After an often bitter and acrimonious partisan debate, the Senate passed its version of health insurance reform on a strict 60-39 party-line vote. The New York Times:
The vote, on the 25th straight day of debate on the legislation, brings Democrats a step closer to a goal they have pursued for decades. It clears the way for negotiations with the House, which passed a broadly similar bill last month by a vote of 220 to 215. If the two chambers can strike a deal, as seems likely, the resulting product would vastly expand the role and responsibilities of the federal government. It would, as lawmakers said repeatedly in the debate, touch the lives of nearly all Americans.
The bill would require most Americans to have health insurance, would add 15 million people to the Medicaid rolls and would subsidize private coverage for low- and middle-income people, at a cost to the government of $871 billion over 10 years, according to the Congressional Budget Office. The budget office estimates that the bill would provide coverage to 31 million uninsured people, but still leave 23 million uninsured in 2019. One-third of those remaining uninsured would be illegal immigrants.
The Senate's more conservative and insurance-friendly bill now heads to conference to merge with the more progressive House version. And it's not likely to be changed: Conrad (ND), Lieberman (I-Aetna) and Nelson (NE) have threatened not to support the final bill if it includes a public option and/or Medicare expansion, or, any changes advocated by the House Progressive Caucus. Losing even one vote of the 60 super-majority would leave the Democrats vulnerable to filibuster.
It's uncertain how LGBTs will fare under this bill. While the House bill included several benefits for LGBTs—most importantly by incorporating the
Early Treatment for HIV Act, key for black and Latino gay men who often learn they are HIV positive in later stages—the Senate bill does not offer such provisions. As mentioned numerous times, LGBT families and same-sex couples are not included in the definition of "family" coverage (=DOMA). Low-income gay and lesbian families, who can’t afford private insurance, will be hit the hardest and forced to buy multiple policies. Black and Latino gay men, more likely to be un- or underinsured and more likely to be raising children, even more so. There is also nothing to prohibit discrimination based on sexuality orientation and/or gender identity. Oh and there's always the issue of hospitals refusing to allow gay men and lesbian to see their hospitalized partners. All the more reasons to strategize in 2010.
But the bill does meet the broad goals of insuring many of the uninsured and expands Medicaid for the working poor. That's major. As far as the bill being a "starter house" and substantive changes being addressed "in a year or two" ... extremely unlikely to happen. It is what it is. WYSIWYG.
