The US Senate on Thursday passed its version of the health care bill. While President Obama promptly hailed the vote as a historic moment, not many are excited.
For one, it is a much diluted version, nothing like the universal coverage that Obama had talked about tirelessly during his election campaign. So many compromises have been made that some liberals feel betrayed and are calling for a more caring legislation.
Besides, there are some glaring differences between the bill passed by the House of Representatives earlier and the present one. Relatively speaking, the House bill is more expansive.
A conference committee must now reconcile the differences and merge them into one.
The House and Senate will then have to pass the revised plan before it can be sent to President Obama's desk. Each chamber needs a simple majority vote for final passage.
The biggest difference between the two bills is the public option. The House bill has one; the Senate bill does not.
The Senate bill originally included a government-sponsored plan with the option or states to opt out, but that was dropped as Senate Majority Leader Harry Reid tried to secure the votes of moderate Democrats.
The Senate bill instead allows nonprofit private insurers to offer coverage with approval of Office of Personnel Management, which oversees the federal employees' health plan.
Another sticking point is coverage for abortion. A late compromise in the House led to the adoption of the Stupak-Pitts amendment, which bans most abortion coverage from the public option. It would also prohibit abortion coverage in private policies available in the exchange to people receiving federal subsidies.
A similar amendment introduced by Sen. Ben Nelson failed in the Senate. To get his vote, a compromise was reached that allows states to choose whether to ban abortion coverage in health plans offered in the insurance exchanges. Individuals purchasing plans through the exchanges would have to pay for abortion coverage out of their own money.
Immigration could pose another obstacle as lawmakers iron out their differences. The House bill mandates insurance coverage for illegal immigrants and allows illegal immigrants to enroll in the public option and to buy private coverage in the national insurance exchange, but prohibits government subsidies for such private coverage.
The Senate plan exempts illegal immigrants from the health coverage mandate, and prohibits illegal immigrants from participating in the insurance exchanges.
The House and Senate bills also conflict on how to pay for the plans - the cost of coverage, the tax measures required and so on.
All the same anything is better than nothing, argue some. Nobel laureate Paul Krugman, well known for his liberal views, applauded the bill as "an awesome achievement," even while calling the legislation "a seriously flawed bill we'll spend years if not decades fixing."
But others seem to be less impressed. Ariana Huffington, for instance, scoffs at the bill as a special interests legislation.
From start to finish, the insurance and drug industries -- and their army of lobbyists -- had control over the process that resulted in a bill that is reform in name only. If the miserable Senate health care bill becomes the law of the land, it's only going to encourage the preservation of a hideously broken system, Ms.Huffington, a noted commentator, wrote.
She went on to cite the example of the failed Byron Dorgan's drug re-importation amendment.
That was an idea that Obama co-sponsored when he was in the Senate and unequivocally championed on the campaign trail: "We'll allow the safe re-importation of low-cost drugs from countries like Canada."
But when Dorgan introduced an amendment that would do just that, the White House, sticking to the deal it made with the pharmaceutical industry, lobbied against it -- and the commissioner of the supposedly non-political FDA just happened to release a letter citing "significant safety concerns" about all those dangerous drugs from Canada. Big Pharma's many congressional lackeys trumpeted the letter and the amendment was killed.
The consensus is that despite such well-meaning concerns, ultimately President Obama will succeed in hammering out some compromise formula and have his own healthcare law in place. But how much the people at large will really stand to benefit is a different issue altogether.