By John Whitesides
WASHINGTON (Reuters) - The U.S. Senate was poised to approve President Barack Obama's healthcare overhaul on Thursday, backing major changes in the medical insurance market and new coverage for tens of millions of uninsured Americans.
The Senate votes at 7 a.m. EST (12 p.m. British time) on the healthcare bill after four weeks of debate and months of political wrangling that have consumed the U.S. Congress and put a dent in Obama's public approval ratings.
The Senate's 58 Democrats and two independents are expected to approve the measure, which needs a simple majority in the 100-member Senate. Supporters mustered the 60 votes needed to clear Republican procedural hurdles on each of the last three days.
"We stand a few short steps from the most significant finish line we've had in Congress for many decades," Senate Democratic leader Harry Reid told reporters.
The vote will clear the way for tough negotiations in January with the House of Representatives, which approved its own version on November 7 that includes different approaches on taxes, abortion and a government-run insurance plan.
Once House-Senate negotiators agree on a single bill, each chamber must approve it again before sending it to Obama for his signature. Democrats hope to finish work before Obama's State of the Union address in late January.
The rare Christmas Eve Senate session fulfils a pledge by Reid to pass the bill before Christmas. Republican critics had delayed the vote as long as possible under Senate rules.
The overhaul, Obama's top legislative priority, would lead to the biggest changes in the $2.5 trillion (1.6 trillion pounds) U.S. healthcare system since the 1965 creation of the government-run Medicare health program for the elderly.
94 PERCENT COVERAGE
The bill would extend health coverage to more than 30 million uninsured -- covering 94 percent of all Americans -- and halt industry practices such as refusing insurance to people with pre-existing medical conditions.
It also would require most Americans to have insurance, give subsidies to help some pay for it and create state-based exchanges where the uninsured can compare and shop for plans.
Major provisions such as the exchanges would not kick in until 2014 but many of the insurance reforms like barring companies from dropping coverage for the sick will begin in the first year.
Republican critics say the bill is an expensive and heavy-handed intrusion in the healthcare sector that will drive up costs, increase the budget deficit and reduce patients' choices.
The nonpartisan Congressional Budget Office estimated the Senate bill will cut the federal deficit by $132 billion over 10 years but critics argue the expected revenue increases and cost savings may never materialise.
Passage of the bill is critical for Obama, whose political standing and legislative agenda could hinge on its success. Obama's public approval ratings have dipped to about 50 percent in many polls as the acrimonious debate dragged on.
Vice President Joe Biden, a former senator, planned to preside over the vote and join Obama at the White House afterward for a victory statement.
Obama then will leave on his Hawaiian vacation, which he delayed until final Senate passage.
(Editing by Bill Trott)
