The US Senate health reform bill has now cleared two of three procedural votes needed before it can go to a final vote on Thursday.

The first vote, held just after 1am on Monday (December 21) was 60-40 in favour of rejecting a Republican challenge to package of amendments to the bill proposed by the Senate Majority (Democrat) Leader, Harry Reid of Nevada, and moving the bill to a final vote this week. Providing the victory were 58 Democrats and two independents.

Then on Tuesday (December 22), the Senate voted 60-39 in favour of changes to the bill including an amendment which would drop the provision of a government-run health insurance plan – the so-called “public option.”

A third procedural vote is due on the afternoon of December 23, and the bill’s supporters expect the final vote to be held at 7pm on Christmas Eve. 60 votes are needed to ensure the bill is approved. This should be followed by the reconciliation progress with the House version – which passed on November 7 with the inclusion of the public option - taking place as early as possible in January. Leaders of both chambers are hoping to have the process completed by the time President Barack Obama gives his State of the Union address, expected towards the end of the month.

Meantime, although proposals in the Senate bill to permit the re-importation into the USA of Food and Drug Administration (FDA)-approved prescription drugs from Canada, Europe and other markets were voted down earlier this month, a presidential adviser affirmed on December 20 that Pres Obama continues to support safe re-importation and that his administration will work for its introduction, although not through the health reform legislation.

Speaking on the CNN State of the Union TV programme, senior White House adviser David Axelrod said that there was “no reason” why Americans should pay a premium for medicines which people in other countries pay less for. Once the concerns over re-imports expressed by FDA Commissioner Margaret Hamburg in a letter to the Senate earlier this month have been resolved, Pres Obama “is committed to moving forward,” he added.