Reid pulls together Senate Dems to take huge step forward on health reform

The Senate will soon begin a historic debate on healthcare reform after a 60-39 vote during a rare Saturday session.

The outcome was clear hours before the vote after two centrists announced they would vote with Senate Majority Leader Harry ReidHarry ReidNearly 400 House bills stuck in Senate limbo Puerto Rico debt relief faces serious challenges in Senate McCain files B amendment to boost defense spending MORE (D-Nev.) on his motion to proceed. Republicans unanimously opposed the vote, with George Voinovich (Ohio) absent.

Although the Senate’s action was a mere procedural vote, it represented the end of weeks of anxiety for Reid while foreshadowing difficult legislative and political battles ahead. Applause from spectators greeted the final tally announced by Sen. Chris Dodd (Conn.), while Democrats including Reid, Daniel Inouye (Hawaii), Carl LevinCarl LevinCarl, Sander Levin rebuke Sanders for tax comments on Panama trade deal Supreme Court: Eye on the prize Congress got it wrong on unjustified corporate tax loopholes MORE (Mich.) and Tom HarkinTom HarkinDo candidates care about our health or just how much it costs? The Hill's 12:30 Report Mark Mellman: Parsing the primary processes MORE (Iowa) exchanged hugs and slaps on the back. Outside the Senate, a crowd of about 50 people greeted senators with cheers and applause as they left the building.

"Ted would be happy," Reid said at the press conference afterward, in reference to the late Sen. Edward Kennedy's (D-Mass.) efforts to push health reform.

"We have the momentum that is going to keep this process moving," Reid said. "Now is the time to make sure all Americans have access to affordable healthcare."

"We're rounding third and we're heading home," Harkin said.

The Obama administration swiftly responded to the pre-Thanksgiving action. "The president is gratified that the Senate has acted to begin consideration of health insurance reform legislation," White House press secretary Robert Gibbs said in a statement.

When Congress returns from its week-long holiday break, the Senate will begin process of actually debating and amending the legislation Reid introduced Wednesday. The House passed its version of healthcare reform earlier this month.

Sen. Ben Nelson (D-Neb.), one of three centrist Democrats whose vote was in doubt until Friday, said he expected to talk to Reid frequently over the Thanksgiving recess. He said he had given Reid a two-page document that listed parts of the bill that needed to be changed to win his final vote, though he said a number of the issues were minor.

"There will be a lot of discussions about what might get enough votes to pass the next threshold," Nelson said. "E-mails will be going back and forth, and phone calls as well."

Nelson announced his support for the motion on Friday, while Sens. Mary LandrieuMary Landrieu oil is changing the world and Washington Ex-Sen. Kay Hagan joins lobby firm Republican announces bid for Vitter’s seat MORE (D-La.) and Blanche Lincoln (D-Ark.) announced their support on Saturday.

Sen. Jay RockefellerJay RockefellerLobbying world Overnight Tech: Senators place holds on FCC commissioner Overnight Tech: Senate panel to vote on Dem FCC commissioner MORE (D-W.Va.) said he wasn't worried about building on what ever momentum was created by the vote. He noted that a few weeks ago, it would not have been predicted that Lincoln would vote in favor of a motion to proceed on a bill that included a public insurance option. "Things change," said Rockefeller, a strong supporter of the public option.

Democrats can not count on 60 votes to pass their healthcare bill as written, partly because of objections to the public option from several senators including Nelson, Lincoln, Landrieu and Sen. Joe Lieberman (I-Conn.).

Lieberman reiterated his opposition to a bill that includes a public option after Saturday's vote, while Nelson said he opposed a public option that is run by a centralized entity in Washington.

The bill would spend $848 billion over 10 years to extend insurance coverage to 31 million more people while cutting the federal budget deficit by $127 billion, according to the Congressional Budget Office. In addition, the measure would cut Medicare spending by more than $400 billion, raise more than $370 billion in taxes and enact sweeping health insurance regulations.

There was little drama when the Senate clerk began the roll call. Earlier in the day, the last two centrist Senate Democratic holdouts cleared up any lingering doubt about the outcome of the vote by taking to the Senate floor to announce they would allow the debate on healthcare reform to continue.

Sen. John McCainJohn McCainTrump should apologize to heroic POWs McCain urges sports leagues to return 'paid patriotism' money Senators to Obama: Make 'timely' call on Afghan troops levels MORE (R-Ariz.) poked fun at the mock-suspense, joking in a loud whisper that could be heard in the press gallery, "What's going to happen?" He later described the vote, with sarcasm, as the one of the most dramatic in the Senate's history.

The last few minutes of floor debate on Saturday night's vote were filled with dueling speeches by Minority Leader Mitch McConnellMitch McConnellIn House GOP, Ryan endorsement of Trump seen as inevitable McConnell: Trump White House will have ‘constraints’ Nearly 400 House bills stuck in Senate limbo MORE (R-Ky.) and Reid. McConnell challenged "just one" Democrat to oppose the motion, speaking sternly and occasionally raising his voice to emphasize the phrase "just one." Reid spoke calmly, urging "my Republican colleagues to join us on the right side of history."

Senators voted unusually — by roll-call voice vote, sitting at their desks, surrounded by a crowd of spectators estimated by Senate staffers at more than 500. On the floor, Democratic Conference Vice Chairman Charles SchumerCharles SchumerPuerto Rico debt relief faces serious challenges in Senate Overnight Healthcare: House, Senate on collision course over Zika funding Ryan goes all-in on Puerto Rico MORE (N.Y.) patrolled the aisles, while Independent Sen. Joe Lieberman (Conn.) spoke quietly with Maine Republican Susan CollinsSusan CollinsGOP lawmaker: 'Republicans were wrong’ to block Garland Senate passes broad spending bill with .1B in Zika funds Senators unveil bill to overhaul apprenticeship programs MORE.

Democrats had to pull out the stops to produce their entire caucus: Max BaucusMax BaucusWyden unveils business tax proposal College endowments under scrutiny The chaotic fight for ObamaCare MORE (Mont.) flew to Washington from his mother's sickbed, and a frail Robert Byrd (W.V.) was wheeled onto the floor in his usual wheelchair.

The three centrist Democrats had withheld their support throughout the process and since Reid introduced the final version of the Senate's healthcare reform bill on Wednesday. Among the trio, Lincoln is in the most precarious position because she must stand for reelection next year in a state that favored McCain over Obama in last year's presidential contest.

The healthcare reform bill does not face an easy path down Pennsylvania Avenue to President Barack ObamaBarack ObamaObama: 'Stop to reflect' on Memorial Day John Bolton slams Obama’s ‘shameful apology tour’ Miss. governor to join lawsuit against Obama transgender policy MORE’s desk, however. Rifts between the liberal and centrist wings of the Democratic Party were clearly evident.

The specter looms of a bloody intra-party fight over whether to create a government-run public option insurance program to compete with private plans. Though far from the only issue dividing Democrats, the public option has proven the hardest problem for the party to overcome.

Liberals steadfastly maintain that the public option is an essential component of the legislation and is needed to promote competition in the insurance market and provide consumers with an alternative to private coverage. As the healthcare debate has progressed this year, liberals have seen the public option continually scaled back; the Senate version, for instance, would allow states to opt out. The House-passed bill does not include the opt-out provision.

But if the Democrats want to hold on to the support of Landrieu, Lincoln and Nelson, they likely will have to bend even further. Each senator made plain their opposition to the public option in Reid’s bill – and their willingness to oppose the legislation when it comes up for a final vote, or even join a Republican filibuster to kill the bill.

“Let me be perfectly clear: I am opposed to a new government-administered healthcare plan as a part of comprehensive health insurance reform and I will not vote in favor of the proposal that has been introduced by Leader Reid as it is written," Lincoln said on the Senate floor, echoing similar sentiments previously expressed by Landrieu and Nelson.

Nelson explicitly threatened to filibuster the bill when the debate comes to an end. “I support parts of the bill and oppose others I will work to fix. If that's not possible, I will oppose the second cloture motion — needing 60 votes — to end debate, and oppose the final bill,” he said in a statement Friday. Nelson also is the strongest critic among Democrats of the abortion provisions in the bill, which he says are too weak to prevent taxpayer dollars from being spent on abortion services.

Discarding the public option, however would create even bigger problems among liberal Democrats, who outnumber their centrist colleagues in the Senate and in the House, said Sen. Sherrod BrownSherrod BrownSanders: Clinton with a moderate VP would be a 'disaster' The Hill's 12:30 Report Clinton urged to go liberal with vice presidential pick MORE (D-Ohio), a vocal champion of the public option. Brown expressed optimism, however, that Democrats would come together in the end.

“Fifty-five Democrats want the public option and I don’t believe that any Democrats want to bring this bill down on a procedural vote, in the end. I don’t think they want to be on the wrong side of history,” Brown said. The centrists, he said, “ will realize that they’re part of a team and this country needs this bill.”

The centrists are in talks with Democratic Sens. Chuck SchumerCharles SchumerPuerto Rico debt relief faces serious challenges in Senate Overnight Healthcare: House, Senate on collision course over Zika funding Ryan goes all-in on Puerto Rico MORE (N.Y.) and Tom CarperTom CarperFinancial industry spars with retailers over data breach bill Week ahead: Cyber Command in the spotlight Lawsuit exposes M cybertheft through banking software MORE (Del.) on a new public option compromise, according to Reid.

Jordan Fabian contributed to this report

This story was updated at 8:40 p.m.