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Senate Democrats are Split on Reform Legislation

Janice Simmons, for HealthLeaders Media, November 23, 2009

When the Senate reform bill was released the middle of last week, Senate Majority Leader Harry Reid (D-NV) maintained that he had the 60 votes needed to proceed with the healthcare debate in the Senate. When it came time to vote in a rare Saturday night session, his prediction proved true.

But can he guarantee that those votes will still be there when the Senate floor debate concludes—presumably by late December?

On Nov. 30, following a short congressional recess during Thanksgiving week, amendments will be permitted to be introduced on the Senate floor for what is now called the "Patient Protection and Affordable Care Act." Reid, charged with piloting the legislation through, said after the vote on Saturday that "we have the momentum to keep this process moving."

While "not all 60 senators in my caucus agree on every aspect of this bill," about 90% of the bill has agreement among Senate Democrats, Reid told reporters after the vote. "All Democrats do believe now is the time to make sure all Americans can access affordable health insurance."

It will be that 10% of the bill, though—which includes the public insurance option—that could be challenging and make or break acceptance of the bill. Four senators—Ben Nelson (D-NE), Blanche Lincoln (D-AR), Mary Landrieu (D-LA), and Joseph Liberman (I-CT)—had said that while they would vote to put the bill into play, they wouldn't go for a bill that contained the current public option.

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