After 25 consecutive days of debate, the Senate on Thursday approved sweeping health care legislation, moving a goal that has eluded Democratic presidents since Franklin Roosevelt closer to enactment than ever before.

The bill gives the Office of Personnel Management responsibility to negotiate insurance plans for the uninsured but requires any new programs to be kept separate from the Federal Employees Health Benefits Program. Risk pools will be separate, allaying federal employees unions' concerns that allowing the uninsured to enroll in FEHBP could drive up premiums.

OPM would have separate administrative departments to oversee FEHBP and the new quasi-governmental program, and OPM would be granted additional but unspecified funds to handle its new tasks, according to the bill.

President Barack Obama, who put off his Hawaii Christmas vacation to remain in town for the 60-39 vote, says the legislation goes a long way toward meeting the goals he set in last year's campaign. "I am very satisfied," the president told the PBS Newshour in an interview on the eve of the roll call.

Sen. Jim Bunning, R-Ky., was the only absent senator.

Underscoring the administration's support for the bill, Vice President Joe Biden exercised his prerogative to chair the Senate for a roll call vote that took place as the sun was rising over the Capitol Dome. It was the first time since 1963 that the Senate met on the day before Christmas and the first time since 1895 that senators cast a roll call vote on Dec. 24.

The unusual timing reflected the intensity of the controversy surrounding the bill and the difficulty Senate Majority Leader Harry Reid encountered in holding together the Senate's 58 Democrats and two independents in support of the bill. The 40 Republican senators all opposed it.

The bill would cost $841 billion over the next 10 years and cover 31 million Americans, according to the Congressional Budget Office's analysis released Dec. 19. The CBO analysis shows that proposed changes to Medicare and other government programs, as well as an excise tax on high-cost "Cadillac'' insurance plans, would reduce the deficit by $132 billion over the next 10 years.

The Senate vote sends the legislation to a conference committee, where Democratic leaders will try to reconcile differences between House and Senate bills on how to pay for health care; how to help low- and middle-income-earners pay for the insurance they will be required to buy; and what restrictions to place on insurance coverage for abortions.

The conference committee must also decide whether to keep the Senate provision giving OPM responsibility to negotiate insurance plans for the uninsured. That provision is not in the House bill, nor does the House bill contain any provisions prohibiting the government from enrolling uninsured Americans in FEHBP.

Each chamber will vote again on a final bill next year.

Republicans are vowing to wage a public relations campaign to derail the legislation before the next round of votes. "This is a historic mistake," said Sen. Lamar Alexander, R-Tenn.

———

Kathy Kiely reports for USA Today, and REBECCA NEAL reports for Federal Times.