8:09 EST: Dodd, presiding over the Senate, said the motion passed, smattering of applause. Motion is agreed to. Clerk is now reporting the bill and amendment.

And that's it for the night. Debate will begin after Thanksgiving, plus amendments, then moving on to the final cloture motion and a final vote.

Here's HCAN's statement on the vote from Richard Kirsch, National Campaign Director:

“By voting to begin debate, Senate Democrats took another key step toward putting a bill on the President's desk that guarantees good, affordable coverage for America's families and businesses.

It is a shame not a single Republican in the Senate could put aside partisan gamesmanship to allow a legislative debate. We thought debating legislation is what Members of Congress were sent to Washington to do. Instead, Republicans continue to shill for the health insurance industry which is trying to kill meaningful reform. Republicans have proven once again they don't know how to say anything but “no.”

Our nation's families and businesses can no longer wait for good, affordable health care with the choice of a public health insurance option, and Senate Democrats clearly understand we have come too far to slow down now.

We look forward to working with Senate Democrats in the coming weeks to make a good bill even better.”

8:04 EST: Cloture passes 60-39. Debate will start after Thanksgiving.

7:57 EST: Voting continuing.

7:56 EST: Clerk reading cloture motion.

The question is: Is it the sense of the Senate that debate on the motion to proceed shall be brought to a close. Clerk is calling the roll.

Voting now.

7:55 EST: Vote starting 5 minutes early.

7:54 EST: Absence of a quorum noted by Reid, and the roll is being called. Vote coming soon!

7:44 EST: The American people want us to start over. All it would take is just one on the other side of the aisle to not end the debate, but change the debate.

And he's yielded.

Senator Harry Reid (D-NV) is up.

My friend, the minority leader, has had since Wednesday to read the bill. Obviously he hasn't done so.

We debate the right to live free of disease and death by giving health care for all. The road has started many times, never been completed. Merged bills have never been done before. We couldn't have got here without the help of many Senators.

As a matter of principle, that I respect, the senior Senator from Arkansas insisted we have time to read the bill. All Senators have now had ample time. That is why we are voting tonight.

I invite Republicans to join the right side of history. Around dining room tables, families are agonizing over what to sacrifice next to afford health care. Employers are wondering whether they can afford to provide health care. Americans need reform.

Debate is constant, but the only place where silence is evened considered is the Senate. Now, finally, we have the opportunity to bring this great deliberation to this body. That and nothing more is what this vote does.

A yes vote says this issue is important and the Senate should at least talk about it.

Some Republicans would like Americans to think voting to debate the bill is voting to pass the bill. Tonight's vote is only the beginning of debate. It's clear Republicans have no problem talking about health care on TV, at town hall meetings, on the radio, yet now that we have the legislation to debate, to amend, to build on, will they refuse to debate?

If we refuse to let the Senate do its job, what are we doing here? What do we fear? And who's voice to you speak for? In who's interest do you vote?

Certainly debating reform can't be more difficult than American deciding to pay their mortgage or medical bills. It can't be more upsetting than having an insurance company take away your coverage when you need it the most.

Kennedy once said let us not be afraid of debate or discussion, let us encourage it.

Don't be afraid of debate. It's our job. We Democrats stand ready to do what needs to be done. We welcome debate. The framers intended for debate here. Imagine if instead of debating historic GI bills, this body has stood silent. Instead of debate social security or medicare, the Senate voices had been still. Instead of debating to abolish slavery or give women the right to vote.

Don't try and silence a great debate over a great crisis. Don't say you ran and hid when given the chance to debate this issue. The right response to disagreement is discussion. Democracy is discussion. Let us debate our differences.

7:32 EST: Senator Mitch McConnell (R-KY) is up.

At a time when Americans are looking for jobs, the Chinese lecturing us about our debt, this bill costs 2.5 trillion the government doesn't have and can't afford.

It imposes punishing taxes on almost everyone. It raises premiums for 85% of Americans who already have insurance. It slashed Medicare by half a trillion dollars.

Anyone who votes "aye" tonight is voting for all of these things. It is a fact, a vote in favor of proceeding is a vote in favor of adding to the tax burden of Americans. A vote in favor is a vote to raise premiums, to deep cuts to Medicare, tells every American family sitting in a waiting room tonight that cost is not our concern. A vote in favor is a vote in favor of a spending binge that's leading to a massive long-term deficit.

If there were one Democrat, just one, who would say no tonight, none of this would happen. And then we could start over.

Under this bill, health care costs will go up, not down. 2000+ pages.

We don't want to end debate, we want to change it. Because once this bill is on the floor, the basic dimensions won't change. It's going to take 60 votes to change this bill. That means the bill that's introduced will fundamentally be the bill we'll be asked to pass sometime in the future. That is a fact.

7:25 EST: Senator Chris Dodd (D-CT) is up.

Recognizing Kennedy, who "is with us only in spirit."

Then asks why we're all watching C-SPAN on a Saturday evening.

Health care costs is the single biggest threat to our financial future. Never before has this body confronted directly this issue. Health care is our most basic need. No matter how much you make, your hopes and dreams, who you are, where you live, what your job is. In America, we should be able to get the care we need.

For too many health care has become our most basic fear. Can't see a doctor. Premiums skyrocket. You lie awake at night wondering what if you lose your job, or you get sick and find out your policy doesn't cover care you need, or it's canceled altogether.

I wish I could say those fears are irrational, but they're not. Our system is broken. People are losing their homes and dying because they get sick. This is not acceptable in our America. That's why we're here on a Saturday night.

We need all the ideas we can get to fix this. But if you've watched the debate over the last few days, nobody has stood up and said we should do nothing at all. Tonight's vote is nothing more than a choice between doing something and doing nothing. I urge my colleagues to join us.

Dodd has yielded.

7:17 EST: Senator Max Baucus (D-MT) is up.

"To be mature means to face, and not evade a crisis." Our health care system is in a crisis, and this crisis will not solve itself. We must face the crisis.

For years we've studied the issue. We've held nearly 70 hearings. We combined a bill and we've brought that combined plan to the Senate floor.

We have a bill that will put Americans, patients, and their doctors back into control. It will end harmful insurance industry practices. No more denials of care. No more hyping up rates for sick Americans. No more taking away health care if you're sick. No more lifetime or annual limits. If you pay your bill, insurance companies must provide you benefits. No more discrimination based on gender. Insurance companies must disclose the share of premiums that go to medical benefits. No longer will insurance companies get tax credits if they pay their CEOs too much.

Our bill is paid for, it will lower costs, and it will reduce the deficit.

Many are happy with their current plans. This bill will not change that. But too many others don't have access to quality insurance. Our bill will give people choice and know exactly what they're buying. Tax credits will help insure all Americans can afford health insurance.

Small businesses will also have access to tax credits, and will be able to spread their risk. And no longer will there be a separate congressional health plan.

Our bill will strengthen Medicare.

We hope to have a full debate. But we have the opportunity at last to face the crisis and show mature leadership.

And Baucus has yielded the floor.

7:10 EST: I believe passionately that we should defeat this bill. We need a bipartisan bill.

Before I came to the Senate, I was a small business owner, a shoe store. When someone said they couldn't afford a shoe, I didn't give them a sales pitch, I found a shoe they could afford. The people in America are complaining, we're showing them the shoe they can't afford.

We have a big decision to make tonight, that will have a lasting effect on our country. If we pass the motion to proceed, we'll debate it for a long time. America will be surprised at the time we waste when we could be doing jobs and the economy.

And Enzi has yielded.

7:00 EST: This bill creates mandatory spending in perpetuity. Talks about the debt growing and jobs being lost. Reid said this bill will be deficit neutral. But the real cost is hidden by implementing taxes first and spending later. When you extend it on out, you won't continue to cover those cost. So, disaster.

What would constitute fraud in the accounting world is being voted on. Medicare is going to go broke, and we're going to take billions from Medicare. If Washington accounting had to come under the same laws as private business, the administration would be in jail.

Now talking about the American people. Majority of Americans believe their costs will go up. The  American public isn't fooled. David Broder, the dean of Washington's journalists, said a recent survey said less than 1/5th believe that health reform will be deficit neutral, and a majority oppose the legislation. Broder said it was a "budget-buster."

The group of six couldn't come to any conclusions because the topic is so big. It's a thousand billion dollars. A billion is a thousand million.

6:50 EST: Senator Mike Enzi (R-WY) is discussing jobs and how health care represents a "massive government intrusion" into health care. Government will determine whether your health care costs too much. What services you should receive. Now he's bringing up the mammogram recommendations.

Saying this bill gets it wrong. Doesn't fix what's broken and leave what works. Senator Reid is trying to jam through a strictly partisan bill. Will increase the deficit and harm our jobs. No serious economist would say this bill creates jobs or helps our economy. Health care spending will increase, will not improve quality, or change the delivery system.

"The voices of August are still echoing, and coming from a vast majority."

Says there is a job-killing tax on business because they will have to provide health insurance. The health reform bill will threaten your jobs. Heritage foundation says this new job-killing tax will put 5 million at risk of losing their jobs.

——-

The bill will threaten our nation's jobs and economic growth, and increase our debt and deficit.

I'll be doing a little bit of liveblogging the Senate health care debate today leading up to the cloture vote at around 8 pm EST.

I'll be keeping up with the debate in the Senate (on C-SPAN 2), as well as trying to explain the Senate procedure and answer questions folks might have.

And with that, here we go…

Senator Harry Reid, the Majority Leader, has introduced the Senate's health reform bill. The Patient Protection and Affordable Care Act (H.R. 3590), is projected to reduce the federal budget deficit by $130 billion in the first 10 years. So how does the final Senate bill stack up against the House bill in the categories I discussed in my previous post ("House Health Bill Should Be A Model For The Senate")? Pretty much as expected.

Read more…

Last week, the case was made that Americans deserve a debate and a vote on health care:

Reasonable people can differ on the question of whether the health reform bill in the Senate is worth passing. Certainly, I'd strenuously disagree with people who believe health reform won't solve our country's health care crisis, or that the status-quo is worth preserving. However, it's hard to put together a reasonable argument that the Senate shouldn't at the very least talk about health care reform, or allow it to come up for a simple vote.

And indeed, America agrees. Health Care for America Now has released a poll showing that voters in Arkansas, Louisiana, and Nebraska overwhelmingly agree that the Senate should debate and have a fair, majority vote on health care.

Here's the relevant questions, via TPMDC:

"In the Senate, before a bill can be voted on, there must be a vote to allow it to be debated," reads the first survey question. "Regardless of whether you support or oppose the health insurance reform plan itself, do you believe that it should be debated on the floor of the Senate?"

In all states, voters overwhelmingly said the Senate health care reform bill should be debated on the floor. Nebraska: 88-9, Louisiana: 82-9, Arkansas: 84-11.

"Once a bill has been debated in the Senate, Senators must then vote on whether to allow the bill itself to be voted on," HCAN asks. "Regardless of whether you support or oppose the health insurance reform plan, do you believe that Senators should allow it to be voted on."

The results are similarly striking. Nebraska: 80-14: Louisiana: 77-14, Arkansas: 77-14.

The American people are looking forward to the opening of debate on the Senate health care bill tomorrow evening. There is no excuse not to give them what they clearly want: A debate and a vote on historic health reform.

NEWS

Health Care Vote Set For Saturday Night - Associated Press

The Senate has a test vote on a health care reform bill scheduled for Saturday night.

Reid, as Legislative Tactician, Takes Ownership of Health Care Overhaul - New York Times

Now it is Senator Harry Reid’s health care bill.

A Health-Care Pep Talk for Senate Dems - Time

With health reform's first test vote on the Senate floor less than 72 hours away, a platoon of top strategists — including pollsters Mark Mellman and Geoff Garin, incoming White House communications director Dan Pfeiffer and deputy White House chief of staff Jim Messina — met with Democratic Senators Thursday afternoon to impress upon those who might be wavering that everyone's political fate is now joined with the success or failure of President Obama's top domestic priority.

CBPP: Despite Insufficient Subsidies, Senate Health Care Bill Enormous Step Forward - TPM

The left-of-center Center for Budget and Policy Priorities, which was critical of a number of provisions in the Senate Finance Committee's health care proposal, has much, much kinder words for the full Senate bill that Majority Leader Harry Reid unveiled this week.

Insurance Industry Criticizes Senate Bill - New York Times

The insurance industry lobby is panning the Senate legislation.The lobbying group, America’s Health Insurance Plans, said in a statement on Thursday that the bill would increase costs for individuals, families and employers; reduce benefits for older Americans; and threaten employer coverage.

Sen. Lieberman Lies, Says "Public Option" Wasn't Part Of Presidential Campaign - Media Matters

Senator Joe Lieberman (I-CT) told Politico that no one mentioned a public option during the 2008 presidential campaign.  Unfortunately for him, historical fact directly contradicts his new conservative talking point.

Last night, the Senate unveiled their health care bill. You can read the full bill here [pdf], or the summery documents here.

On the whole, the Senate bill looks very much like the House health care bill. It ends insurance company abuses like denying care for those with pre-existing conditions and it sets benefit standards to make sure the coverage people receive - both on their own and through their employer - actually covers the care they need. It gives people the choice of a public health insurance option like the one in the HELP bill, though states would be able to opt-out of the public option if they passed a law saying so. And it sets up a health insurance "Exchange" that would provide tax credits (subsidies) to make health care affordable, as well as helping business afford health care for their employees.

On the budgetary front, the Senate bill would cost $849 billion over 10 years, and reduce the deficit by $127 billion over the same period. You can read the CBO's projections on the bill here [pdf].

Of course, there are major differences. Igor Volsky at the Wonk Room has a handy comparison chart:

	Senate Bill ($849 billion/10 years)	House Bill ($894 billion/10 years)
Individual Mandate	Yes, penalty of $750 by 2016 for those don’t purchase coverage. ($95 penalty in first year)	Yes, penalty of 2.5% of income for those who remain uninsured
Employer Mandate	Free rider provision. Employers would have to pay whichever is lower: $3,000 per every employee who receives a subsidy in the Exchange, or $750 for every employee (not just the subsidized worker).	Yes, employers who don’t’ offer coverage would pay a fee equal to 8% of their payroll
Medicaid Expansion	Up to 133% FPL. 100% federal funding for the first 3 years, then revert to Senate Finance language.	Up to 150% FPL
Subsidies	Between 133 – 400% FPL on sliding scale; spend 2%-9.8% of income on premiums	Between 133 – 400% FPL on sliding scale; spend 2%-12% of income on premiums
Public Option	National public plan, states can opt-out by 2014. Co-ops are also available.	Yes, HHS secretary negotiates rates
Financing	Excise tax on policies above $8,500 (individuals) and $23,000 (families), increases the payroll tax by .5% (increases to 1.95%) on individuals who earn more than $200,000 and families earning more than $250,000 a year, tax on insurers, pharmaceuticals, and medicare devices; Medicare savings	5.4% surtax on individuals earning > $500,000, couples earning more than $1 million; Medicare savings

The New York Times also has a great comparison.

Overall, the fact that Majority Leader Harry Reid did the right thing and listened to the American people by including things like a public health insurance option and a tax credit level that goes a long way towards making health care affordable means that this bill deserves a debate and a fair, majority up-or-down vote.

Republicans and the insurance companies will try to block this bill any way they can, even going so far as to recommend the Senate not even talk about this bill, let alone vote on it. These tactics only preserve the status quo. The American people deserve health care reform - reform that delivers affordable coverage, a choice of a public health insurance option, and fair financing - and this bill deserves a fair vote by the full Senate so it can meet the House bill in conference.

NEWS

Senate unveils health-care bill - Washington Post

Senate Majority Leader Harry M. Reid presented an $848 billion health-care overhaul package on Wednesday that would extend coverage to 31 million Americans and reform insurance practices while adding an array of tax increases, including a rise in payroll taxes for high earners.

Senate girds for historic debate on health bill - Associated Press

After months of maneuvering, the Senate stands at the brink of a historic battle over health care with President Barack Obama and his allies on one side and Republicans, outnumbered but unflinching, on the other.

Reid plan ups pressure on moderates - Politico

Senate Majority Leader Harry Reid unveiled his $848 billion health reform bill Wednesday to broad support from fellow Democrats — and the move quickly turned up the pressure on the last few wavering moderates to support the plan, which includes a sizable chunk of deficit cutting.

Reid rolling out big guns to push healthcare bill to 60 needed votes - The Hill

Senate Majority Leader Harry Reid has recruited an all-star team of former senators — Vice President Joe Biden, Tom Daschle and Ken Salazar — to push healthcare reform over the finish line.

Nelson: I'm Comfortable Being Lone Democrat To Derail Reform - Sam Stein

Ben Nelson, a key conservative Senate Democrats, said on Wednesday that he was pleased with the changes party leadership had made to health care legislation, specifically on matters of deficit reduction. But the Nebraska senator, whose vote has been elusive to pin down so far, said he would be comfortable being the lone Democrat to prevent the bill from overcoming a Republican filibuster.

Rising Prices of Drugs Lead to Call for Inquiry - New York Times

Democrats in Congress asked for two separate investigations of drug industry pricing Wednesday as they continue working on legislation to overhaul the nation’s health care system.

We've put together a video of the event out in Chicago, where small business owners from around the country tried to confront Karen Ignagni about her industry's job-killing ways. Ignagni, as usual, didn't show up to look these people in the eye. In her absence, they told their stories about how health care cost them jobs, and how reform would bring them back.

Watch:

Majority Leader Harry Reid seems to be moving away from taxing so-called "Cadillac" health care benefits as a means to pay for health reform, a tax that would eventually hit 40% of health care plans in the country. This is good news. As I've argued before:

Why tax the very people health care reform is supposed to help to pay for it?

The middle class doesn't need another tax hike. Health reform should indeed be paid for, but it should be paid for by those in society who can most afford it.

And Reid may be thinking about doing just that, financing reform the way the House did, with a surtax on the richest members in society.

The case for the surtax is clear: It will help millions, and it would only affect the very richest among us. The bill passed by the House would tax only individuals earning more than half a million dollars per year, 0.3% of the taxpaying population, or 422,510 households in America. In return, by 2013, 29,210,600 more uninsured people would gain coverage, rising to 36 million by 2019.

NEWS

Reid To Release Details Of Overhaul Plan To Caucus Today - CongressDaily

Senate Majority Leader Reid will share the details of his long-awaited healthcare overhaul bill with his Democratic Caucus today, according to his spokesman, Jim Manley.

Reid 'optimistic' about getting 60 votes on health bill - Washington Post

Senate Majority Leader Harry M. Reid scrambled Tuesday to lock down votes behind a health-care bill that he may present as early as Wednesday.

3 Democrats Could Block Health Bill in Senate - New York Times

Senator Ben Nelson, Democrat of Nebraska, says he is not sure he is ready to help a Democratic health care proposal clear even the most preliminary hurdle: gaining the 60 votes his party’s leaders need to open debate on the measure later this week.

Small Firms Scrapping, Scaling Back Health Plans - Associated Press

Faced with high health insurance costs, a North Carolina brokerage passed the buck on to its employees, a Texas public relations firm switched from group insurance to stipends, and a Missouri travel agency let its workers walk away instead paying for insurance.

How to pass a health bill fast - Politico

“Ping-pong” might be too difficult. Reconciliation, too partisan.

Today in Chicago, a message was delivered: Insurance company greed kills jobs, and we're not going to take it anymore.

Eight small business owners from around the country met at the Renaissance Hotel in downtown Chicago this afternoon, where the insurance industry was holding their national conference. They were there because they had sent a letter to Karen Ignagni, the insurance companies' top lobbyist, requesting a meeting:

Our businesses are facing dire choices- between being able to reinvest profits into the future of our businesses and meeting the ever-growing costs of health care coverage; between denying our employees coverage for needed medical services and having to cut their jobs entirely.

…

Ms. Ignagni, we are not simply opportunities for profit. We are people trying to provide for our families, contribute to our local economies, and make ends meet in this recession, who believe you should look us in the eye, hear our stories, and understand what you are lobbying against.

We plan to be at the Renaissance Hotel at noon on Tuesday and hope to see you there. Please understand that we are not interested in discussing these issues with a representative or spokesperson. With our livelihoods on the line, we feel the least you could do is participate in this meeting personally.

Ignagni didn't show up today.

She didn't have the courage to look these small business owners in the eye and hear their stories. People like Mecheall Williams from Louisiana, can't afford to stay afloat and give his employees insurance, and who worked to woo back one of his best employees even though he couldn't offer her health insurance, and a few weeks after she agreed to work for him again, got sick and had to go to the drive an hour to the hospital because she wasn't covered. Or Rick Poore from Nebraska, who said his skyrocketing health care costs are preventing him from purchasing another printing press for his t-shirt business, or giving his employees a raise they deserve. Or Alton Johnson from Arkansas, who may have to drop insurance coverage for his employees because his premiums keep rising.

Outside the Renaissance Hotel, five hundred people marched in solidarity with the small business owners inside - labor, community organizations, MoveOn.org local councils, doctors and medical students, and other health care supporters, all pulled together by Citizen Action of Illinois.

The small business owners, led by Wendell Potter, left the hotel and joined us outside when it was clear Ignagni wasn't going to show up. There, we heard the truth from a man who used to attend conferences like the one in Chicago today, but as a member of the insurance industry.

As Wendell has told the world over and over, the insurance companies are the biggest enemy of reform we have. They will do anything to keep health care in Wall Street's hands, and protect their obscene profits and bonuses. If that means killing jobs and their fellow Americans to do it, so be it.

Karen Ignagni couldn't even meet with the entrepreneurs she's putting out of business. But no matter. The insurance industry can't stop health reform from happening, especially the kind they fear the most - reform with a public health insurance option to give us a choice and to finally end their profiteering ways.

With reform, we'll be on our way to getting our economy and our lives back on track.