This was ostensibly a vote on a motion to table (kill) a "motion to commit (i.e. an amendment) by Sen. Orrin Hatch (R-UT) that would have eliminated a provision in major health care legislation that cut funding for the Medicare Advantage program.  (Under the Medicare Advantage program, Medicare beneficiaries can receive their benefits through private insurers as opposed to the traditional government-run Medicare program.) The measure Hatch 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.”

If passed, a motion to commit sends the legislation back to committee with instructions to amend the legislation as specified.

While drafting the health care bill, Democrats decided to cut funding for Medicare Advantage because it is more costly to taxpayers than the traditional Medicare program.

Hatch urged support for his motion to commit: "…The bill the President signed into law yesterday would slash $120 billion from the Medicare Advantage program. This reconciliation bill would cut the program by an additional $66 billion for a grand total of $202 billion….Medicare Advantage works. Every Medicare beneficiary has access to a Medicare Advantage plan. Almost 90 percent of Medicare beneficiaries participating in the program are satisfied with their health coverage. It is time for us to stand up for more than 10 million seniors and ensure that this program is not used as a piggy-bank to finance Washington's big government plans."

Sen. Max Baucus (D-MT) made a motion to table (kill) Hatch's motion, contending it was intended to kill the companion bill: "…This clearly is designed to kill the bill. All motions to commit have that intent and effect. Let's remind ourselves, the underlying bill protects all Medicare beneficiaries....the underlying bill reforms Medicare Advantage which rewards high performance Medicare Advantage programs, those providing value, whereas under current law that is not the case."

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 tabled (killed) the motion to commit by a vote of 56-42. 56 Democrats voted "yea." All 40 Republicans present and 2 Democrats voted "nay." As a result, the Senate did not include a provision in the companion health care bill eliminating budget cuts to the Medicare Advantage program, which Democratic leaders feared could have torpedoed the entire companion health care measure.