news release said the vote indicated her support for President Barack Obama’s “government-run health-care plan.”

“There’s no doubt that this vote will be a critical issue for Sen. Lincoln as she embarks on her uphill re-election bid, and the people of Arkansas will have an opportunity to hold her accountable when they cast their ballots next November,” said committee spokesman Amber Wilkerson Marchand.

But Lincoln, who sits on the Finance Committee, reiterated her opposition to a public health-care option. She supported that panel’s bill, which didn’t contain a public option.

In her floor speech, Lincoln called that “the most responsible approach to health-insurance reform” from the five congressional committees that produced proposals. She pledged to work to move the Senate’s bill closer to that version.

“It was not a perfect bill; we never see perfect bills around here, quite frankly,” she said. “But I can honestly say that I will fight hard so that our final product will be more closely resembling the common-sense, deficit-reducing plan” the Finance Committee produced.

Saturday’s vote to begin considering health-care legislation in the Senate came two weeks after the House passed its bill. Arkansas’ delegation of four split its vote, with Democratic Reps. Vic Snyder and Marion Berry voting for it, and Democratic Rep. Mike Ross and Republican Rep. John Boozman voting against it.

Pryor, who had previously announced his support for advancing the Senate debate, issued a short statement Saturday.

“It’s time for Congress to move forward with a robust floor debate on health-care reform,” Pryor said. “In the end, I hope to be able to vote for a bill that will allow coverage to be affordable, reliable and accessible without breaking the bank.”

In advance of the vote, senators began debating the procedural motion Friday. Democrats recited statistics about the number of Americans without insurance and recounted stories of individuals who had had difficulty obtaining coverage.

Republicans cited the bill’s cost, saying it would add to the federal deficit. They also pointed to recent announcements that fewer screenings may be needed for breast and cervical cancers as evidence that more government involvement in health care would lead to rationing.

Although Saturday’s procedural vote marked a critical step in the legislative process, many hurdles remain. When they return from their Thanksgiving break, senators will begin a debate predicted to last weeks.

“We can see the finish line now, but we’re not there,” Senate Majority Leader Harry Reid, D-Nev., said just moments after the vote.

White House Press Secretary Robert Gibbs issued a statement saying the president was “gratified” by the vote.

“Tonight’s historic vote brings us one step closer to ending insurance-company abuses, reining in spiraling health-care costs, providing stability and security to those with health insurance, and extending quality health coverage to those who lack it,” Gibbs said.

Numerous amendments are expected from members of both parties before a final vote. And several contentious issues - from paying for the overhaul to dealing with coverage for abortion procedures and illegal aliens - remain unresolved.

After the House and Senate approve separate measures, those bills would have to be merged into a single compromise measure, which would then have to be approved by each chamber. Only then could it be sent to the president to sign or veto.

Talking with reporters after her floor speech, Lincoln suggested the process could be expedited if the House skipped the lengthy conference process and vote to accept the Senate’s bill. She echoed Senate leaders, who have predicted the process could spill into next year.

“It’s going to take a good bit of leadership to make sure that process actually goes forward and it doesn’t fall off into a ditch of real partisan bickering,” she said in a conference call with Arkansas reporters.

A key to that, Lincoln said, would be for Obama to be more involved. Although she met with the president at the White House earlier this month to discuss health care, she didn’t talk with him in the days leading to Saturday’s vote.

On the other hand, Lincoln said, she has talked at length with Reid and Finance Committee Chairman Max Baucus, D-Mont. She also discussed the issue with former President Bill Clinton, who oversaw a failed attempt to overhaul health care during his administration.

None of them pressured her to support the measure, Lincoln said.

“Every one of them said, ‘You do what’s right; do what you think is the right thing to do,’” she said. “I was very pleased. There was no arm twisting or any of that.”

The Senate’s bill contains key differences from the House version. It aims to provide coverage for 94 percent of legal residents. That’s up from the current 83 percent of those under age 65 who have coverage, but lower than the 96 percent who would be covered under the House bill.

Like the House bill, it would require virtually all Americans to buy health insurance. But in contrast to the House’s, it would not require businesses to provide coverage, although they might have to pay fees to offset the cost of their employees’ coverage.

Both bills would create a public health-insurance option as well as a health exchange of participating plans, although there are differences between the House and Senate versions, such as the Senate’s provision to allow states to opt out of the public option.

Both the Senate and House measures would prohibit insurers from denying coverage on the basis of pre-existing conditions, imposing coverage limits, or varying premiums on the basis of criteria such as age or sex.