On a 58-42 vote, the Senate defeated an effort by Sen. John McCain, Arizona Republican, to send the bill back to a committee where lawmakers would have had to drop the cuts in Medicare payments and instead find another way to pay for the bill, which overhauls the nation’s health insurance system and guarantees coverage for tens of millions of people who lack insurance.
“This isn’t the first time defenders of our broken health care system have tried to scare seniors, and it won’t be the last,” said Sen. Christopher J. Dodd, Connecticut Democrat and chairman of the Health, Education Labor and Pensions Committee.
With four votes Thursday, the Senate broke a stalemate that had lasted since the official debate on the bill began Monday.
In addition to the Medicare cuts vote, the Senate adopted an amendment that gives the government authority to eliminate co-payments for women’s health screenings such as mammograms - and along the way turned back a Republican effort to try to stop the government from relying on task force recommendations to decide what services should be covered.
The Medicare fight was the biggest test.
Democrats argued that the cuts - totaling $464 billion over 10 years - would not affect the basic services guaranteed by Medicare, and instead would squeeze insurance companies and hospitals that are overcharging for the level of service they are providing.
They pointed to Republicans’ historic opposition to Medicare as evidence that the Republicans’ protests were political.
“Now they’re coming riding to the rescue of Medicare; we have a right, I think, to be skeptical,” said Senate Majority Whip Richard J. Durbin, Illinois Democrat, charging that Republicans were simply trying to protect insurers.
Republicans said the cuts would hurt care for seniors.
Sen. Tom Coburn, Oklahoma Republican and a doctor, said physicians will be slower to respond.
“I know what goes on inside a hospital. When you cut $130 billion out of the hospitals, the time you’re going to wait between the time you push your call button is going to get extended,” he said. “The complications from that are going to result in decreased quality of care and shortened life expectancies.”
The AARP, the large and influential seniors lobby, opposed Mr. McCain’s amendment.
Mr. McCain responded by telling seniors: “Take your AARP card, cut it in half and send it back. They betrayed you.”
The cuts span payments to hospitals, hospices, nursing homes and the Medicare Advantage program, among others. With 11 million people enrolled in it, the Medicare Advantage program cuts were a particular fight.