As snowplows worked overtime in Washington DC over the weekend to clear the nearly two feet of snow that blanketed the city in a record snowstorm, Senate lawmakers, too, worked overtime, staying late night Sunday night and into the wee hours of Monday morning to pass, at slightly after 1AM this morning (December 21), the first of several procedural votes to avoid a filibuster of the Senate healthcare bill. The 60-40 vote on party lines sets the stage for a Senate vote on the bill that is currently scheduled for Christmas Eve.

Also over the weekend, the Congressional Budget Office released its analysis of the Senate bill as amended. According to the CBO, the bill is estimated to have the following effects:

• Over the course of the first 10 years, through 2019, it would reduce the federal budget deficit by $132 billion.
• It would reduce the number of legal US residents who lacked health insurance in 2019 by 31 million, leaving 23 million nonelderly people uninsured (about one-third of whom would be illegal immigrants).
• Most Americans would continue to receive insurance coverage through their employers, but 26 million would receive coverage through newly-created insurance exchanges, with subsidies for individuals and families with incomes between 133% and 400% of the Federal Poverty Level (FPL). Individuals with incomes below 133% of the FPL would become eligible for Medicaid, resulting in an increase in the population covered by Medicaid and SCHIP to 50 million in 2019 (from 35 million in 2019 without the reforms).
• It would establish an Independent Payment Advisory Board, which would be responsible for limiting growth in Medicare spending and whose recommendations automatically would go into effect unless blocked by Congress.
• It would establish a voluntary federal program for long-term care insurance.

Beyond the first decade, the CBO expects the provisions of the bill to continue to slightly reduce the federal deficit after 2019, possibly by 0.25-0.5% of GDP. In contrast to the original language of the bill, which allowed a slight growth in physicians’ payments under Medicare Part B in 2010, the amended bill eliminates this increase, which would result in a cut of 21% in physician payments 2010 under the Sustainable Growth Rate (unless, as is likely, these cuts are subsequently overturned later in 2010). Among other changes, the amendments also cut the annual fees the medical device and insurance industries would have to pay, although there is no mention of cutting the fees the pharmaceutical industry would have to pay.

If the Senate bill passes as expected on Christmas Eve, the next step will be to reconcile the House and Senate versions and have each chamber vote on the final bill in time for President Obama to sign into law by his State of the Union address next month.