Senate health bill clears final hurdle

WASHINGTON (Reuters) - Senate Democrats cleared the last 60-vote hurdle on U.S. President Barack Obama's healthcare overhaul on Wednesday, virtually ensuring final passage of its version of the biggest health policy changes in four decades.

For a third straight day, Democrats mustered the 60 party-line votes needed to keep the healthcare bill on track for passage on Thursday over unified Republican opposition.

The vote on final approval, which requires a simple majority in the 100-member Senate, is slated for 7 a.m. EST (1200 GMT) on Christmas Eve on Thursday.

Passage in the Senate would set up potentially tough negotiations in January to iron out differences with the House of Representatives, which approved its own version on November 7.

"It's been a long, hard road for all of us," Senate Democratic leader Harry Reid told reporters. "We stand a few short steps from the most significant finish line we've had in Congress for many decades."

The overhaul, Obama's top legislative priority, would lead to the biggest changes in the $2.5 trillion U.S. healthcare system since the 1965 creation of the government-run Medicare health program for the elderly.

The bill would extend health coverage to more than 30 million uninsured -- covering 94 percent of all Americans -- and halt industry practices such as refusing insurance to people with pre-existing medical conditions.

It also would require most Americans to have insurance, give subsidies to help some pay for it, and create state-based exchanges where the uninsured can compare and shop for plans. Many of the major provisions would not kick in until 2014.

Passage of the bill is critical for Obama, whose political standing and legislative agenda could hinge on its success. Obama's public approval ratings have dipped to about 50 percent in many polls as the acrimonious debate dragged on.

"Considering how difficult the process has been, this is an end product that I am very proud of and is greatly worthy of support," Obama told National Public Radio, dismissing liberals' concerns that compromises with Senate moderates had weakened the final version.

Democrats hope to complete House-Senate negotiations and send the bill to Obama before his State of the Union message in late January, although previous deadlines in the healthcare debate have been missed repeatedly.

TOUGH NEGOTIATIONS

The House-Senate negotiations could be difficult, with clashes looming on a government-run insurance plan, which is in the House bill but not the Senate one, and competing approaches on taxes and the use of federal funds to pay for abortions.

In the NPR interview, Obama said he liked the Senate's proposed tax on high-cost "Cadillac" insurance plans even though it has been criticized by labor unions and some House liberals.

"Taxing Cadillac plans that don't make people healthier, but just take more money out of their pockets because they're paying more for insurance than they need to, that's actually a good idea," he said.

Republican critics say the bill is an expensive and heavy-handed intrusion in the healthcare sector that will drive up costs, increase the budget deficit and reduce patients' choices.

The nonpartisan Congressional Budget Office estimated the Senate bill will cut the federal deficit by $132 billion over 10 years, but critics argue the expected revenue increases and cost savings may never materialize.

"Tomorrow, the Senate will vote on a bill that makes a bad situation worse," Republican Senator Charles Grassley said. "This bill slips rapidly down the slippery slope of more government control of healthcare."

The healthcare fight has consumed Congress for months, sparking bitter political brawling and a grueling schedule of late-night and early-morning Senate votes this week to finish work by a Christmas deadline set by Democrats.

Obama said he would delay his planned Hawaiian vacation, scheduled to start on Wednesday, to wait for passage.

(Editing by Arshad Mohammed and Paul Simao)