President Barack Obama's signature drive to remake US health care faced a critical Senate test vote yesterday, amid bitter 11th-hour debate and behind-the-scenes wrangling on a century-old policy feud.
Lawmakers were to vote at 2 a.m. today on whether to formally take up White House-backed Democratic legislation estimated to extend coverage to some 31 million Americans who currently lack it.
The measure, which includes a government-backed insurance programme to compete with private firms and restrictions on dropping care for pre-existing ailments, is estimated to cost $848 billion through 2019 but cut the sky-high US budget deficit by $130 billion over the same period.
If Democrats held together and rallied the 60 votes needed to ensure passage over united opposition from the 100-seat chamber's 40 Republicans, the Senate was due to take up the bill around November 30 for at least three weeks.
A successful vote after that would force the Senate and the House of Representatives, which passed its own version of the legislation on November 7, to craft a compromise bill and vote again in order to send it to Obama.
Republicans, one of whom has vowed a "holy war" against the bill, hope to delay the battle into next year with the expectation that the 2010 midterm elections may make it harder for centrist Democrats to support the legislation.
As debate opened yesterday, Republican Minority Leader Mitch McConnell warned against passing "this staggering spending programme at a time when many would argue our international bankers, the Chinese, are lecturing us about debt".
Democratic Majority Leader Harry Reid shot back that McConnell had unquestioningly backed spending hundreds of billions of dollars for the "war of choice" in Iraq under then-president George W. Bush.
Reid charged it was "beyond the pale" for McConnell "to lecture us now on debt when not only the war but the other actions of the Bush administration drove this country into deep debt."
The heated debate was unlikely to sway the most-watched wavering Democrats, Louisiana's Mary Landrieu and Blanche Lincoln of Arkansas, whose vote was perhaps most in doubt because she faces a tough re-election campaign in 2010.
Last Thursday, another swing-vote Democrat, Senator Ben Nelson of Nebraska, said he would vote with his party while warning he might side with Republicans in subsequent fights.
The White House, which has wooed undecided Democrats, declared the legislation "a critical milestone" last Friday and warned "the nation cannot wait another year for health insurance reform".