WASHINGTON-Delivering a hard-fought victory in President Barack Obama's year-long pursuit of a national healthcare overhaul, a divided House tonight narrowly approved legislation which both supporters and opponents call historic in its sweep.
The House's 219-212 vote tonight on a Senate-passed bill will deliver to the president's desk an initiative for which he has fought on Capitol Hill and campaigned across the country: A healthcare bill that he finally can sign.
Thirty-four members of the president's party joined all the House's Republicans in voting against the healthcare bill.
The House then approved, by a vote of 220-211, a package designed to reconcile differences between the Senate-and-House-approved bill and another which the House already had approved in November.
Together, the two measures would present the president with a long-sought triumph for the signature domestic agenda of his presidency, a bid to offer health insurance to an estimated 32 million Americans who are uninsured and improve the coverage of those with insurance.
The second measure still must go to the Senate, where leaders hope to approve it by a simple majority vote under a process of "budget reconciliation.'' Any changes made in the Senate, however, would return that to the House before the President signs it.
"I know this bill is complicated, but it's also very simple,'' said House Majority Leader Steny Hoyer (D-Md.) during the final debate. "Illness and infirmity are universal, but we are stronger against them together than we are alone. In that shared strength is our nation's strength.''
"Tonight, we will make history for our country and progress for the American people,'' House Speaker Nancy Pelosi (D-Calif.) said in the leadership's closing argument. Crediting Obama for his "unwavering commitment to healthcare for all Americans,'' the speaker said "this legislation if I had one word to describe it tonight, it would be opportunity.''
"Today, we should be standing together, reflecting on a year of bipartisanship,'' House Minority Leader John Boehner (R-Ohio) said near the close of debate. "We should be looking with pride on this legislation, and our work. But it is not so. Today we are looking at a healthcare bill that nobody in this body believes is satisfactory.''
As the outcome of the vote appeared certain, Rep. John Kline (R-Minn.) told the House: "Perhaps it's time for Washington to stop talking and start listening. I'm listening to the thousands of citizens who traveled to our nation's capital this weekend to tell us in no uncertain terms, they want us to kill this bill.''
At an estimated cost of $940 billion over 10 years, supported in part by additional taxes on the wealthiest Americans, the legislation is projected to offer coverage to some 32 million uninsured people.
Democratic leaders hail the healthcare measure as "historic,'' legislation on a par with the enactment of Social Security after the Great Depression and Medicare in the 1960s. Underscoring that sense of history, House Rules Chair Louise Slaughter (D-N.Y.) brought to the floor and read from a copy of the typed 1939 letter that President Franklin Delano Roosevelt sent to Congress asking it to make a national healthcare program part of the Social Security Act.
"This is a historic day, and we are happy warriors,'' said Rep. John Larson (D-Conn.) in an appearance on CNN's State of the Union. said. "We will be a part of history, joining Franklin Delano Roosevelt's passage of Social Security, Lyndon Johnson's passage of Medicare and now Barack Obama's passage of healthcare.''
Republicans deride it as "a government takeover of healthcare.''
"Some say we're making history. I say we're breaking history,'' said Rep. Mike Pence (R-Ind.), near the end of the debate.
"Only in Washington, D.C., could you say you're going spend $1 trillion and save the taxpayers money,'' Pence said. "This Congress is poised to ignore the will of the majority of the American people…. This is the people's House, and the people don't want a government takeover of healthcare.''
The bills augurs the creation of "a European nanny-state,'' said Rep. Ted Poe (R-Texas) during an afternoon-long series of debates on the House floor. "The American people don't desire more oppressive, intrusive government in control of their health.''
"This trillion-dollar tragedy is just bad medicine,'' said Rep. Lee Terry, (R-Neb.), during final evening debate.
Although House leaders were confident of winning a close vote heading into the floor vote today, a critical logjam was broken when the White House announced that Obama will issue an executive order after expected passage of the healthcare legislation in the House asserting that it will not interfere with an existing ban on federal funding for abortions.
The move was designed to allow bill-critics concerned about abortion to vote for the healthcare bills, and several said they would.
"While the legislation as written maintains current law,'' White House Communications Director Dan Pfeiffer said in an issued statement, "the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation's restrictions against the public funding of abortions cannot be circumvented.
"The President has said from the start that this health insurance reform should not be the forum to upset longstanding precedent'' on abortion, Pfeiffer said. "The health care legislation and this executive order are consistent with this principle.''
The move was a signal to conservative Democrats in the House, led by Rep. Bart Stupak of Michigan, that they could lend their votes to the legislation. With House leaders fighting to corral the votes needed, support from Stupak and other holdouts would cement that final vote.
In a news conference following the White House announcement, Stupak and six of his Democratic colleagues said they would vote for the bill. Making no apologies for holding the bill up until the agreement was reached, Stupak said, ''We've all stood on principle. We've always said we were for health care reform but there was a principal that means more to us than anything the sanctity of life.''
"An executive order is not law,'' Rep. Dan Lungren (R-Calif.) argued on the House floor, asking abortion opponents not to be swayed.
The House's Democratic leaders have secured a narrow victory over monolithic Republican opposition as well as resistance from some wary Democrats in the approval of the healthcare bill which the Senate passed in December. The Senate passed it on a 60-39 vote cast strictly along party lines in a Christmas Eve session.
This bill would require most individuals to buy health insurance, offer federal subsidies to help pay premiums, impose penalties on employers that don't offer affordable polices and create a new insurance marketplace of exchanges for people with employer-supported coverage.
In addition, insurers would be prevented from denying coverage based on preexisting medical conditions or setting any lifetime cap on the benefits that they pay. Young adults also will be allowed to remain on their parents' plans longer, until they are 27 years old.
A momentous day began with protesters assembling early on the plaza of the Capitol. Opponents of the bill milled around in front of the House side calling out derisively to House Speaker Pelosi ``Naaancy, Naaancy, come outside,'' shouted one protestor. Another, with an anti-abortion slogan on her sweatshirt, knelt in prayer at the stairs leading to the Capitol dome.
In a closed-door caucus for Democrats, Rep. John Lewis, a Georgia Democrat and veteran of the Civil Rights movement who reportedly faced racial epithets from protesters outside the Capitol on Saturday, reminded his colleagues that they were acting on healthcare on the 45th anniversary of the Selma-to-Montgomery Civil Rights marches. Lewis was beaten in an infamous confrontation with police during the first of those marches.
As the caucus meeting ended, Pelosi joined Lewis in leading a caucus march through the street to the Capitol, almost daring protesters to repeat the previous day's slurs. Surrounded by a phalanx of security officers, Pelosi and Majority Leader Hoyer linked arms with Lewis and led House Democrats through a gauntlet of angry protesters.
On the House floor later, Lewis emotionally implored his colleagues to "answer the call of history… Give healthcare a chance.''
A familiar counterpoint between Democrats and Republicans aligned against the bill had played out all day long.
Rep. Patrick Kennedy (D-R.I.) quoted his father, the late Sen. Edward M. Kennedy of Massachusetts, a career-long champion of healthcare reform until has passing last year.
"The parallel between the struggle for Civil Rights and the fight to make healthcare affordable for all Americans is significant,'' he said. "Healthcare is not only a Civil Right. It's a moral issue".
Democrats are hailing the measure for its deficit relief with an estimated $138 billion reduction in the annual federal budget deficit over 10 years. Republicans are dismissing the projection of the Congressional Budget Office as phony math.
"The oldest trick in the book in Washington is you can manipulate a bill to manipulate the results,''' Rep. Paul Ryan (R-Wis.) told the House.
"This bill is a fiscal Frankenstein,'' Ryan said.
Even as the year-long legislative journey came to a climactic House vote, the debate was shrouded in uncertainty about how and whether the legislation would work and about how the politics will play out in the fall. Republican leaders maintain that Democrats who support the bill will face "a price to pay'' in the midterm congressional elections.
That is fitting for a debate that, at every stage, has been riddled with unpredictable twists and turns.
The progress of the healthcare bill has been buffeted by unexpected events, such as the death of Sen. Kennedy, the he patriarch of the drive for universal health care; the loss of the Democrats' 60-vote majority in the Senate when Kennedy was replaced by Republican, Scott Brown; an abrupt and well-publicized boost in health insurance premiums charged by Anthem Blue Cross in California; and the proclaimed death and resurrection of the" public option,'' a government-run alternative for which liberal Democrats had fought, time and again. It is absent from the final bills.
More importantly, consumers face vast uncertainty about the impact of the bill. Democrats and Obama plan to devote the next few months to making sure consumers understand its benefits immediate (insurance regulation) and in the future (insurance purchasing exchanges); concrete (closing the gap in Medicare prescription drug coverage) and abstract (sense of security).
Democrats believe that one of the most important documents in their arsenal is a list prepared by their leadership of the provisions of the bill that kick in almost immediately, including the guarantee that children will not be denied coverage for preexisting conditions and the provision allowing young adults to remain on their parents' policies.
But some Democrats are still anxious that voters will now blame the President and the Democrats for every thing that goes wrong from long lines at the pharmacy to delays in processing insurance claims whether they are attributable to the health care bill or not.
President Obama's Remarks Following Health Care Reform Bill Passage
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