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Dems get 60th health care vote

The Associated Press . Sen. Robert Casey Jr., D-Pa., checks on the snow from near the Senate floor on Capitol Hill in Washington on Saturday. Despite a blizzard-like snowstorm, the Senate was in session and reached the 60-vote threshold to ensure passage of the health care bill.

The Associated Press . Sen. Robert Casey Jr., D-Pa., checks on the snow from near the Senate floor on Capitol Hill in Washington on Saturday. Despite a blizzard-like snowstorm, the Senate was in session and reached the 60-vote threshold to ensure passage of the health care bill.

WASHINGTON -- Democratic leaders secured the support of Sen. Ben Nelson to provide the 60th and deciding vote for sweeping health care legislation in the Senate, capping a year of struggle and a final burst of deadline bargaining on President Barack Obama's top domestic priority.

Nelson, D-Neb., said Saturday he made his decision after winning fresh concessions to limit the availability of abortions in insurance sold in newly created exchanges, as well as tens of million in federal Medicaid funds for his home state.

''I know this is hard for some of my colleagues to accept and I appreciate their right to disagree,'' he said at a news conference in the Capitol, referring to the abortion issue. ''But I would not have voted for this bill without these provisions.''

He also noted he had successfully fended off attempts to provide for a government-run insurance option to compete with private insurers.

The Congressional Budget Office estimated the revised measure would lower deficits by $132 billion over a decade, with the possibility of much higher reductions in the subsequent decade.

Forecasters said the bill would expand coverage to roughly 94 percent of eligible Americans under age 65, a total that excludes illegal immigrants.

Majority Leader Harry Reid of Nevada said the measure ''will finally level the playing field between American families and the insurance industry.''

With Nelson's decision, Obama's Senate allies appear on track to pass the legislation by Christmas, overcoming unanimous Republican opposition and a swirling early winter snowstorm. The House passed its version of the legislation last month, and final compromise talks are expected quickly.

''This bill is a legislative train wreck of historic proportions,'' Senate Republican leader Mitch McConnell of Kentucky said. He said it includes cuts to Medicare, home health care and hospices as well as ''massive tax increases'' at a time of double-digit unemployment.

At its core, the measure is designed to spread coverage to tens of millions who lack it, while banning insurance company practices such as denial of coverage on the basis of pre-existing medical conditions. The White House also wants the legislation that eventually makes it through Congress to slow the rate of growth in national medical spending overall.

Nelson disclosed his decision as Majority Leader Harry Reid, D-Nev., unveiled a final series of changes designed to solidify support. Among them was an increase in the Medicare payroll tax of 0.9 percent on income over $200,000 a year for individuals and $250,000 for couples. The bill earlier raised those taxes by 0.5 percent.

The legislation includes new limits designed to limit insurance company profits and overhead, by requiring them to spend 80 percent of their premium income on medical care for individual insurance policies, and 85 percent for group policies. The industry says such a limitation is unnecessary because profits generally are in the single digits.