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Health Care Reform Bill Clears First Procedural Hurdle in Senate, Clearing the Way for a
Free-For-All on Senate Floor Beginning on November 30
By Micheal E. Hill
Monday, November 23, 2009 -- 1:15 am EST
The Senate has moved a big step closer to passing a landmark health care reform bill. But there is still a long way to go.
The Senate on Saturday, November 21, voted to invoke cloture (bring debate to a close) on a motion to proceed to consideration of legislation that has become the vehicle for a health care reform bill assembled by Senate Majority Leader Harry Reid (D-NV). The Senate invoked cloture by a party-line vote  of 60-39. The 60 votes that the Majority Leader mustered to shut down debate was the minimum that was needed. Immediately following the vote to invoke cloture, the Senate agreed to the motion to proceed to the bill, and Senator Reid laid down a substitute amendment reflecting the text of his health care reform bill. The Reid Substitute will be the vehicle for floor amendments beginning on Monday, November 30 -- a debate that will likely take up almost all of the remainder of the first session of the 111th Congress.
The outcome of this evening's cloture vote was in doubt for most of the week last week. Indeed, as Saturday began, Senators Blanche Lincoln (D-AR) and Mary Landrieu (D-LA) were the only Democratic senators whose votes were in doubt; all of the other 58 senators who caucus with the Democratic party had already announced that they would support invoking cloture. Senators Landrieu and Lincoln announced their support for invoking cloture during the course of Saturday afternoon's debate, removing much of the drama that had been present over the last week.
The health care reform bill that the Senate is has agreed to take up contains a number of provisions relating to immigrants' access to health insurance. Its immigration-related provisions are substantially similar to those that are contained in the Senate Finance Committee's health care reform bill. However, there are some changes around the edges.
As was the case with the Senate Finance Committee bill, the bill that the Senate is attempting to take up would exempt persons who are not lawfully present in the United States from the measure's general mandate that virtually everyone living lawfully in the United be covered by a qualified health insurance plan or face tax penalties for failure to comply. The new measure also mirrors the Finance Committee bill's provision that would make legal immigrants eligible for health care affordability tax credits without regard to a waiting period. And although there is a slight change in the phraseology, the new bill generally would bar aliens who are not lawfully present in the United States from using their own funds to purchase health insurance products that are listed on the Health Insurance Exchange that the bill would create. The new bill would establish a new citizenship and immigration status verification regime that would exist in order to ensure that persons who are not lawfully present in the United States do not receive health insurance products and benefits from which they are barred. It would rely on the recently enacted Children's Health Insurance Program reauthorization bill's mechanism for verification. It would subject everyone who purchases health insurance through the exchange, benefits from an exchange plan, or receives an affordability tax credit, to a citizenship and immigration status verification using the new regime.
In addition to the immigration provisions that are included in the new bill, it is anticipated that the measure will become the target of a number of floor amendments that would further restrict immigrants' access to health insurance.
Senate Majority Leader Harry Reid (D-NV) unveiled the new 2,074 page-long health care reform bill on Wednesday, November 18, 2009. He spent more than a month putting it together, taking parts from bills approved by the Senate Committee on Finance and Senate Committee on Health, Education, Labor, and Pensions. He unveiled the measure after holding a special, 5:00 pm Wednesday evening meeting of the Senate Democratic Caucus. The Majority Leader formally moved on Thursday, November 19, that the Senate proceed to consideration of the measure (this motion is popularly referred to as a "motion to proceed"). Immediately thereafter, he filed a cloture petition to shut off debate on the motion to proceed.
As last week began, it seemed unlikely that the Senate would actually consider the health care bill this week. This was, in part, because at least four Democratic senators (Senators Mary Landrieu (D-LA), Ben Nelson (D-NE), Blanche Lincoln (D-AR), and Ron Wyden (D-OR)) were thought to be considering voting against invoking cloture on the motion to proceed to the bill. Given the partisan makeup of the Senate and the unlikelihood that any of the Senate's 40 Republicans will vote to invoke cloture on the motion to proceed to the bill, the Majority Leader will need the votes of all 60 sitting Democrats, including the four waivering Democrats, in order to prevail and bring the bill before the full Senate. By the beginning of Friday, however, it was looking more and more likely that the Majority Leader might prevail on the attempt to invoke cloture on the motion to proceed to consideration of the health care reform bill.
Last week's Senate action by no means assures that the Senate will pass a health care reform bill. Senators Landrieu, Nelson, and Lincoln have made it clear that their votes in favor of permitting the bill to move forward should not be mistaken for support for the legislation as it currently is drafted. Indeed, Senators Nelson and Landrieu have made it clear that they cannot support the bill as it currently is drafted.
The immigration provisions in the Senate bill represent only one of several areas of controversy that could prove difficult for the Senate as it forges ahead. Other controversial issues include the question of whether the bill should contain a public option (it does, as drafted) and whether it should place strict restrictions on abortion coverage (the House bill does; the Senate bill, as drafted does not).
The Congressional Hispanic Caucus (CHC) is bitterly opposed to at least one provision in the Senate bill. That provision would bar undocumented aliens from using their own funds to purchase health insurance products that are listed on health insurance exchanges that would be created by the bill. Representative Luis Gutierrez (D-IL), Chairman of the CHC Immigration Task Force has called the proposal “mean-spirited” and “dehumanizing.”
The Senate resumes debate on the measure on Monday, November 30.
RELATED DOCUMENTS:
Text of the Reid Health Care Reform Bill
Preliminary Analysis of the Immigration Provisions in the Reid Health Care Reform Billl
Summary of the Reid Health Care Reform Bill (Prepared by Senate Democratic Staff)
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