Health care reform - Light at the end of the tunnel?

The breaking news Saturday morning was that the Senate Democrats now had 60 votes to break the Republican filibuster and move ahead with a bill. So far, there are no indications that this deal has fallen apart. It's showtime!

At best, there is still a lot of legislative trench warfare ahead before the Senate actually passes a bill, and that still leaves the process of reconciling the House and Senate bills, etc. Furthermore, whatever bill finally does emerge will be far from perfect or unambiguously desirable in all respects. But it does look as though this tortuous process, which has already swallowed up most of a year, will produce a genuine result in the end. Whatever one thinks of the Senate health care bill in substantive terms, this is (potentially) historic. Stay tuned ...

--Jeff Weintraub
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New Republic
(Health Care Blog: The Treatment)
December 19, 2009 | 9:35 am
BREAKING: Nelson Says Yes; That Makes 60
Jonathan Cohn

The Washington Post is reporting, and multiple independent sources are now confirming, that Nebraska Senator Ben Nelson has said he will support the Senate Democrats' health care reform bill. That would give Majority Leader Harry Reid the 60 votes necessary to break a Republican filibuster and pass the legislation.

After weeks of negotiation that culminated in a 13-hour session yesterday, the clincher was some tinkering with Medicaid to help his state and modified abortion language. Critically, the language does not seem to have cost the support of abortion rights advocates in the Senate. E-mails one senior aide:

Nelson is in. Pro-choice Dems are cool with it. The caucus is jubilant.

Nelson will speak with the press at 10 a.m., Reid will do the same shortly thereafter. And Reid's office has just released his manager's amendment. So there will be a lot to report today.

But, for now, the bottom line is simple: The debate goes forward. And it looks like the Democrats have the votes they need.

Yes, that thing you see at the end of the tunnel is a light.

Update: The Hill's Jeffrey Young and Wonk Room's Igor Volsky have more details on the final compromise with Nelson and other features in the manager's amendment. The gist of the abortion amendment is that it'd give states the right to prohibit coverage of abortion within their own insurance exchanges, which is what the Stupak amendment in the House bill would do nationally. Also of note: Ron Wyden did a get a scaled-down version of his Free Choice amendment.

Another update: Nelson, speaking to the press moments a little after 10 a.m., hailed the reform in strong, robust terms, invoking comparisons to Medicare and Social Security:

I truly bleieve this reform will stand the test of time ... [and prove to be] one of the major reforms of the 20th century. The lives of millions of Americans will be improved. Lives will be saved and our health care system will once again refelct the better nature of our country.

But he also sent a stark message to his counterparts in the House and on the left: If, after the Senate approves the bill, negotiations with the House change the terms of his compromise substantially, he's fully prepared to vote "no" on that final package. Specifically, he called for a "limited" conference proceeding and warned:

If there are material changes in that caucus, chnages that adversely affect the agreement, I reserve the right to vote against the next cloture vote... I will vote against it if that is the case.

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