http://news.bbc.co.uk/1/hi/world/americas/8429345.stm

US senators have passed the final Senate version of a historic healthcare reform bill.

The bill aims to cover 31m uninsured Americans and could lead to the biggest change in US healthcare in decades.

The bill's passage is a major boost to President Barack Obama, who has made reform a priority. He rejects claims that compromise has left it weakened.

However, it must still be reconciled with more expansive legislation passed by the House of Representatives.

The Senate bill was adopted by 60 votes to 39, with senators voting along party lines.

BILLS: KEY DIFFERENCES Public option: House yes, Senate no Abortion: House bill has stricter restrictions on federal funding How to pay for reform: House relies heavily on income tax increase for high-earning Americans; Senate bill taxes high-cost health insurance plans Healthcare bills compared Send us your comments Q&A: US healthcare reform US and Europe compared

Fifty-eight Democrats and two independents backed the legislation, while Republicans voted unanimously against it.

"This is a victory for the American people," Democratic Senate Majority Leader Harry Reid is quoted by Reuters as saying after the vote.

Top Republican Senator Mitch McConnell responded: "The fight is long from over.

"My colleagues and I will work to stop this bill from becoming law."

The bill's passage in an early morning vote on Christmas Eve follows months of political wrangling and 24 days of debate in the Senate chamber.

Opposition Republicans say the legislation is expensive, authoritarian and a threat to civil liberties and accuse the Democrats of rushing it through.

Delaying tactics

Healthcare reform has been the key domestic policy of Mr Obama's administration but finalising the details of the proposed bills has been a lengthy and complex process.

MARDELL'S AMERICA I suspect it is all over bar the shouting, but there will be an awful lot of shouting before we're done Mark Mardell, BBC North America editor Read Mark's thoughts in full

On Wednesday, the bill passed the last of three procedural votes in the Senate, with Democrats collecting the 60 votes needed to bring an end to Republican delaying tactics and vote on the final bill.

The process of reconciling the Senate's legislation with the House bill - passed in November - is expected to begin in mid-January.

Under the Senate bill, most Americans would have to have health insurance.

Private insurers would be banned from refusing to provide insurance because applicants had pre-existing medical conditions.

The House version still includes a public option and also differs on how to pay for the reform.

The non-partisan Congressional Budget Office estimates that efficiency savings made as a result of the Senate healthcare reform bill will cut the federal deficit by $132bn (£83bn) over 10 years, but critics say the predicted savings may never materialise.

I nearly threw up when I heard him blandly spouting those clichés this morning. Reid is such a grey, bloodless shade of a man.

The conference committee will adopt the Senate's excise tax and there will be no PO. Hopefully, and I think this will occur, the conference committee will adopt the House's national insurance exchange-this is the key provision. Yes, it is an imperfect bill, but it is preferable to the status quo.

Whilst I support national healthcare for the USA, I am beginning to question the competence of their government to pull it off well. I like Obama, he's a very intelligent and hard working man, but he's going to have to whip the government into shape if he wants to do this well.

If this is in imperfect bill, then they need to make it perfect - after all, isn't it our senators jobs to make good bills law?

The way they passed this - by giving out favors to those that questioned the bill - is horrible. As much as I would like to say the current administration has some iota of worthiness to it, I do not believe it does. We do need healthcare reform, but this kind of 'reform' is a sham - we're funding a bad system for more people, rather than passing laws to make the system better, THEN looking into giving it to everyone.

While I agree with the majority of what you're saying I don't think perfection is a reasonable requirement for legislation (or really even defineable).  I do agree however, and I think you probably meant this, that they should be striving for perfection when crafting their legislation.

As for the bill itself, I would find it comical if it weren't so awful.  At this point it is pretty well understood that they are passing something just to have something, and I mean anything at all, passed.  They are selling out what they obviously understand to be a problem that needs a serious legislative solution to the political needs of their president and their party.

The only thing the bill does that actually meets a campaign goal of the administration's is bring together republicans and democrats alike...unfortunately they are brought together in their opposition to the bill and even then not because of any common issue, but rather opposing issues with the bill. 

If the actual legislative language is somehow agreeable to some folks I still have a hard time believing that anyone can honestly be satisified with the process that brought it about in the first place.   Lacking the C-SPAN coverage promised of the negotiations during the campaign as an example of how open the process would be is one (unsurprising) thing, but to literally have kept the bill from all but the most inner circle of the inner circle of democratic leadership is, without a doubt, one of the most disturbing aspect of this bill's crafting.  But add to that the bribery required to get senators to blindly vote for the bill before knowing fully what they are voting for is really quite astounding.

Should the bill find final passage, it will be interesting to see what kinds of failures of foresight and generally idiotic provisions begin to come to light as a result of this bastardized legislative process. 

I can see how some on the left are OK with numerous shortcomings in the legislative language of this bill.  I can even see how those folks might be able to rationalize the blatant disregard for overwhelming opposition to the bill.  But I really don't understand how anyone justifies the out and out corruption and bribery used to secure the bill's passage. 

As much as this bill is a turd sandwhich, both in terms of it's awful ideas and its incomrehensible inability to grasp the reality of our national debt and budget deficit.  I do have to wonder if the fallout in future legislation will be a bigger issue, with the precedent set now that it is OK to bribe, that you can force citizens to purchase goods and services, and least of all lets not forget that a new precedent is now set that any controversial bill can be fortified to require a supermajority to amend or annul.  With all of those things, I have, and I never thought I would or could say this, even less faith in the ability of our congress to (intentionally) pass positive legislation. 

Sqrl -

Yes, I wasn't attempting to mean that legislation should always be 100% perfect, but that should be the goal of each bill passed. I would have much perfected if they would have debated healthcare over the next year or two, and passed pieces of legislation independently without requiring a huge, massive, thousand page bill that sweeps everything under the rug - the more pages that go into a bill, the more pork that seems to be packed in.

If this bill becomes law, I can only wonder what it means for the legislative process. It would seem that we now have a crony legislature in addition to crony capitalism.

Too many compromises = worthless bill.

I shouldn't say its totally worthless, there are some good parts to it but I wanted a UK style system and I wanted it now!

Healthcare reform began in Arpil. It has been nearly nine months. There has been adequate debate. Perhaps the debate would have been more constructive had Republicans been willing to negotiate rather than obstruct. Anyway, it is disingenuous to feign shock and outrage about the legislative process and the implications this bill will have for it. This behavior is de rigueur for Congress; it always has been and always will be.

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