With Republicans boycotting, Democrats in House and Senate must grapple with multiple disparities - on abortion, taxes, and the government's role in the health insurance market.
But they are under political pressure to act quickly on President Obama's goal of overhauling a medical system that provides world-class health care for many but is marked by huge gaps in coverage, uneven quality, and skyrocketing costs.
Yesterday's 60-39 vote on strict party lines came in an unusual Christmas Eve session, with exhausted senators gathering at 7 a.m., Philadelphia Inquirer reports.
Meanwhile, Vice President Biden presided over the 60 to 39 party-line vote, described as a historic milestone by senators on both sides of the aisle. Despite the early hour, Democrats sat alert at their desks, exhausted but exuberant, savoring a victory that had eluded so many of their predecessors. "This is probably the most important vote that every sitting member of the Senate will cast in their tenure here," said Sen. Christopher J. Dodd (D-Conn.), one of the authors of the bill.
The toughest stretch may lie ahead as House and Senate leaders attempt to fuse their separate bills with their different approaches to providing coverage and paying for it. And Republicans vow to make the process as difficult as possible, in hopes of stopping the legislation.
President Obama delayed a family holiday trip to Hawaii until after the 7 a.m. vote was gaveled to a close. "Seven presidents have tried to pass comprehensive health insurance reform, seven presidents have failed" since Theodore Roosevelt proposed universal coverage in 1912, Obama noted in brief remarks before he left the White House. But no effort had ever come this distance.
"We are now finally poised to deliver on the promise of real, meaningful health insurance reform," Obama said. Once the House and Senate merge their bills, he added, "this will be the most important piece of social legislation since the Social Security Act passed in the 1930s and the most important reform of our health-care system since Medicare passed in the 1960s," The Washington Post reports.
News agencies also report, the House passed its bill in November, and officials said it was likely to be February before the two sides can sort out their differences over issues as diverse as government's role in a remade health care system, coverage for abortion and federal subsidies for lower and middle-income families who would be required to purchase insurance.
Senate Republican attacked the bill to the end, and citing public opinion polls, said they would use it as an issue in the 2010 congressional elections. "This debate was supposed to produce a bill that reformed health care in America. Instead, we're left with party-line votes in the middle of the night, a couple of sweetheart deals to get it over the finish line, and a public that's outraged," said the Republican leader, Sen. Mitch McConnell, R-Ky, ABC News reports.