, WASHINGTON, Dec 21 – President Barack Obama\’s top domestic goal, remaking US health care, cleared a key Senate hurdle on Monday with no room to spare and seemed all but sure to pass by his self-imposed Christmas deadline.
After hours of bitter debate, all 58 Democrats and their two independent allies closed ranks in a vote after 1:00 am (0600 GMT) to get exactly the 60 senators needed to end debate on a landmark compromise bill.
"What\’s really killing more and more Americans every day is complications from our health care system," Democratic Senate Majority Leader Harry Reid said in the final speech before the ballot.
All 40 Republicans voted against the measure, acknowledging that for the moment they lacked the power to kill the sweeping proposal but warning Democrats would pay a price in the November 2010 mid-term elections.
"It\’s not too late. All it takes is one. Just one. All it takes is one. One can stop it — or every one will own it," Republican Senate Minority Leader Mitch McConnell said in a vain last-ditch appeal for a Democratic defector.
Senators were scheduled to hold two more procedural votes a day apart and then a final ballot on Thursday — Christmas Eve — on passing what would be the most sweeping overhaul of its kind in four decades.
Passage would set up tough negotiations for the Senate and the House of Representatives — which approved its version of the bill on November 7 — to craft a compromise version they could send to Obama to sign into law.
Democratic leaders hope to do so before his State of the Union speech in late January or early February.
Intra-party Democratic feuds were expected over tough new restrictions on federal monies going to subsidize abortions and the Senate\’s decision to strip out a government-backed "public option" to compete with private insurers.
The highly unusual overnight vote came after a day of often bitter debate inside the Capitol as Washington dug out from under the worst winter storm in years, which dumped a thick layer of snow and iced-over some roads.
"What the American people ought to pray is that somebody can\’t make the vote tonight. That\’s what they ought to pray," said Republican Senator Tom Coburn, a medical doctor.
That drew a sharp rebuke from Senator Dick Durbin, the number two Democrat, who said he did not "think it\’s appropriate to be invoking prayer to wish misfortune on a colleague.
"We are becoming more coarse and more divided here," he scolded. "I don\’t wish misfortune on any of my colleagues."
The underlying legislation would extend coverage to 31 million of the 36 million Americans who currently lack insurance.
It would require most Americans to buy insurance and offer subsidies for low-income families to do so, while forbidding insurers from denying coverage because of pre-existing medical conditions.
Democrats said the bill met Obama\’s goals of costing less than 900 billion dollars and not add to the deficit, citing findings from the non-partisan Congressional Budget Office that it will cost 871 billion over the next 10 years and cut the deficit by about 132 billion dollars.
Several Democrats invoked the name of late senator Ted Kennedy, who had made fixing US health care a main cause of his life, and his widow Vicki Kennedy was in the visitors gallery as the vote took place.
The United States is the world\’s richest nation but the only industrialized democracy that does not provide health care coverage to all of its citizens.
Washington spends more than double what Britain, France and Germany do per person on health care, but lags behind other countries in life expectancy and infant mortality, according to the Organization for Economic Cooperation and Development (OECD).