A pivotal Senate committee has approved a sweeping remake of the country's health care system, delivering a long-sought boost to President Barack Obama's goal of expanding coverage.
The 14-9 vote in the Senate Finance Committee sets up a historic debate on the Senate floor and moves health care overhaul closer to reality than it has been for decades.
Sen. Olympia Snowe of Maine was the only Republican to join 13 committee Democrats in voting "yes."
The 10-year, $829-billion plan approved Tuesday is aimed at extending coverage to millions more Americans, holding down costs and improving health care for all.
The Finance Committee was the last of five congressional committees to act. It produced a centrist-leaning compromise bill.
Original report continues below:
WASHINGTON – President Barack Obama's plan to remake the nation's health care system is about to take its biggest step yet toward becoming reality.
The pivotal Senate Finance Committee was poised to approve sweeping legislation Tuesday requiring nearly all Americans to purchase insurance and ushering in a host of other changes to the nation's $2.5 trillion medical system.
Much work would lie ahead before a bill could arrive on Obama's desk, but action by the Finance Committee would mark a significant advance, capping numerous delays as Chairman Max Baucus, D-Mont., held marathon negotiating sessions — ultimately unsuccessful — aimed at producing a bipartisan bill.
Four other congressional committees acted before August to pass health legislation, so for months all eyes have been on the Finance Committee, the remaining one. It's also the panel whose moderate makeup most closely resembles the Senate as a whole. And the committee's centrist legislation is seen as the best building block for a compromise plan that could find favor on the Senate floor.
With Democrats holding a 13-10 majority on the committee the outcome of Tuesday's vote is not in doubt. The big question mark is whether moderate Sen. Olympia Snowe of Maine will become the first Republican to support a health overhaul bill. The legislation that passed the other House and Senate committees did so without a single Republican vote. On Monday, Snowe still wasn't saying.
With Finance Committee passage, Obama's top domestic priority will have advanced farther than former President Bill Clinton's effort ever did. The Clinton health plan never made it through all the congressional committees with jurisdiction.
The final days before Tuesday's long-anticipated vote were rocky. After playing nice for months, the health insurance industry released a report contending that the legislation would cause hefty increases in health insurance premiums.
Democrats and their allies scrambled Monday to knock it down. "Distorted and flawed," said White House spokeswoman Linda Douglass. AARP's senior policy strategist, John Rother, called it "fundamentally dishonest."
PricewaterhouseCoopers, the accounting firm that did the industry-commissioned analysis, issued a statement late Monday acknowledging it did not look at the entirety of the legislation, only the effects of four provisions that the insurance group wanted analyzed.
The drama threatened to overshadow the vote on the 10-year, $829-billion plan that Baucus has touted as the sensible solution to America's problems of high medical costs and too many uninsured.
The bill includes consumer protections such as limits on copays and deductibles and relies on federal subsidies to help lower-income families purchase coverage. Insurance companies would have to take all comers, and people could shop for insurance within new state marketplaces called exchanges.
Medicaid would be expanded, and though employers wouldn't be required to cover their workers, they'd have to pay a penalty for each employee who sought insurance with government subsidies. The bill is paid for by cuts to Medicare providers and new taxes on insurance companies and others.
Unlike the other health care bills in Congress, Baucus' would not allow the government to sell insurance in competition with private companies, a divisive element sought by liberals.
Last-minute changes made subsidies more generous and softened the penalties for those who don't comply with a proposed new mandate for everyone to buy insurance. The latter change drew the ire of the health insurance industry, which said that without a strong and enforceable requirement not enough people would get insured, and premiums would jump for everyone else.
The industry report was timed just ahead of the vote on Baucus' bill but the industry was already looking ahead to negotiations on a final package to bring to the Senate floor.
Once the Finance Committee has acted, the dealmaking can begin in earnest with Senate Majority Leader Harry Reid, D-Nev., working with White House staff, Baucus and others to blend the Finance bill with a more liberal version passed by the Health, Education, Labor and Pensions Committee.
A major question mark is whether Reid will include some version of a so-called public plan in the merged bill. Across the Capitol, House Democratic leaders are working to finalize their bill, which does contain a public plan, and floor action is expected in both chambers in coming weeks. If passed, the legislation would then go to a conference committee to reconcile differences.
Snowe to vote for Democratic health care bill
Republican Sen. Olympia Snowe says she will vote for a Democratic health care bill, breaking with her party on President Barack Obama's top legislative priority.
The Maine senator kept virtually all of Washington guessing how she would vote until she announced it late in the Senate Finance Committee debate Tuesday. Until then, she told reporters, she had not even let Senate Majority Leader Harry Reid, D-Nev., in on her secret.
She told her colleagues: "When history calls, history calls," even though she had some criticism of the bill.
This video is from MSNBC's Andrea Mitchell Reports, broadcast Oct. 13, 2009.
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