Congress prepared for historic floor debates on health care reform after Democrats on the Senate Finance Committee came together early Friday — after 2 a.m. — to finish the heavy lifting on a bill designed to appeal to moderates. President Barack Obama hailed it as a milestone and noted, for history, that overhauling health care has eluded presidents from Harry S. Truman to Richard Nixon to Bill Clinton.
"We are now closer than ever before to finally passing reform that will offer security to those who have coverage and affordable insurance to those who don't," Obama said.
But not yet. And not for sure.
The 10-year, $900 billion bill would remake one-sixth of the U.S. economy, clearing a path to health insurance for millions who don't have it now. It would be financed by reducing Medicare and Medicaid payments to health care providers, and by ordering new taxes and fees that are already meeting resistance. Insurers would no longer be able to turn away those in poor health.
Final passage in the Finance Committee, a political bellwether with 13 Democrats and 10 Republicans, is all but assured next week. After that, things start to get interesting.
Here's a look at what's next.
• The bill will be delivered to the nonpartisan Congressional Budget Office for a cost estimate; committee members will study the cost analysis when it is finished.
• If the analysis produces an acceptable price tag — lawmakers are hoping for no more than $900 billion over 10 years, fully offset by new taxes or reductions in government spending — the panel would vote to send the bill to the full Senate.
• The Finance Committee is next scheduled to meet on Tuesday. A final vote on the measure is expected next week.
• Senate Majority Leader Harry Reid, D-Nev., will work to meld the Finance Committee bill with an alternate measure approved by the Senate health committee in July.
• Many of the big amendments that failed in committee debate, including a proposal by liberal Democrats to add a government-run insurance plan, or public option, will probably be proposed again for the entire Senate to consider.
• Attention will also shift back to the House, where Democrats are still wrangling over their version of the health legislation. Three House committees — Ways and Means, Education and Labor, and Energy and Commerce — have each approved a version of the America's Affordable Health Choices Act of 2009.
• House Democrats are still proposing a surtax on high-income Americans as a way to generate revenue. But the Senate shunned that idea, choosing instead to tax high-cost health insurance plans. House leaders are considering whether they can incorporate some version of the tax on costly insurance policies into their bill.