House Passes Health-Care Bill

Published:March 22, 2010
Inquirer

By David Espo
Associated Press

WASHINGTON - Summoned to success by President Obama, the Democratic-controlled Congress approved historic legislation last night extending health care to tens of millions of uninsured Americans and cracking down on insurance-company abuses, a climactic chapter in the century-long quest for near-universal coverage.

Widely viewed as dead two months ago, the Senate-passed bill cleared the House on a 219-212 vote, with Republicans unanimous in opposition. Congressional officials said they expected Obama to sign the bill as early as tomorrow.

Obama watched the vote in the White House's Roosevelt Room with Vice President Biden and dozens of aides. When the long-sought 216th vote came in - the magic number needed for passage - the room burst into applause and an exultant president exchanged a high-five with his chief of staff, Rahm Emanuel.

"We proved that we are still a people capable of doing big things," the president said a short while later in televised remarks. "We proved that this government - a government of the people and by the people - still works for the people.

A second measure, making changes in the first, cleared the House 220-211 shortly before midnight and was sent to the Senate, where Democratic leaders said they had the votes necessary to pass it quickly.

Crowds of protesters outside the Capitol shouted "just vote no" in a futile attempt to sway the historic vote taking place inside a House packed with lawmakers and ringed with spectators in the galleries above.

Across hours of debate, House Democrats predicted the central bill, costing $940 billion over a decade, would rank with other great social legislation of recent decades.

"We will be joining those who established Social Security, Medicare, and now, tonight, health care for all Americans," said Speaker Nancy Pelosi, partner to Obama and Senate Majority Leader Harry Reid in the grueling campaign to pass the legislation.

"This is the civil rights act of the 21st century," added Rep. Jim Clyburn of South Carolina, the top-ranking black member of the House.

Defeated Republicans warned of a government takeover of the health-care system, financed by a trillion dollars in higher taxes and Medicare cuts combined.

"There is dirty deal after dirty deal after dirty deal in the bill this House will vote on," Rep. Mike Rogers of Michigan said during the debate. "It is a disgrace."

The measure cleared a critical early test vote, 224-206, a few hours after Obama and Democratic leaders struck a compromise with antiabortion lawmakers whose votes had left the outcome in doubt. The president issued an executive order pledging that no federal funds would be used for elective abortion.

Rep. Bart Stupak (D., Mich.) and a handful of fellow abortion opponents said they were satisfied and announced their support for the bill. A spokesman for the U.S. Conference of Catholic Bishops expressed skepticism that the presidential order would satisfy the church's objections. The National Right to Life Committee quickly issued a scathing statement disputing Stupak's claim.

A shouting band of protesters outside the Capitol dramatized their opposition, and one man stood up in the House visitors' gallery yelling, "Kill the bill" before he was ushered out - evidence of the passions the tumultuous yearlong debate over health care has stirred.

For the president, the events capped an 18-day stretch in which he traveled to four states and lobbied more than 60 wavering lawmakers in person or by phone to secure passage of his signature domestic issue. According to some who met with him, he warned that the bill's demise could cripple his still-young presidency.

Far beyond the political ramifications - a concern the president repeatedly insisted he paid no mind - were the sweeping changes the bill held in store for millions of individuals, the insurance companies that would come under tougher control, and the health-care providers, many of whom would face higher taxes.

For the first time, most Americans would be required to buy insurance and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums. The measure would also usher in a significant expansion of Medicaid, the federal-state health care program for the poor.

Coverage would be required for incomes up to 133 percent of the federal poverty level.

The insurance industry, which spent millions on advertising trying to block the bill, would come under new federal regulation. Insurance companies would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of preexisting conditions, and from canceling policies when a policyholder becomes ill.

A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion would go into high gear.

After more than a year of political combat - certain to persist into the fall election campaign for control of Congress - Democrats piled superlative upon superlative across several hours of House debate.

Rep. Louise Slaughter of New York read a message President Franklin Roosevelt sent Congress in 1939 urging lawmakers to address the needs of those without health care, and said Democrat Harry Truman and Republican Richard Nixon had also sought to broaden insurance coverage.

Republicans attacked the bill without let-up, warning it would harm the economy while requiring a government takeover of the health-care system.

"The American people know you can't reduce health-care costs by spending $1 trillion or raising taxes by more than one-half trillion dollars. The American people know that you cannot cut Medicare by over one-half trillion dollars without hurting seniors," said Rep. Dave Camp (R., Mich.). "And, the American people know that you can't create an entirely new government entitlement program without exploding spending and the deficit."

But Democrats were jubilant. "It is time to put American families back in control of their health care," Rep. Allyson Y. Schwartz (D., Pa.) said as the debate began.

Obama has said often that presidents of both parties have tried without success to achieve national health insurance, beginning with Theodore Roosevelt.

The 44th president's quest to succeed where others have failed seemed at a dead end two months ago, when Republicans won a Massachusetts special election for a Senate seat, and with it, the votes to prevent a final vote. But Pelosi (D., Calif.) and Reid (D., Nev.) soon came up with a rescue plan that required the House to approve the Senate-passed measure despite opposition to many of its provisions, then have both houses pass a fix-it measure incorporating numerous changes.

To pay for the changes, the legislation includes more than $400 billion in higher taxes over a decade, roughly half of it from a new Medicare payroll tax on individuals with incomes over $200,000 and couples over $250,000. A new excise tax on high-cost insurance policies was significantly scaled back in deference to complaints from organized labor.

In addition, the bills cut more than $500 billion from planned payments to hospitals, nursing homes, hospices, and other providers that treat Medicare patients. An estimated $200 billion would reduce planned subsidies to insurance companies that offer a private alternative to traditional Medicare.

The insurance industry warned that seniors would face sharply higher premiums as a result, and the Congressional Budget Office said many would return to traditional Medicare as a result.

The subsidies are higher than those for seniors on traditional Medicare, a difference that critics complain is wasteful, but insurance-industry officials argue goes into expanded benefits.

This article contains information from the New York Times.