Voting was expected to start late Wednesday on a long list of Republican amendments to a "sidecar" bill making changes Democrats agreed to in the main legislation already signed by Obama. The main legislation, which Obama signed Tuesday, would extend coverage to 32 million uninsured Americans over 10 years with a first-time requirement for nearly everyone to carry insurance and would ban insurance company practices such as denying coverage to sick people.
Major components of the "fix-it" legislation include scaling back a tax on high-cost insurance plans opposed by labor unions, eliminating a special Medicaid deal for Nebraska, closing the coverage gap in the Medicare prescription benefit, and imposing higher taxes on upper-income earners.
But Republicans have other ideas. Sen. Tom Coburn, R-Okla., wants a vote on his amendment to prohibit coverage of Viagra for sex offenders. Sen. Judd Gregg, R-NH, wants savings from Medicare cuts plowed back into the health care program for seniors, instead of being used to expand coverage to the uninsured. Sen. Mike Enzi, R-Wyo., wants to gut penalties on employers whose workers wind up getting taxpayer-subsidized coverage.
Democrats are vowing to bat down the GOP amendments one-by-one, and also hope Republicans won't succeed with any procedural objections.
"All of the amendments we'll take care of. Points of order -- we'll see what they do," said Majority Leader Harry Reid, D-Nev.
"How serious could they be offering an amendment on Viagra for rapists?" Reid said.
Should the GOP prevail on any amendment or procedural point, the bill would have to go back to the House. Speaker Nancy Pelosi, D-Calif., has put members on notice they may be needed to vote on any changes that get through the Senate, though House leaders also say they don't expect any to be made.The fixes under consideration by the Senate were demanded by House Democrats as their price for passing the mammoth overhaul legislation over the weekend.
In another move to block action by Democrats, Republicans invoked obscure Senate rules that prevent hearings from taking place without unanimous consent, resulting in the cancellation of a number of routine hearings Tuesday and Wednesday.
Approval of the fix-it bill at the end of this week is virtually assured, since it's being debated under fast-track budget rules that allow passage with a simple majority instead of the 60 votes usually required for action in the 100-seat Senate. Democrats control 59 Senate seats.
That didn't stop Republicans, who are unanimously opposed, from using the floor debate that began Tuesday afternoon as an opportunity to repeat the accusations they've lobbed at Obama's health legislation for the past year: that it raises taxes, slashes Medicare and includes a burdensome and constitutionally questionable requirement for nearly all Americans to carry health insurance.
Although the battle may soon be over on Capitol Hill, opponents already have launched a campaign from the outside, with 13 state attorneys general suing Tuesday to overturn the legislation on grounds it is unconstitutional.
And Senate Minority Leader Mitch McConnell, R-Ky., served notice Tuesday of the GOP's continued campaign against the legislation going into the fall election season. "The slogan will be 'repeal and replace,' 'repeal and replace,"' McConnell said.
Obama planned to sign an executive order Wednesday affirming existing law against federal funding of abortions, except in cases of rape, incest or danger to the woman's life. A critical bloc of anti-abortion Democrats in the House had pledged to vote against the health care package unless given greater assurances that it would not amend current law.
In a last-minute deal, Obama agreed to issue the order to get their votes.