US Senate passes health reform bill

Early on Christmas Eve the US Senate passed its health reform bill, marking a step closer towards 30 million or more of America’s 46 million uninsured becoming eligible for health care. In January a conference committee comprising members of both the Senate and the House of Representatives will work to reconcile the bill with a similar, but different, health reform bill passed by the House of Representatives in November. There are two health reform bills because bills to raise revenue must originate in the House of Representatives. Both bills are estimated to increase health care spending during the next decade―the Senate bill by nearly $900 billion (£567 billion; €627 billion) and the House bill by just over $1 trillion. Both houses will then vote on the reconciled bill and, if passed, it will be sent to President Barack Obama for his signature. The latest development in the saga follows a 60-40 vote on 21 December ( BMJ 2009;339:b5622, 23 Dec, doi:10.1136/bmj.b5622) that allowed the Senate to proceed to a final vote. The subsequent 24 December vote was 60-39 in favour, but all Republicans voted against it. The narrow vote margin means that all changes in the reconciled bill must be accepted by 60 senators—all Democrat senators and the independent senators who vote with them. Otherwise, opponents could mount a filibuster and effectively talk the bill to …