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Why has Congress set a Christmas deadline for healthcare reform?

If the debacle of August's healthcare reform town halls told Democrats anything, it was this: Don't send your legislators back to their districts without a bill to defend.

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The fine print

Meanwhile, lawmakers on both sides the aisle – and their snowbound staff – are digging into the details of the Democratic revisions for grist for the floor debates expected to run into Christmas eve.

Key changes include:

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• Dropping a public option run by the Department of Health and Human Services in favor of multistate plans.

• Expanding the small business tax credit

• Increasing payroll taxes on higher-income workers

• Increasing penalties on individuals who don’t purchase mandated health insurance

• Dropping provisions to increase payment rates to physicians treating Medicare patients.

Senate Republicans aim to highlight the deals in the revised bill that favor some states over others.

“Democrats say they have 60 votes, but we’ll see after people read this bill,” says Don Stewart, a spokesman for Senate Republican leader Mitch
McConnell. In the revisions introduced today, “Virginia has to take second seat to Nebraska and Vermont, which both got extra Medicaid money,” he adds.

Just like the days of Wilbur Mills

Republicans hope to peel off Democrats like Sen. Jim Webb (D) of Virginia, who voted with Republicans on an amendment to drop proposed cuts in Medicare.
GOP moderates, such as Sen. Olympia Snowe (R) of Maine, pushed for more time to understand changes in the bill, build support across party lines, and propose amendments to improve the bill. But Democratic leaders say they have seen little evidence that Republicans, even with more time, would support this bill.

“What we saw in the floor in the last two hours is very reminiscent of how they passed Medicare in 1965,” says Julian Zelizer, a congressional historian at Princeton University in Princeton, N.J. “When [House Ways and Means Chairman] Wilbur Mills released the text of the bill, most committee members didn’t even know what he was about to do. It was a big surprise to everyone and that was standard practice in the 1950s and '60s.”

“It’s not democratic, but it facilitates doing things,” he adds.

Despite the closed door negotiations that produced the final version of this bill, leaks and the power of the Internet made the process this year more open than in the heyday of Wilbur Mills.

“To the chagrin of the White House, many of the deals that produced this legislation were up on the Internet within hours,” Professor Zelizer says.

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