Senate Democrats Strike Deal for 60 Votes on Health Reform

Updated 6:55 p.m. ET:

Senate Democrats announced Saturday morning that they had struck a deal with the last Democratic holdout on health care reform, paving the way for a vote on the bill before Christmas. Sen. Ben Nelson, D-Neb., agreed to a compromise at 10:30 p.m. Friday night, after a marathon 13 hours of negotiations, it was widely reported.

“Change is never easy, but change is what’s necessary in America,” Nelson said during a morning news conference, according to the New York Times. “And that’s why I intend to vote,” he said, “for health care reform.”

The deal gives Senate Majority Leader Harry Reid the 60 votes he needs to block a Republican filibuster and pass the bill. Reid is expected to file his manager’s amendment – the final changes to the bill – on Saturday, setting up a series of votes on portions of the bill that could begin in the early hours of Monday morning and last until Christmas Eve.

Reid’s office has posted a link to the 383-page manager’s amendment.

Nelson’s concerns had centered mainly on the abortion language in the bill – he wanted stronger language prohibiting people from using federal subsidies to buy insurance plans that cover abortion. In the end, the compromise that won his vote shifts the issue to states – it allows states to prohibit abortion coverage in the new state-based insurance exchange markets where people will buy coverage. Nelson also won special concessions just for Nebraska — increased federal money to pay for the Medicaid expansion in the bill, as well as an exemption to an insurance tax for non-profit insurers in Nebraska. The compromise bill is in many other ways similar to the original $848 billion legislation Reid floated. However, in order to win the votes of moderates such as Nelson and Joe Lieberman, I-Conn., Reid dropped a proposed government-run public insurance option and replaced it with private, non-profit plans that would be administered through the federal Office of Personnel Management, which administers federal employees’ insurance. The final bill also includes a few other changes. In one, insurers would be barred immediately from denying coverage to children based on pre-existing conditions. That new regulation would go into effect for adults with the rest of the legislation, in 2014. The new bill would also require insurers to spend 80 cents of every dollar they collect in premiums on providing health care. The [Congressional Budget Office](http://www.cbo.gov/) also released a [cost estimate](http://www.cbo.gov/ftpdocs/108xx/doc10868/12-19-Reid_Letter_Managers.pdf) Saturday. The non-partisan agency [estimates](http://cboblog.cbo.gov/?p=446) that the new bill will cost $871 billion over 10 years, but reduce the federal deficit by $132 billion due to other cost savings, mainly changes to Medicare. The next — and most critical — test vote for the bill is reported to be set for about 1 a.m. Monday. The measure faces continued opposition from Republican lawmakers, who may maneuver to further delay the legislatgion. “This bill is a legislative train wreck of historic proportions,” the party’s Senate leader, Mitch McConnell of Kentucky, [said at a news conference](http://politicalticker.blogs.cnn.com/2009/12/19/mcconnell-health-care-bill-a-legislative-train-wreck/), citing the cuts to Medicare detailed in the CBO analysis, among other issues. Groups on both sides of the abortion issue also weighed in with their reactions — NPR has rounded those up [here](http://www.npr.org/blogs/politicaljunkie/2009/12/ben_nelson_on_board_democrats.html). *Watch Monday’s NewsHour for more reporting and analysis on the health reform push.*