Healthcare bill gains ahead of US Senate test

A broad healthcare overhaul moved closer to clearing its first US Senate hurdle when one of two wavering Democrats said she would vote to begin debate on the landmark legislation.

Senator Mary Landrieu ended days of uncertainty when she said she would support a procedural motion on Saturday to open debate to reform the US$2.5 trillion healthcare system -- the bill's first crucial test vote.

The healthcare overhaul, President Barack Obama's top domestic priority, would expand coverage to millions of uninsured and bar insurance practices like denying coverage to those with pre-existing conditions.

A surprise loss in the vote would be a huge setback for Obama, undermining his legislative agenda and political standing less than a year into his term.

Democrats need 60 votes to approve the motion in the 100-member Senate and have no margin for error -- they control exactly 60 votes and Republicans are united in opposition.

Landrieu and Blanche Lincoln, moderate Democrats from conservative Southern states where the overhaul is unpopular, had been the last uncommitted Democrats on moving the bill to the floor. Lincoln still has not announced her stance.

Landrieu said she wanted the debate to begin but she did not commit to supporting the final bill. She said she wanted changes to make healthcare more affordable, ease the burden on small businesses and rein in the growth of costs.

"It is a vote to move forward to continue the good and essential and important and imperative work that is underway," she said on the Senate floor.

"I've decided that there are enough significant reforms and safeguards in this bill to move forward but much more work needs to be done."

Republicans have condemned the measure as a costly and heavy-handed government intrusion in the private sector that would raise insurance premiums and increase taxes.

'A BIG VOTE'

Republican Senator Judd Gregg, appearing on Saturday on MSNBC, said almost all Senate bills that clear this hurdle eventually pass. "So this is a big vote, this is a real vote. This isn't about debating the bill."

Asked if Democrats had the votes, Gregg said "most likely."

Senate Democratic leader Harry Reid, speaking on the Senate floor, said, "All we're asking today is have a debate on it. Why would anybody be afraid in the greatest debating society supposedly in the world, to debate healthcare?"

If the Senate takes up the bill, the debate is expected to begin on November 30 and last at least three weeks, making it unlikely Obama can sign a final bill by the end of the year.

Any differences between a Senate bill and the version passed earlier this month by the House of Representatives would have to be reconciled -- a potentially difficult task -- before a final bill can be voted on again in both houses and sent to Obama.

The legislation would spark the biggest changes in the healthcare system -- which accounts for one-sixth of the US economy -- since the 1965 creation of the Medicare government health insurance plan for the elderly.

The Senate bill would require all Americans to buy insurance and would set up exchanges where they could choose among various options. It would offer subsidies to help low-income workers pay for the coverage.

Republicans have criticized its tax increases to help pay for the expanded insurance coverage. It would raise the Medicare payroll tax on high-income workers, which is used to finance Medicare, and impose a tax on high-cost "Cadillac" insurance plans.

- Reuters