Health overhaul clears big hurdle in Senate

WASHINGTON - Historic legislation to expand U.S. health care won its first Republican supporter Tuesday and cleared a key Senate hurdle, a double-barreled triumph that propelled President Obama's signature issue toward votes this fall in both houses of Congress.

"When history calls, history calls," said Maine Republican Olympia Snowe, whose declaration of support ended weeks of suspense and provided the only drama of the Senate Finance Committee's 14 to 9 vote to approve legislation that would, for the first time, require every American to have health insurance.

With her decision, the 62-year-old lawmaker bucked her own leadership on the most high-profile issue of the year in Congress, and gave the drive to remake health care at least a hint of the bipartisanship that Obama seeks.

Obama, speaking in the Rose Garden, described the committee's action as "a critical milestone" and declared, "We are now closer than ever before to passing health reform." But he added: "Now is not the time to pat ourselves on the back. Now is not the time to offer ourselves congratulations. Now is the time to dig in and work even harder to get this done."

That work is likely to be grueling. Groups from across the political spectrum opened fire on the panel's measure, mindful that it is likely to form the backbone of compromise legislation to be crafted in the coming weeks. Labor unions complained that the legislation lacks a government-run insurance plan to compete with private insurers. Insurance companies said that new regulations on their industry could cause premiums to rise higher. And major business groups joined with labor in decrying a proposed tax on high-cost insurance policies, which could increase health-care expenses for employers and workers alike.

"Although it was the best effort to date, the Senate Finance Committee missed an opportunity to create a truly bipartisan bill to reform our nation's health-care system," said R. Bruce Josten, chief lobbyist for the U.S. Chamber of Commerce. "The Senate Finance bill increases premiums [and] raises taxes."

The reaction from many Republicans was equally strong. With the exception of Snowe, nearly all Republicans in Congress oppose the bills in their current form, saying they cost too much, raise taxes, cut Medicare and dangerously expand federal power.

Sen. Charles Grassley of Iowa, the senior Republican on the Finance Committee, said the bill put the nation on "a slippery slope toward more and more government control of health care."

Still, nearly nine months after Obama pledged in his Inaugural Address to tackle health care, legislation to expand coverage to millions who lack it has now advanced further than President Bill Clinton's ill-fated effort more than a decade ago -- or any other attempt in more than a generation.

With its vote, the Finance Committee became the fifth -- and final -- congressional panel to approve a sweeping health care bill. The action will now move to the floors of the House and Senate, where the health care measures still face significant hurdles.

The next move in the Senate is up to Majority Leader Harry Reid, D-Nev., who will be responsible for blending the latest legislation with a version approved by the Senate health committee into a final product that can unite the Democratic caucus, keep Snowe on board and win the 60 votes necessary to avert a GOP filibuster.

Snowe's vote lent the imprimatur of bipartisanship to the finance panel's measure, said a senior Democratic aide, making it easier for Reid to rally support among Democratic moderates who have been reluctant to back a health care bill without political cover from the GOP.

Snowe helped write the bill, but had not committed to vote for it. She gave no clue how she would vote in the first few hours of deliberations. While colleagues spoke, she kept her head buried in papers, fidgeted and spoke occasionally with aides. When Baucus stepped over to speak to her, a small army of photographers snapped pictures.

Finally, she said that while she shared many of her GOP colleagues' reservations about the legislation, the risks of doing nothing were too great. But she pointedly warned Democrats that they could lose her support later in the legislative process. "My vote today is my vote today," she said. "It doesn't forecast what my vote will be tomorrow."

The bill would cost $829 billion over 10 years, said the Congressional Budget Office (CBO). The costs include $345 billion for the expansion of Medicaid and $461 billion for subsidies to help lower-income people buy insurance.

The CBO said the costs would be offset by new fees and taxes and by cutbacks in Medicare, so federal budget deficits in the next 10 years would be $81 billion lower than now projected. But Douglas Elmendorf, director of the CBO, said his agency had not estimated the impact of the bill on overall national health spending.

The Associated Press, Washington Post and New York Times contributed to this report.

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