This was ostensibly a vote on a motion to table (kill) an amendment by Sen. John Cornyn (R-TX) to health care legislation that would have prohibited the Health and Human Services Department from implementing health care reform legislation until the Actuary of the Centers for Medicare and Medicaid Services (CMS) certifies that the legislation will lower health care costs. (The CMS actuary analyzes issues relating to health care financing.) The measure Cornyn sought to amend was a “companion bill” making a number of changes to health care reform legislation already signed into law by President Obama. The underlying context was that Republicans were trying to attach amendments to the companion bill in order to send it back the House, where it had passed by a narrow margin. CNN reported that Republicans had chosen to offer a slew of amendments in order to “undermine the measure,” while the Associated Press characterized the amendments as “a final drive to thwart President Barack Obama's health care remake.”

Cornyn urged support for his amendment: “…This amendment would ensure that health care reform costs are lowered by this piece of legislation. If independent actuaries for the Centers for Medicare and Medicaid Services cannot certify that this health care reform legislation lowers national health expenditures, this bill will not go into effect.”

Sen. Max Baucus (D-MT) made a motion to table the amendment, saying: “…This amendment is a thinly disguised attempt to kill health care reform…the Congressional Budget Office [CBO] has told us that in the first 10 years the bill actually will reduce the deficit by a significant amount. CBO also informs us that health care reform will lower premiums for 97 percent of Americans, improve benefits for many who are underinsured, and health care reform will bend the growth curve of health care spending. The CMS Actuary also says that national health care spending will be lower under the law than it will be without reform.”

After the House and Senate both passed their respective health care reform bills, the two chambers had intended to reconcile those two bills into a final package. After the House and Senate passed that final package, it would have been sent to President Obama, who would have signed it into law. Sen. Scott Brown (R-MA), however, won a special election to replace the late Sen. Ted Kennedy (D-MA) before the final health care bill could be brought up for a vote. Brown's victory gave Republicans 41 votes in the Senate, leaving Democrats with 59 members – one vote short of the 60 votes they needed to defeat a unanimous Republican filibuster against the final health care bill. 

In order to pass comprehensive health care legislation without a 60-vote majority in the Senate, Democratic leaders devised a plan in which the House would pass the Senate health care bill (H.R. 3590), thereby enabling the president to sign it into law. The House would then pass a separate companion bill (H.R. 4872) to make changes to the Senate health measure under a process known as "budget reconciliation." Bills considered under budget reconciliation cannot be filibustered under Senate rules. This process allowed the House to make changes to Senate-passed health care legislation without sending the entire health bill back to the Senate, where it could have been filibustered indefinitely.   The companion bill incorporated changes to the Senate health care legislation desired by House Democrats. The House passed the companion measure, and sent it to the Senate, where Democratic leaders hoped to defeat all amendments -- thereby avoiding a second vote in the House on a substantively changed bill; a vote that Democrats might have lost given the already tight margin when it was voted on the previous week.

The Senate voted to table (kill) the Cornyn amendment by a vote of 58-40. All 58 Democrats present voted “yea.” All 40 Republicans present voted “nay.” As a result, the Senate rejected an amendment Democratic leaders feared could have torpedoed the entire companion health care bill and that would have prohibited the Health and Human Services Department from implementing health care reform legislation until the Actuary of the Centers for Medicare and Medicaid Services (CMS) certified that the legislation will lower health care costs.