12/31/09 HC Reform Update by Mark Sanna: What happens when you spend months crafting a big piece of legislation, making the compromises and deals necessary to win passage in Congress? You get something like the 2009 (soon to be 2010) healthcare reform bill, a hulking 2,000-page piece of legislation designed to the appeal to no one – or rather, designed to be just acceptable enough to appeal to just enough politicians to pass.

12/30/09 HC Reform Update by Mark Sanna: Prominent conservatives are calling for Republicans to campaign in 2010 on a pledge to repeal the Democrats' health care legislation. Meanwhile, Democrats have yet to even pass the bill. Before the bill is ready for the President’s signature, a conference committee made up of members of the House and Senate must merge the two health care bills. Then, each chamber will have to pass the new version of the bill.

12/29/09 HC Reform Update by Mark Sanna: At the heart of health care legislation is a paradox. Both the Senate and House bills squeeze a half-trillion dollars from Medicare over the next 10 years to offset the cost of covering the uninsured. At the same time, this money would shore up the Medicare trust fund to cover older Americans in the future. How can Medicare savings mean both more money available to spend now and more money to spend later?

12/28/09 HC Reform Update by Mark Sanna: Many major provisions in the health care legislation would not begin until 2013 under the House bill, and 2014 under the Senate bill. On the flip side, many of the new taxes and fees that will help pay for the legislation would take effect much sooner. For this reason, some Republicans have criticized the bill as akin to legislation on a layaway plan: pay now for benefits later.

12/24/09 HC Reform Update by Mark Sanna: Health care reform legislation is likely to be approved Thursday morning, with the Senate divided on party lines — something that has not happened in modern times on so important a shift in domestic policy or on major legislation of any kind. Many senators said the current vitriol, which continued on the floor on Wednesday with a fight over when to cast the final health care vote, was unlike anything they had seen.

12/23/09 HC Reform Update by Mark Sanna: The Senate voted 60 to 39 early Tuesday on 3 steps leading up to a final vote Thursday morning on sweeping health care legislation. Democrats began celebrating their imminent victory with a raucous news conference. Republicans said that they were still searching the bill for unexpected provisions and that they would not agree to hold the last vote any sooner than Christmas Eve.

12/22/09 HC Reform Update by Mark Sanna: Nancy Pelosi, Harry Reid, and the White House face major challenges in merging the House and Senate health bills. They must find a way forward on abortion even as they confront other big differences between the bills, including how to pay to expand insurance coverage to more than 30 million Americans and whether to include a government-run plan to compete with private insurers.

12/21/09 HC Reform Update by Mark Sanna: After a long day of acid, partisan debate, Senate Democrats held ranks early Monday in a dead-of-night procedural. The vote was 60 to 40, a tally that is expected to be repeated 4 times as further procedural hurdles are cleared in the days ahead, and then once more in a dramatic, if predictable, finale tentatively scheduled for 7 p.m. on Christmas Eve.

12/20/09 HC Reform Update by Mark Sanna: Thirty million people without health insurance stand to gain coverage under a deal announced on Saturday by Senate Democrats. To get the 60 votes needed to pass their bill, Democrats scrapped the idea of a government-run public insurance plan and replaced it with a proposal for nationwide health plans, which would be offered by private insurers under contract with the government.

12/18/09 HC Reform Update by Mark Sanna: The White House and Senate Democratic leaders seem willing to give Senator Ben Nelson, Democrat of Nebraska, just about anything he wants to win his support of major health care legislation. Anything, that is, but the item at the top of Mr. Nelson’s wish-list: air-tight restrictions on insurance coverage for abortions. The bid to win Mr. Nelson’s support has become a race against the clock. The Senate majority leader, Harry Reid of Nevada, has developed plans for a series of votes beginning at 1 a.m. Monday and round-the-clock Senate sessions intended to meet his deadline of completing the health care bill before Christmas.

12/17/09 HC Reform Update by Mark Sanna: Healthcare reform came to a standstill on the 17th day of Senate floor debate on Wednesday with the request by Sen. Tom Coburn (R-OK) to read out Sen. Bernie Sanders’ (I-VT) 767-page amendment supporting a single-payer system on Wednesday. While Sanders later withdrew the amendment, which stopped the reading, the action’s impact on Democrats was palpable.

12/16/09 HC Reform Update by Mark Sanna: The scuttling of the public option from the Senate health care bill has infuriated organized labor and left their leaders in a bind about how to proceed. Top labor officials of several unions are meeting with their executives today, and some plan to on Thursday, to devise their strategies, now that the Senate has dropped the public option, a government-run health insurance plan to compete with private insurers.

12/15/09 HC Reform Update by Mark Sanna: With the Senate facing a potential deadline next week for voting on its health care legislation, interest groups have unveiled a raft of television commercials — most of them arguing against the bill. A group called the 60 Plus Association, which bills itself as a conservative alternative to AARP, is spending $1.7 million to run commercials for eight days starting Monday.

12/14/09 HC Reform Update by Mark Sanna: In a surprise setback for Democratic leaders, Senator Joe Lieberman, independent of Connecticut, said on Sunday that he would vote against the health care legislation in its current form. But on Sunday, Mr. Lieberman told the Senate majority leader, Harry Reid, to scrap the idea of expanding Medicare and abandon any new government insurance plan or lose his vote.

12/12/09 HC Reform Update by Mark Sanna: Democratic leaders hit a rough patch Friday in their push for sweeping health care legislation, as they tried to fend off criticism of their proposals from a top Medicare official, Republicans and even members of their own party. Slogging through a 12th day of debate on the legislation, the Senate found itself at an impasse over a proposal to allow imports of low-cost prescription drugs from Canada and other countries.

12/10/09 HC Reform Update by Mark Sanna: Tuesday night, Senate Democrats announced a tentative agreement, retreating from the proposed government-run insurance plan or public option, which is opposed by some centrists, and taking shelter in some more familiar programs, including an expansion of Medicare. The agreement calls for creating a new menu of national insurance plans, modeled after those offered federal workers, including members of Congress.

12/9/09 HC Reform Update by Mark Sanna: The Senate has rejected an anti-abortion amendment to a healthcare bill. The Senate majority leader, Harry Reid, said Tuesday night that he and a group of 10 Democratic senators have also reached “a broad agreement” to resolve a dispute over a proposed government-run health insurance plan, which has posed the biggest obstacle to passage of health care legislation. Mr. Reid refused to provide details.

12/8/09 HC Reform Update by Mark Sanna: In return for concessions on their proposal for a new government-run health insurance plan, liberal Democratic senators pushed Monday for expansion of Medicare and Medicaid and more stringent federal regulation of the insurance industry. Liberal and centrist Democrats are trying to work out a deal on the proposal for a public option.

12/7/09 HC Reform Update by Mark Sanna: The upcoming Senate vote on the pro-life Hatch-Nelson amendment to the health care bill has been called into question as an audio recording has surfaced with Wisconsin Senator Herb Kohl vowing to vote against abortion in the health care bill. The vote is expected as early as Monday.

12/5/09 HC Reform Update by Mark Sanna: Senate Democrats on Friday beat back Republican efforts to strip out two major provisions of their health care bill that would make deep cuts in payments to private Medicare Advantage plans and create a new long-term-care insurance program.

12/4/09 HC Reform Update by Mark Sanna: The Senate voted Thursday to require health insurance companies to provide free mammograms and other preventive services to women, and it turned back a Republican challenge to Medicare savings that constitute the single largest source of financing for the bill. With the votes Thursday, the Senate broke a logjam over how to handle the first amendments to the health care bill. But Senate Democrats still face a long road ahead.

12/3/09 HC Reform Update by Mark Sanna: Senate leaders of both parties said they would vote Thursday on four proposals dealing with two issues: how to guarantee additional health benefits for women and how to squeeze nearly half-trillion dollars from Medicare over 10 years without adversely affecting older Americans. Democrats offered one proposal to cover a wide range of screenings and preventive health services for women.

12/2/09 HC Reform Update by Mark Sanna: The Senate health care debate has just begun and already there is evidence that it is going to be a slog. For much of Tuesday, Senate Democrats had predicted that there would be an early evening vote on the first amendment to the big health care legislation — a proposal by Senator Barbara Mikulski, Democrat of Maryland, to require insurers to provide a package of enhanced health benefits to women, with no co-payments.

12/1/09 HC Reform Update by Mark Sanna: The Congressional Budget Office said Monday that the Senate health bill could significantly reduce costs for many people who buy health insurance on their own, and that it would not substantially change premiums for the vast numbers of Americans who receive coverage from large employers.