Senate Health Reform Vote May Not Happen Until After Christmas

Janice Simmons, for HealthLeaders Media , December 17, 2009

Healthcare reform came to a standstill on the 17th day of Senate floor debate on Wednesday with the request by Sen. Tom Coburn (R-OK) to read out Sen. Bernie Sanders' (I-VT) 767-page amendment supporting a single-payer system on Wednesday. The reading could create a series of procedural hurdles to keep Democrats from passing the reform bill before Christmas.

While Sanders later withdrew the amendment, which stopped the reading, the action's impact on Democrats was palpable. "It's about stopping healthcare reform," Sen. Dick Durbin (D-IL), the Senate Majority Whip, declared on Wednesday. "My Republican colleagues are acting Scrooge-like during this holiday season—holding so tightly to political tactics."

It still may be possible for the Democrats to get a bill voted on before Christmas, but it will involve a tight schedule and many late nights next week. The healthcare reform bill action will compete with other Senate business, such as the approval of the defense spending bill approved by the House on Wednesday.

For this process, three cloture votes will be required, and each cloture vote will require at least 60 votes for Democrats to move forward. When a cloture motion has been approved by the required 60 vote majority, a debate is opened up to 30 hours; when that 30 hours is expired, another vote may be taken and the process is moved to the next stage.

The process could start as early as Friday or Saturday with Senate Majority Leader Harry Reid's (D-NV) introduction of his "manager's amendment," which contains changes to the healthcare bill.

The second stage will use a substitute amendment. Since the healthcare package includes taxes and spending—and the Constitution requires revenue bills to originate in the House—an unrelated House bill that has been approved and sent to the Senate will be stripped, with the reform bill's contents inserted. The final phase will include the final bill, and that vote could come by Christmas Eve at the earliest.

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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