After months of debate and meetings, the Senate Finance Committee voted to move its health-care bill on to the full Senate 14-9, with full Democrat support and one Republican crossing party lines. 

“This is our opportunity to make history, said Finance Committee Chairman Max Baucus before the final five hours of debate. “Our actions here will determine whether we extend better health care to more Americans.”

After weeks of speculation, Democrat Senator Blanche Lincoln, a moderate from Arkansas facing a strong primary opponent, and Republican Senator Olympia Snowe voted to report the bill out of the Finance Committee.(vote break down).

“People do have concerns about what we will do with reform.  But at the same time, they want us to continue working,” said Senator Snowe.  “That is what my vote to report this bill out of committee here today represents.  It's to continue working the process.”

Though Snowe cautioned “my vote today is my vote today.  It doesn’t forecast what my vote will be tomorrow.”

Despite hundreds of amendments and pages of technical changes, committee liberals and conservatives maintained their basic objections to the end.

“This bill is already moving along a slippery slope of more government control of health care,” said Senator Chuck Grassley, the ranking committee Republican and a member of the bipartisan Gang of Six that negotiated over the summer.

“We are riding hell for leather into a health-care box canyon, full of spending quicksand, cactus tax hikes, policy briar patches, complete with CMS regulatory scorpions, rattlesnakes and bad news bears,” said Senator Pat Roberts, with his expected objection, yet unexpected analogy. 

“The status quo that some of our colleagues are trying to protect is a health insurance Ponzi Scheme, where insurers collect ever-increasing premiums from families and do everything in their power to minimize their own risk by denying them claims while finding a way to pay benefits only when absolutely necessary,” said Senator Bob Menendez.

“Health insurance companies have been laughing all the way to the bank for years while Americans suffer,” said Senator Jay Rockefeller, in another defense of a strong government-run option. 

The key concern among Democrats and Republicans is whether the Finance bill decreases the rate of health-care costs, known as “bending the cost curve.” 

Committee members questioned the Douglas Elmendorf, director of the nonpartisan Congressional Budget Office, and Chief of Staff to the Joint Committee on Taxation Thomas Barthold on the bill’s cost curve. 

The budget experts said they had not conducted a thorough analysis of the bill’s effects on the cost curve and said some provisions would increase costs, others would decrease their growth.  Barthold pointed to the bill’s 40 percent tax on insurance companies on their group plans worth more than $21,000 as a way to reduce increases in spending.

“The excise tax on high-cost plans has the incentive for individuals and employers to look to make smarter choices, or different choices,” said Barthold.  “So to the extent that smart choices would tamp down future health spending, that would be a factor in that direction.”

Republicans seized on the lack of a thorough analysis to slam the Finance Committee proposal. 

“Our CBO scorekeeper was not given enough time to determine the premiums will increase, or decrease, under this bill, or whether national health spending will increase or decrease,” said Senator Jim Bunning.  “Wasn't that the major selling point in this bill?”

With Tuesday’s vote, the bill has moved into the hands of Senate Majority Leader Harry Reid.  He will merge this version with a bill reported out of the Senate Committee on Health, Education, Labor and Pensions, known as the HELP Committee bill.

There are significant discrepancies between the two bills, most notably the HELP bill’s inclusion of a government-run plan and provisions allowing insurance companies to charge older Americans more in premiums based on age.

Senate Democrat leadership must decide which provisions make it into the full Senate bill.

“The real bill is currently being written behind closed doors in the dark corners of the Capitol and the White House,” charged Senator Orrin Hatch.   

Once Senate leaders produce an initial proposal, senators will change and debate it the coming months.