WASHINGTON The U.S. Senate backed a plan on Thursday to make it easier for women to get preventive health screenings such as mammograms as it cast its first votes on a sweeping healthcare overhaul.
On the fourth day of a sometimes bitter debate, the Senate voted 61-39 for an amendment to improve access to women's screenings for diseases like cancer and diabetes by eliminating insurance co-pays and deductibles for them.
The move follows last month's controversy over federal task force recommendations that women delay regular mammograms for breast cancer and from a doctors' group that women delay pap smears for cervical cancer.
"This amendment makes sure that the insurance companies must cover the basic preventive care that women need at no cost," said Democratic Senator Barbara Mikulski, sponsor of the amendment.
On a 58-42 vote, Democrats also backed the bill's cuts of more than $400 billion in the Medicare health program for the elderly. Republicans said the cuts would mean fewer benefits for seniors, but Democrats said they would eliminate waste and improve the program's fiscal health.
The votes broke a two-day Senate stalemate that had stalled progress on the healthcare bill, President Barack Obama's top domestic priority. On Wednesday night, party leaders finally agreed on a timeline for the votes.
Senate Democratic leaders have vowed to pass the bill by the end of December but Republicans want to prolong the debate into the 2010 campaign season in hopes public opposition will grow.
The Senate bill is designed to rein in costs, expand coverage to about 30 million uninsured Americans and halt insurance practices such as denying coverage to those with pre-existing medical conditions.
The House of Representatives passed its version last month. If the Senate passes a bill, the two will have to be reconciled in January and passed again by each chamber before being sent to Obama for his signature.
The votes occurred as Senate Democrats searched for compromises on the two toughest issues remaining -- the government-run public insurance option and language barring the use of federal funds for abortions.
'MANY DIFFERENT CONVERSATIONS'
"There are many different conversations underway," said Dick Durbin, the No. 2 Senate Democrat.
Senate Democratic leader Harry Reid faces a difficult task keeping his coalition together. Democrats control 60 votes in the 100-member Senate -- the number needed to overcome Republican hurdles -- but some moderate Democrats have objected to the public option and abortion provisions.
Democratic Senator Tom Carper is leading talks with moderates to find a compromise on the public option, focusing on plans run by non-profit boards rather than the government in states that lacked affordable insurance.
Democratic Senator Ben Nelson said he will offer an amendment with the stricter abortion language included in the House version of the bill. He could oppose the overhaul if the amendment is rejected, he said.
"I've always found him to be a reasonable man," Reid said when asked about Nelson.
National polls show opinion is divided on the bill. A Thomson Reuters poll on Thursday found most Americans back a government-run public insurance option in the plan but doubt if the bill will improve their healthcare in the short term.
The first few days of the debate featured heavy political skirmishing designed to appeal to women and the elderly, two big blocs of voters that polls show have concerns about the measure.
Republican Senator John McCain, sponsor of the amendment to strip the Medicare cuts out of the bill, attacked the lobbying group for seniors, AARP, for backing the healthcare overhaul and defending the cuts.
"Cut up your AARP cards and send them back," McCain urged members of the group.
On the healthcare screenings for women, the Democratic amendment repudiated Republican charges the task force recommendations on mammograms were a precursor of the type of healthcare rationing the overhaul would create.
On a 59-41 vote, the Senate rejected a related Republican amendment on screenings that would have ensured the task force recommendations could be ignored. Democrats said it was "too tepid" and would not remove cost barriers to the services.