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American Morning

Senate Holds Final Vote on Health Care Bill; Senate Health Care Bill Passes

Aired December 24, 2009 - 07:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

ROB MARCIANO, CNN ANCHOR: ... additional amendments until we evolve this plan into something...

CAROL COSTELLO, CNN ANCHOR: I think they'll vote on a final version of this bill sometime in February, at least that's the guess. They'll have everything married and they'll vote on this final package in February, and then of course it will go to the president's desk, and he'll sign it.

We understand Senator Byrd just arrived. I wish we could show it to you. Do you want to go to the senator live for just a bit? OK. Let's listen in to Senator Harry Reid.

SEN. HARRY REID, (D) SENATE MAJORITY LEADER: How much do we put this off or ask the uninsured for their patience? Until health care costs consume not just a sixth of our economy, but a third or a half, or until premiums consume more than half of a family's income?

We certainly don't have, Mr. President, the luxury of waiting until America becomes the only developed nation on earth where you can die for lack of health insurance. We already bear that blemish.

That's why we're bringing securing and stability to millions who have health insurance and bringing health insurance to millions who have none. Mr. President, could we have order?

MARCIANO: The Senate will be in order.

COSTELLO: All right, we're going to jump back out.

MARCIANO: Well, we've been watching pretty much history in the making there, live in the Senate chambers. And Senator and Majority Leader Harry Reid making his comments, and seemingly with a little bit of an interruption there, with the gavel being dropped. So interesting times for sure this morning.

COSTELLO: There's a lot to parliamentary procedure. They should be getting to voting very soon. Jessica Yellin is standing by in the thick of it all on Capitol Hill. Gloria Borger is here to put this all in political and historic perspective.

MARCIANO: And we also have Dr. Sanjay Gupta digging through the 2,000 pages of the bill, and Christine Romans will tell us when and if we'll reap the benefits of it all. COSTELLO: Bur first, let's start with Jessica Yellin. She's live on Capitol Hill. And Jessica, explain to us what's going on inside the Senate chambers right now.

JESSICA YELLIN, CNN CORRESPONDENT: Well, right now the two leaders are making statements. You heard Senator McConnell announce, as you say, that this fight is far from over. Republicans have done what they can to block this bill. So far they have not succeeded.

Harry Reid, the Democrats' leader, is saying this is a triumph, a historic triumph, 65 years almost after Harry Truman called for universal health care reform. He's feeling enormously proud that the Senate is on the verge of passing a bill.

Let me tell you, though, Carol, that the overwhelming mood is one of exhaustion. On my way in I spoke to a Democratic senator who has been very involved in crafting all of the Senate legislation.

And I said you must be very excited this morning. This senator said, let's get this over with. And I said, well, when are you coming back to begin negotiations? The person said, we're already talking, it's already begun. We need a break, though.

So there's this momentous vote is going to happen beginning in just a few minutes, but there's also a real sense that these folks need to go home, decompress so they can get to the big work that's ahead.

COSTELLO: And talking about that big work still ahead, there will be a House-Senate conference committee that will meet sometime after the holidays in January, and they'll try to marry these two bills. That's going to be kind of an arduous process, isn't it?

YELLIN: Yes, and let me demystify this a bit. It's not some sort of conference where folks sit down in a room and begin to discuss. They're already starting phone calls, they're already having conversations.

What will happen next, staff will come back in about a week. Some staff will be here next week. They'll start merging these two very different bills.

You know, the House version and the Senate version treat language for abortion in different ways, they treat taxes in different ways. Will there be a public option? Already some House members are saying they realize that they are going to have to likely give up on the public option. That is something that many liberals in the house were adamant must be in the bill.

They're realizing like that's something they'll have to jettison. But the House is insistent they're not just going to swallow this Senate bill whole.

So the big fight will come most likely in the new year when Senator Reid, Nancy Pelosi, and the White House begin their intense discussions about what they think can be in this final compromise version, and it's not going to be easy, Carol. There are significant differences.

COSTELLO: Well, that brings up this. You know, the president's dream was to get this done by the State of the Union, but that's unlikely to happen, isn't it?

YELLIN: Well, you say that, but folks in the White House say they think that this is still doable, that if they continue to negotiate throughout this period while they're on break, they are still aiming for that goal of State of the Union. And so do leaders here say that that's still their goal.

That said, we know how long it's taken to get to where we are now. So let's say that it's not a guaranteed deadline. They want to be on their way by state of the union, but who knows if it's really likely.

COSTELLO: You know, it's interesting. We're looking at a picture of Joe Biden, and he made sure he was in the Senate chambers for this historic vote today. Why?

YELLIN: He is presiding because it is so momentous and it's the president's top initiative. This is one of the reasons -- I want to emphasize this. The president and the White House will be deeply involved in these negotiations coming up eventually because it's so important to the White House.

So Vice President Biden is there to preside. We do not expect him -- usually the vice president is there if they want to cast a tie breaking vote. We do not expect him to have to do that. If he does, that will be huge news. We'll be on all day talking about it.

(LAUGHTER)

COSTELLO: That would be exciting, though, wouldn't it? I mean, I know that Senator Reid will probably get his 60 votes for this thing. He doesn't really need to get 60 votes, he just needs a simple majority. But why do you think all 60 will vote for this?

YELLIN: Because they want to show that the Democrats are in full force behind this major piece of legislation. It's a political statement to have 60 votes, if that's what it comes to.

But I should say that if there are fewer senators there's than 100, then they don't even need to cross the 50 threshold. They need a simple majority of whoever is present.

So it's possible you could have 48 votes and still have a win. But of course with the 60, it's a symbolic, political victory, saying we got what we need. We can't be defeated. We're moving forward to passing health care, by the Democrats.

COSTELLO: We heard a little bit from the minority leader, as you mentioned, Mitch McConnell. He was talking right in between Senator Reid's speeches on the floor of the Senate chambers.

He has been quoted as saying that the Democrats are arrogant and basically they have told the American people to sit down and shut up. Is there anything -- pretty harsh words -- is there anything the Republicans can do after this vote is said and done to slow the process even more?

YELLIN: Well, the truth is that the process will be most slowed by Democrats. There is so much disagreement among the Democrats right now that it's still possible that one of those crucial last folks that they negotiated to bring in at the end could decide that whatever the final negotiated compromise is doesn't meet their needs, that there's not enough money for their states or the abortion language is wrong.

So there's plenty of treacherous terrain between here and the finish line for Democrats. And if Republicans go out there and stir up more discontent and put more pressure on some of these Democrats who have been wavering, that could create enormous pressure, making it much harder to get this done in the end.

But it's political pressure, less legislative.

COSTELLO: We understand the official vote has begun. How long do you think that process will take?

YELLIN: Probably around 15 minutes. It's going to be a quick one, we expect, unless folks aren't in their seats. I can't see from here, but probably 15 minutes.

COSTELLO: I can see, and it looks like pretty much everybody's in their seat. And I'm sure they want to all escape and get to where they're going this holiday season.

YELLIN: They have one other vote, interestingly, after this before they get to go home on an unrelated issue. But they want to get it done and get out of here, as you said.

COSTELLO: And that's to raise the debt ceiling, right?

YELLIN: Yes, yes.

COSTELLO: Another happy thing to deal with on Christmas Eve.

(LAUGHTER)

Jessica Yellin, I'm sure you will stand by, because we have many more questions for you. We will have all the play by play of all of today's events from the Hill to the White House with passage all but certain this morning.

Senate Democrats of course will speak at the top of the hour, 8:00 eastern time, and then at 8:45 eastern, the president will make a statement.

MARCIANO: Right before the first family leaves for their holiday in Hawaii, conveniently enough.

COSTELLO: Yes, they postponed it a couple days because the president wants to get a word in edgewise on something that has been his dream.

Are you still not clear about how this will affect you and your family? What's in this bill for you? For answers and all the latest headlines head to CNN.com/healthcare.

MARCIANO: Also new this morning, nine years old Sean Goldman reunited with his father, David. It just happened moments ago at the U.S. consulate in Rio de Janeiro.

And these pictures of the emotional exchange are fresh into CNN. Here you're seeing Sean clutching his stepfather before meeting up with his dad.

All legal processes have been resolved and Sean will return to the United States. The father and son have been apart since 2004.

COSTELLO: Can you imagine the emotion? All those cameras surrounding this family after the long court battle.

MARCIANO: It has been fascinating to see unravel. I just feel awful for the kid, of course, and hopefully he has a nice Christmas.

COSTELLO: I hope so. Lots of counseling to come, I'm sure.

(WEATHER BREAK)

MARCIANO: We're still monitoring what's happening in the Senate right now, live pictures for you inside the chambers. They are having that vote right now on health care reform, and our live coverage continues.

COSTELLO: We think it will wrap up in just about five minutes, at least we hope so.

Also, you know, we had a lot of terror threats in 2003 shortly after 9/11. And those threats were usually targeted to the airline industry.

Well, it turns out many of those threats were bogus. We will trace the info to the source of those bogus threats. You might be surprised. We'll be right back.

(COMMERCIAL BREAK)

COSTELLO: Welcome back to the most news in the morning. You're looking live at the Senate floor. Of course, you can hear senators are voting right now, minutes away from passing an $800 billion health care reform bill.

Lawmakers will come back in 2010 to hammer out a final bill along with the House version and maybe, just maybe it will get to the president's desk by February.

MARCIANO: He's wishing for that, for sure.

At 8:00 a.m. Eastern Senate Democrats will come out and talk about what they're calling an historic day, certainly, in Washington as far as their view is concerned. And then at 8:45 the man who pushed for the health care reform from day one, President Obama will speak to the nation. And, of course, we'll have that for you live right here on CNN.

With millions of Americans flying off for Christmas and New Year's holidays, there's a stunning new report about a holiday terror alert from six years ago that had travelers on edge.

COSTELLO: Right at the time the threat level was raised, flights were grounded. Now it appears much of the fear and anxiety that gripped the country at that time was based on bogus intelligence. Brian Todd is following that for us.

(BEGIN VIDEOTAPE)

BRIAN TODD, CNN CORRESPONDENT: The closing days of 2003, a period of heightened travel during the holidays and heightened tension. Intelligence officials knew that two years after 9/11 air travel was still a prime target for Al Qaeda. On December 21st of that year the terror threat level was raised from yellow to orange.

TOM RIDGE, HOMELAND SECURITY SECRETARY: Recent reporting reiterates, and this is a constant stream of reporting, that Al Qaeda continues to consider using aircraft as a weapon.

TODD: Fran Townsend, a White House deputy national security adviser at the time and now a CNN contributor, says this about the information.

FRANCES TOWNSEND, CNN NATIONAL SECURITY CONTRIBUTOR: It seems that the intelligence community was producing on a running basis, on an ongoing basis, information related to specific planes that may be targeted, specific locations. And so it was being taken very seriously.

TODD: Townsend says some commercial planes were grounded, others diverted, but within days she says the White House learned this about the intelligence.

TOWNSEND: In retrospect it was not credible.

TODD: A major disruption in holiday air traffic based on bogus intelligence. Where did it come from? An investigation by "Playboy" magazine trace it back to a Nevada software company named eTreppid and a programmer there named Dennis Montgomery.

(on camera): Two former employees of eTreppid tell CNN Montgomery claimed to have developed technology that he said could decode al Qaeda messages that were hidden in secret barcodes, transmitted unknowingly by the al Jazeera TV network, codes that supposedly specifically gave specific information on airline flights.

(voice-over): The employees we talked to say people widely believed within the company to be U.S. intelligence officials came to eTreppid to look at the Montgomery's programs, but employees say they never saw the technology. "Playboy" cites sources saying no secret al Qaeda messages ever existed on al Jazeera and Montgomery's alleged technology apparently didn't exist, either.

In Washington, doubts about the information got around quickly.

(on camera): How did this all start to unravel?

TOWNSEND: Well, as the threat begins to unfold and there's massive disruption and chaos at airports around the world, our allies are asking more questions and putting greater pressure on us to really understand the source and credibility of the intelligence.

TODD (voice-over): In the end, Townsend says, none of the intelligence held up.

Our repeated attempts to reach Dennis Montgomery and the CEO of eTreppid were not successful. But in court documents filed four years later, Montgomery defended his overall work, claiming to have provided the government specific target coordinates and flight numbers which helped to disrupt a different threat.

Contacted about the original reporting of the bogus intelligence in late 2003, the FBI and Department of Homeland Security would not comment. Our inquiries to the office of former Homeland Security Secretary Tom Ridge were not returned. The CIA declined to comment.

(on camera): Fran Townsend says she still doesn't regret the actions...

(END VIDEOTAPE)

ANNOUNCER: This is CNN Breaking News.

COSTELLO: And we apologize to Brian Todd. We'll get the rest of that story later.

But something historic has just happened on Capitol Hill. The Senate is done voting, and as expected, Senate Democrats have passed health care reform, and they have their 60 votes.

Jessica Yellin is standing by live to tell us more -- Jessica.

JESSICA YELLIN, CNN NATIONAL POLITICAL CORRESPONDENT: Carol, it is an historic moment and also enormously important for Democrats here in the Senate and for the White House. They have passed this major hurdle to getting health care reform bill to the president's desk some time next year.

The Senate, as you say, crossed a 60-vote threshold to pass their version of health care reform and they can now begin the negotiation stage to merge a House version of this bill with a Senate version of this bill, a lot of work ahead.

I'd like to tell you a little bit about some of the moments on the floor as this -- a momentous vote was going down. First of all, Senator Robert Byrd, whom you may know as the oldest member of the U.S. Senate, has been quite ill and has had, at times, to come out of a sick bed to pass votes, he came on the floor this morning during this vote, he stood up, he said, "I am casting this vote for health care for my friend Ted Kennedy," and then voted "aye."

As you know, health care -- universal health coverage was the cause, Kennedy said, of his life, and, of course, a great loss to many Democrats this year. So, his widow, Vicki Kennedy, was in the chamber at the time of the vote, present to watch it, as were some White House staff members, and great sighs of relief from everyone when it crossed the 60-vote threshold.

And, Carol, I think there was also a very funny, unusual and unexpected moment when Senate Majority Leader Harry Reid, who has been driving this process relentlessly, was called on to vote. Senator from Nevada, Harry Reid, he accidentally voted "no."

COSTELLO: Oh, no.

MARCIANO: Come on.

YELLIN: And he voted no.

(LAUGHTER)

YELLIN: And everybody started to laugh and gasp, and he put his head in his hands, shook his head, and finally, corrected the vote to a "yes." And you're allowed to do that. You can change your vote while the clock is still counting down.

(CROSSTALK)

COSTELLO: ... if he wasn't allowed to change his vote? He's like on the edge of a nervous break down now, I think.

MARCIANO: Right. Maybe he was just joking, you know?

YELLIN: Maybe he was joking.

MARCIANO: I'm sure the comedians are going to have something with this in the coming day.

COSTELLO: Oh, I think he's exhausted. And, you know, he's fighting for his political life because, you know, his constituents back in Nevada aren't all that happy with him.

YELLIN: You're right. The health care reform proposal is not very popular itself in Nevada right now. He is in a tough re-election fight -- fighting, as you say, for his political life. But there's a lot of confidence among Democrats, a belief, that the discontent with the American public reflects an uneasiness with the process, and they believe that once they pass something, have a final bill, those poll numbers will go up.

Of course, that's yet to be seen and we're nowhere near that yet -- a lot of tough negotiating ahead first.

COSTELLO: You know, it's kind of nice to hear you say there was laughter in the Senate chambers because this has been such a vicious, partisan fight. And the fight over health care reform, I think, has made the partisanship in Washington even worse.

YELLIN: Well, it does sometimes seem almost as if -- if a Democrat proposes something that a Republican likes, they're going to say no just on principle and vice versa, because right now, there's such a disagreement between the two parties on politics.

But in this one instance, on health care reform, there are significant policy substantive differences. The Republican Party is in a very different place on these issues, and it reflects a strong divide in this country we're going to see play out in the elections next year, 2010 elections. We are -- we might finish health care reform by the end of next month or by February, as you predict, but we're going to keep hearing about this bill through the next year's midterm elections.

And already, Democrats are taking strategy meetings about how to sell this to the American public, how to tell people what benefits they're going to get from these bills. And it's going to be a difficult fight. It's been hard to explain health care reform.

COSTELLO: It's been very difficult. You know, I've already seen commercials on television touting the merits of this Senate bill. Not by any -- not by any political party but by certain groups.

I'm sure that the senators will go back to their constituents and try to -- at least the Democrats, will try to send what they feel are the good portions of this bill, like, you know, 30 more million Americans will be covered by insurance, that don't presently have it.

(CROSSTALK)

YELLIN: And there will be insurance reforms, is the other big piece of it. And you can't be denied because of a preexisting condition eventually. You can't be kicked off and denied a service because your company doesn't want to pay for it. Those are some of the big changes that will kick in eventually.

The big problem and the challenge is that a lot this won't kick in until 2014, maybe 2013 if they renegotiate the two bills. But how do you tell people what it's going to do for you down the road and make that seem relevant now? So, they're trying to focus on the pieces of this bill that go into effect immediately, and there are many, but just not the biggest pieces.

MARCIANO: And it's not obviously be...

(CROSSTALK)

YELLIN: Go ahead.

MARCIANO: ... be the same bill as it is now, because both chambers have to agree on it.

Jessica, as -- now that we're in the season of giving, is there any Christmas spirit, or New Year's resolutions that you've heard in this, all of this exhaustive debate, that says, you know, "Next year, in 2010, I'm going to be a little bit more partisan, I'm going to be a little more agreeable, I'm going to work a little bit more with the other side of the aisle"?

YELLIN: You want me to say yes, but I have to say no.

MARCIANO: I was afraid of that.

YELLIN: Yes. The political calculation here is that Republicans are going to be more successful, they believe, at the ballot box, if they are uniformly opposed to the Democrats' proposals and the Democrats aren't happy at all with the way the process has gone in a not -- in a terribly accommodating route (ph) either. So the acrimony is worse. Maybe everybody will be better after they get a break and a rest.

(CROSSTALK)

COSTELLO: Yes, you know, we're looking at a live picture, Jessica, at least we were. Oh, what the heck is that? That's outside.

MARCIANO: That might be outside, the escape route.

COSTELLO: But inside the Senate chamber, people were hugging but I'm sure they were only Democrats hugging Democrats. There it is. They look very collegial right now.

But the reason that we're live outside too is we expect some of them to like bolt for the door so they can catch flights home. It looks like a lot of them have already done that.

YELLIN: Well, first of all, they do -- you know, a lot of these people are actually friends, across party lines, and they're just relieved it's over. So, there can be cross-party hugging to say we got her done at least, and we're going.

MARCIANO: Right. Like after a football game.

COSTELLO: Yes, there's nothing like a cross-party hug.

YELLIN: Right. Exactly.

(LAUGHTER)

YELLIN: It's allowed, right?

MARCIANO: Yes. like after a football game, two guys you played in college and they get beat up after four quarters. They go across the 50-yard line, and they give a little hug and a pat.

COSTELLO: Yes, I can see the senators...

YELLIN: That's what you go.

COSTELLO: ... you know, jumping up like they do and, like, knocking chests.

(LAUGHTER)

YELLIN: I don't think we're quite there yet.

COSTELLO: We see Senator Claire McCaskill hoofing it. She's going. She's running for the car.

MARCIANO: Well, it's cold out, too. In her defense, it is cold. It's not that she's running away. It's cold.

YELLIN: And there's a winter storm blowing in that's going to prevent some people from getting flights home soon if they don't make their planes now. So some folks just got to book to get to the airport, to get home by Christmas. And that's part of the reason they moved the vote up so early this morning, because of that winter storm.

MARCIANO: All right. Well, Jessica Yellin for us, giving us some insight and play-by-play. We've got cameras inside; we've got cameras outside. The Senate version of the health care bill is being passed just moments ago and congratulatory hugs, or at least exhausted hugs as Jessica is pointing out be given across party lines in some cases.

COSTELLO: Yes. We're going to take a short break.

And when we come back, we're bring in Gloria Borger for some analysis on, you know, what this means politically, what comes next, et cetera, et cetera. We're also going to bring in Dr. Sanjay Gupta. He's actually read all 2,000 pages of the Senate bill and he's going to tell you more of what this bill means for you.

It's 24 minutes past the hour.

(COMMERCIAL BREAK)

COSTELLO: And it's just about 28 minutes past the hour. Time to check our top stories.

After all the debating and the voting, and the voting, we are now closer than we've been in generations to expanding health care coverage in this country -- Senate passing its version of health care reform just seconds ago. The president is set to speak to the nation about it in a little over an hour.

MARCIANO: And if you're heading home for the holidays today, you could be in for a major headache. A huge winter storm bearing down on the Midwest this time is icing roads and canceling flights. And the forecast is not any better, I think Reynolds says it's going to get worse. So, if you're packing right now and about to head to the airport, certainly, double-check that flight. Two feet of snow and some ice in places possible by Christmas morning.

COSTELLO: Plus, what an emotional reunion. Nine-year-old Sean Goldman has finally been reunited with his father David on Christmas Eve. That's after five years of being apart.

These pictures of the emotional exchange. You're going to him in just a second. You'll see Sean clutching his stepfather before meeting up with his dad. Here's he is with the dad, and you see the reporters all around them.

A court in Brazil ordered that Sean be returned to his father. The handover happened just over an hour ago at the U.S. consulate in Rio de Janeiro. Officials say all legal proceedings in this case have now been resolved. Now, Sean and David Goldman can finally get back home and hopefully repair their relationship.

A Christmas Eve present for President Obama. Just minutes ago, as we said, the Senate passing its version of a health care reform bill. It's a strictly partisan celebration. The bill is passing on a 60-39 party line vote.

The president still isn't home free on health care. He's far from that. The Senate measure needs to be merged with a version passed by the House. That's a new fight for the New Year.

We want to show you what happened in the Senate chambers just a short time ago while senators were taking their vote. Senator Harry Reid was just about to cast his vote, and he accidentally votes no. Let's listen.

UNIDENTIFIED FEMALE: Rhode Island? Aye.

UNIDENTIFIED FEMALE: Mr. Reid of Nevada? Mr. Reid of Nevada. Aye.

COSTELLO: I know you couldn't quite hear him say no, but you certainly saw his fellow senators laughing and then his reaction, you know, putting his head in his hands saying what am I doing?

Joining us now to help break things down from Washington, Gloria Borger, CNN senior political analyst, and from Atlanta, our chief medical correspondent, Dr. Sanjay Gupta. Welcome both of you.

GLORIA BORGER, CNN SENIOR POLITICAL ANALYST: Hi. That was something.

COSTELLO: I guess that just shows how frustrating and how long a process this has been, Gloria.

BORGER: You know, I think it just shows you how exhausted poor Harry Reid is. You know, in a way, in trying to herd these cats, he's had a long couple of months here. And he's had to do everything, and we all know about what he had to give away and trade votes and all that to get this final majority passed.

So the poor guy must really be to the point of exhaustion where he would vote against his own legislation. Glad he had the time to change it. But by the way, he still got an awful lot of work to do, because right now they have to reconcile the bill that passed in the Senate with the bill in the House.

And there are major differences on major parts of this legislation, like how to pay for it, for example. Will there be a public option? What kind of abortion legislation will it contain? So he's still got a lot of work ahead of him.

COSTELLO: Absolutely. And you know, Republicans are very concerned about just what exactly health care reform will cost. You know, we keep hearing $871 billion over 10 years. You know, that's what's in the Senate bill, that's what it will cost. But that's unlikely what the final cost will be, right?

BORGER: Oh, yes. I think, you know, you never know when you try and estimate these things, Carol, 10 years out, 12 years out. You really don't know what the unintended consequences are going to be. It's very hard to estimate in advance what the savings are going to be, because a large chunk of this legislation, as Sanjay knows, is trying to change the way we do health care in this country, and control costs.

And it's hard to estimate something you haven't ever done before. So we really don't know what the cost is.

COSTELLO: Well, Sanjay, can you give us a little more on that? I mean, is anybody projecting what the final bill could cost? I know Republicans are saying it could cost over $1 trillion.

DR. SANJAY GUPTA, CNN CHIEF MEDICLA CORRESPONDENT: Right. And those costs are, you know, going to change. There's no question about it, when they were trying to project costs for Medicare back in the mid'60s. They were wildly off in terms of what they projected 10, 20 years down the road. I think what Gloria is also sort of alluding to is this idea that, does this idea of insuring 31 million more people somehow overall just by that alone start to decrease health care costs by making us a healthier society?

That's part of this whole idea of bending the cost curve down is all about. If people have health insurance, are they more likely to take better care of themselves and not show up in the emergency room with stage four as opposed to stage one cancer, or get preventive screening, things like that. But there's this idea which is causes eye glaze in a lot of people but it's called comparative effectiveness, really trying to figure out which procedures, which medications, which interventions work.

We don't always know the answer to that, as a medical community, but really figuring which things work and then making sure that we're pushing people in the right direction.

COSTELLO: So we're wrestling with these historic problems. And I want to go back a little bit, Gloria, and put this vote today on Christmas eve in perspective. How historic is this?

BORGER: Oh, hugely. Hugely. I mean, you really can't understate it. You know, in my lifetime, Richard Nixon tried to do it, Hillary Clinton tried to do it, and were unable to do it. So whatever you think of this Democratic bill, and make no mistake, it's Democratic, they've gotten this done.

And so as far as they're concerned, they're on the path to making good history. What's astonishing to me as a political journalist is I've really never watched the parties make such different bets on history here. We are seeing unified Republicans saying, this is going to come back and haunt this country.

And we are hearing Democrats say, if you don't do it, we will rue the day because we will destroy our nation fiscally. And so, you know, just different bets on history here. And in the short term one party may be right and the long-term another party may be right. We just don't know at this point, where it's going to come out, because this is really unchartered waters for us.

COSTELLO: I want to ask Sanjay a little bit more about that. Because when you hear These two very different viewpoints, for the public at large, it's very difficult to figure out who to believe, especially in tough economic times when you tend to believe the worst of things.

GUPTA: Yes, think that's a fair statement, and what's sort of interesting as well is the Republicans are uniformly opposed to this, but there was a lot of fragmentation as you know as well within the Democratic party, lots of negotiation to try to get this done. A lot of people think this bill doesn't go far enough, still, you know and not having the public option in the Senate bill specifically has angered a lot of people. There's a lot of people writing about that this morning.

But sort of, you know, in the longer run, it's going to be a little bit hard to say how this plays out. You know, and people will take credit for the things that work and blame others for the parts that don't work. But I think two things that did seem to get agreed on for the most part is that you shouldn't discriminate people for pre-existing conditions.

If you got sick at some point in your life, Carol, and then you were going to another job, you had a hard time getting insurance as a result of that, that practice is going to end. That was tough to watch, I think, for the medical community, really anybody to see that happen. And also getting rid of the caps on expenses for medical care.

So you know, a child who has some sort of chronic disease that's going to live with that disease their entire life, if they're capped at some point, you can imagine the position that might put them in at a very early part of their life. So those two things are going to go. And I think for the most part people seem to agree on that. Everything else, for a long time still, and still to come, is up for grabs.

COSTELLO: And I want to go back a little bit to the public option, this idea of a state-run insurance program, Gloria. Because the president said he could frankly live without it. He would sign a bill into law without the public option. But that's going to make many liberal Democrats angry, and I know that's included in the House bill. It's pretty likely that that will completely go away, isn't it? When these two bills are married, the Senate and the House version?

BORGER: Well, you know, the House Speaker Nancy Pelosi who has done a lot of talking to her liberals and she has said to them privately that we're not just going to buy into what the Senate has done, which is a quasi public plan run by private insurers. And so she's saying, look we're not going to buy in a that necessarily, so don't think you can't vote for this.

Look, I think in the larger picture here for the Democratic party, they're going to -- the liberals are going to have to hold their noses and they're going to have to vote for something that is not going to be perfect. Because what's at stake here is a governing majority.

They have to prove to this country in a way, and it's very difficult for them because right now a majority of the American public doesn't like health care reform. So they're going to have to vote for something in the end, the public may not like, to prove that they can govern. And it's a very, very difficult political conundrum for them right now, but that's where they are.

COSTELLO: Gloria Borger, Dr. Sanjay Gupta, I'm sure you're going to stick around through the rest of AMERICAN MORNING to help us with this, and we appreciate it. And of course, we'll have the play by play of all of today's events from the hill. And also the president is going to speak at 8:45 a.m. Eastern time.

MARCIANO: That's right at 8:00 a.m., straight up, the Senate Democrats are going to speak, then the president. I'm not sure if the Republicans are going to chime in there as well. The presidential priorities, how was the president done with meeting his goals so far? Obviously this one was the biggest.

COSTELLO: It is one of his biggest. We'll hear from him at 8:45 a.m. Eastern time as we said. We're going to take a short break. 38 minutes past the hour.

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UNIDENTIFIED MALE: I look forward to working with my friends in the House, so we can send a bill to the president as soon as possible.

And Baucus, we're going to hear from Baucus, Dodd, Durbin, (INAUDIBLE) and we're not going to take any questions.

SEN. MAX BAUCUS (D), SENATE FINANCE CHAIRMAN: It's been nearly two years since we began our work on health care reform here in the Senate, and we're all very, very proud of this moment. We stand here at the finish line, though, as we stand here, we're not standing alone. We stand with those who have blazed a trail ahead of us, tireless champions of health care reform all the way from President Theodore Roosevelt to our good friend with us in spirit, Ted Kennedy. We're standing with millions of American families who have been forced to bankruptcy to cover the cost of health care. We stand in behalf of 45,000 Americans who die each year simply because they don't have health insurance. We stand with small business owners who cannot afford health insurance for their employees. We stand with Americans suffering from diseases like cancer, diabetes, and all those who have been discriminated against or denied health insurance coverage because of a pre-existing condition.

Today we make history for them and every American who has fallen victim to our broken health care system. I especially want to thank leader Reid for the terrific way he's managed to navigate the waters to get us here to the final passage. This is going to be a day that we're going to look back upon as senators, very proud of what we've accomplished.

But more important, very happy to see people getting health care they now cannot get, and very happy to see health care costs being much more under control. This is why we came here. This is why we hired on for these jobs, to pass something very historic and important like this. Thank you.

SEN. CHRIS DODD (D), CONNECTICUT: Well, let me also thank Senator Reid. This is -- on this Christmas eve, I can't think of a better gift that the United States Senate could give to our fellow citizens than lifting the burden of fear from their shoulders. The fear that they would not be able to provide health care for their families and a loved one in a time of need.

This was an enormous victory for the American public and I'm proud to have been one vote cast in favor of this effort. Last year, of course proved progress was not easy, but today we're able to prove it's not impossible. Because of the leadership of Harry Reid, Max Baucus, Tom Harkin and so many others we're now on the cusp of achieving something that has defied generations, that is to provide all Americans with the security of a decent health care.

There's never been a vote cast in my tenure here that's done as much to relieve the burdens or provide more security for middle class working families in America than this one. This is probably the most important vote that every sitting member of the Senate will cast in their tenure here. I'm proud to have been a part of it, I thank my colleagues for this, and I wish Ted Kennedy were here to enjoy this. Merry Christmas to everybody.

SEN. DICK DURBIN (D), ILLINOIS: The corridors of the Senate are filled with portraits and statues of political leaders whose reputations have faded into obscurity. But I will tell you the contribution to this nation made by Senator from Searchlight, Nevada will become one of the shining chapters in the history of the United States Senate and our nation. He achieved what others have failed in trying to achieve, and he did it with the tenacity and a strength and a determination that I've never seen in my time serving in Congress, and I am honored to have stood beside him with so many others to see this great day finally arrive. This is a time of year of long nights and darkness, when history tells us that from the beginning of time people would gather, and they, with their families and friends, would look for signs of hope and light a light and even light a candle.

This morning, this vote in the United States Senate lit a candle of hope for 50 million Americans who went to bed last night without the protection of health insurance. For millions who wake this morning wondering if they'll ever win that battle with the health insurance company for the coverage that they need, for the surgical procedure, for the medication. It's also a candle of hope for this nation that we are finally tackling an issue which every family, every business knows is central to our progress as a nation.

We have succeeded through the efforts of Senator Baucus and Senator Dodd and Senator Schumer and Senator Murray and Senator Reid, but also with the help and inspiration and leadership of a president who made this the highest item on his agenda and told us that he would work hard night and day to help us reach this moment. We owe our appreciation to him and the vice president especially for presiding over this historic session this morning.

SEN. CHARLES SCHUMER (D), NEW YORK: Thank you, and a happy holiday, Merry Christmas, Happy New Year to everybody.

The bill can be described in a single sentence. At the same time it cuts cost, the waste, the fraud, the duplication endemic to our system, and at the same time it covers 31 million people.

Who would have thought we could do both in the same bill? Who would have thought we could do it with not a single Republican vote and getting every one of the 60 Democratic votes? Who would have thought that we could finally get a handle on the thing that is driving our budget deficit to great heights, which is health care costs, and at the same time do so much good by covering so many people?

This is an amazing accomplishment. It would be under ordinary times, it's even more amazing under extraordinary times. And the Three Horsemen of this bill stand behind me. Leader Reid did an incredible job. Just amazing. I just watched with awe, with how he could weave a legislative fabric. Max Baucus, who never gave up. He started out early and just persisted and persisted and persisted and persisted, no matter what log was thrown in the way. And Chris Dodd, who kept the flame of Ted Kennedy and the spirit of doing the right thing and doing the good thing and reaching to the highest values of this country alive.

This is a happy day.

Mitch McConnell said on the Floor that we're going to go home and hear our constituents rail against this bill. I don't believe that. I believe that the negativity that Leader McConnell and others have continually displayed on the Floor has peaked. And now, when people learn what's actually in the bill and all the good it does, it is going to become more and more popular, because it is good for America, good for the American people, and a true symbol of what we can do if we all pull together.

COSTELLO: And you just heard from Senators Reid, Baucus, Dodd, Durbin -- Democratic Conference Vice Chairman Charles Schumer just spoke, and, you know, Democratic Conference Secretary Patty Murray was in there somewhere, but we didn't hear from her.

But -- but as you heard, Senator Dick Durbin, a Democrat of course, called the health care reform bill, now passed, a candle of hope. But that's certainly not what the Republicans are calling it.

MARCIANO: No. There's been a lot of analogies and Christmas metaphors, I guess, thrown -- thrown about this morning, and the Republicans have come out with a -- a bit of a statement. This from the RNC chairman, and just a little snippet of one of them. We hope to get a full (ph).

COSTELLO: This is from Michael Steele, the RNC Chairman.

MARCIANO: Yes, just -- just to give you an idea of one of the things he said, to continue that analogy of Christmas, the Democrats have put a $2.5 trillion lump of coal in the stockings of Americans, knowing that their risky health care experiment still increases premiums, still cuts Medicare, still enacts hundreds of billions of new taxes to pay for it -- and the punch line?

COSTELLO: Scrooge would be proud.

And, you know, a lot of -- a lot of Americans feel the same way, because support for this bill has gone down in recent months, and now the majority of Americans -- well, they're wary of this bill. They're afraid of what it will do to costs, to taxes, to our deficit.

I want to bring in our CNN Analyst, Gloria Borger. And you heard those Democratic senators talking about this health care bill and...

GLORIA BORGER, CNN SENIOR POLITICAL ANALYST: Right.

COSTELLO: ... you know, they're trying to sell it as hard as they can even now.

BORGER: Well, they're -- you know, that's what they have to do, and, quite honestly, that's what the president of the United States has do because, as you were saying, Carolyn, all of our CNN polls -- not only does a majority of the public now disapprove of it, but they think it's not going to make their health care any better. They think it's going to raise their taxes. They think it's going to add to the deficit.

So the longer we've seen this bill out there, the arguments against it have really gotten a lot of traction. Right now, once they come together and come up with some measure, some final measure, it's going to be a big job to convince the American public that this is the right medicine, if you will, for -- for them. And I think the problem they've got, quite frankly, is that some of the things that would appeal to the American public don't kick in until the out years 2013, 2014. So, I think this could be a bit more of a -- of a difficult sell than they thought, but you sort of never know. Public opinion has changed on this since August. It can clearly change on it once again.

MARCIANO: Are -- are they worried? I mean, as a politician, I -- I would think if people are against this or at least against rushing this...

BORGER: They're worried.

MARCIANO: They are worried. I mean why -- why not step back and, you know, let's go home for Christmas and we'll tackle this in 2010?

BORGER: Well, you know, again, as we were talking about earlier, it's kind of -- they've got a political moment here when this has been the top legislative agenda for this president. He could have decided in this economic situation to just sort of punt on health care. He could have decided to do a smaller, more circumscribed version of health care.

The Democrats and the president decided this was their moment and they're going to -- they're going to do it. And so they're all in, you know? If this were a poker game, all in on this one.

And so, now, they've got to -- they've got to go out there and tell the American public why they are right and the Republicans are not right. They've got a midterm election coming up in 2010. The American public may just say we're not so sure by 2010, but who knows by 2012, when Barack Obama, presumably, is going to run for re- election?

So there's a lot of political risk here on both sides of the aisle.

COSTELLO: So -- so what are the chances, you know? Let's say that the House and the Senate marry these bills and they come up for...

BORGER: Right.

COSTELLO: ... for votes in -- in both chambers. I mean, is it passage for sure? I mean, how much of a chance will this thing not be passed?

BORGER: You know, I -- I never say anything is for sure up in Congress, particularly these days. You saw how Harry Reid literally had to buy people's votes in order to get 60 votes in the Senate, Senator Ben Nelson of Nebraska being the most famous or infamous purchase?

And I think that you've got an abortion issue out there that is going to be very, very sticky to deal with and you may lose a lot of Liberals on that. You may lose Conservatives on that. I always joke and say it's kind of a game of "Whack-a-mole" that they're dealing with because one time you get one Senator, another one pops up. There is no margin for error here on the Democratic side of the aisle. They need to get all of their votes. And, you know, as Sanjay pointed out earlier, the Democrats haven't exactly been agreeing with each other on -- on this measure. So, you know, I think that there's not one vote to waste in the United States Senate. The House is more Liberal than the Senate, and this is where, again, I think we're going to have to see presidential leadership come in.

I think we're going to have to see President Obama get involved and say this is what we're going to do. This is what I can accept. This is where the compromise has got to come down. It's going to require his leadership.

COSTELLO: But he didn't do that -- he didn't do that earlier.

BORGER: No, he did not.

COSTELLO: He stayed out of it.

BORGER: He did not, and -- and a lot of people looking back on this, Carol, might say that the president should have gotten involved a little earlier on this, that, in fact, he relegated all of the responsibility for writing this legislation to the Congress because he didn't want to make the same mistakes Hillary Clinton made when she tried to pass health care reform. She came up to the Congress with a bill already written, and it became a big fat target.

So, they decide to be anti-Hillary here and they let the Congress write the legislation, and some would argue that it became too big, too fat, too Liberal, and he shouldn't have done that.

Well, now, this is his opportunity to kind of peel away what needs to be peeled away in this legislation and get something that will pass both Houses. And he's got to sort of take charge of this. But he's also got to pivot to the jobs issue because that's what people are really caring about these days.

COSTELLO: You're absolutely right about that.

BORGER: He's got to go on two tracks.

COSTELLO: Absolutely right about that. Stick around.

Gloria Borger, thanks so much.

BORGER: Sure.

COSTELLO: An hour more to go of AMERICAN MORNING.

MARCIANO: Yes. A special edition of AMERICAN MORNING continues with breaking news coverage of this historic event after this break.

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