The
House of Representatives passed legislation for the first time Saturday
night that would provide health coverage to almost every American after
nearly a century of false starts and un-kept campaign promises.
The final vote was 220-215. In all, 219 Democrats voted to approve the
measure in a largely party-line vote, with 39 Democrats voting no. One
Republican supported the bill, Rep. Joseph Cao (R-La.).
The bill has a steep cost – both in dollars, $1.2 trillion, and
political capital – but Democrats hailed its passage as the next
chapter in a governing legacy that produced Medicare and Social
Security.
“Today, as we all know, is an historic moment for our nation and for
American families,” Speaker Nancy Pelosi said on the House floor hours
before the vote.
President Barack Obama has made health care reform his signature
legislative priority — and he put his personal prestige on the line
Saturday by traveling to the Capitol to rally Democrats, telling them
to answer the call of history by passing the bill.
But Republicans were equally sweeping in their objections to the bill.
“This is perhaps the worst bill I have seen come to the floor in my 11
years in Congress,” said Wisconsin Rep. Paul Ryan.
The bill includes fundamental changes to the American health care
system – creating a public health insurance option to compete with
private insurers and for the first time, requiring employers to offer
health insurance.
The path ahead remains shaky – for the bill and for many of the
Democrats who voted to approve it. Party leaders need to mend the
bruised feelings that will linger from this debate before they can
address whatever legislation the Senate can produce.
And in the Senate, Majority Leader Harry Reid has made clear he might
not meet the White House’s Christmas deadline to pass a bill and is
still struggling to find 60 votes for Senate legislation.
Fights over abortion, immigration and the size of the federal
government exposed long-standing cultural and regional divides within
the disparate Democratic caucus. A last-minute abortion fight left a
particularly bitter taste in the mouth of Democratic women who spent
the early part of their careers fighting for reproductive rights.
“People are furious,” said Colorado Rep. Diana DeGette.
After hours of negotiations with a group of abortion opponents, led by
Indiana Rep. Brad Ellsworth, and the United States Conference of
Catholic Bishops, Pelosi made a final painful sacrifice to pick up
crucial support, allowing a vote on an amendment sponsored by Ellsworth
and Michigan Rep. Bart Stupak that would bar any insurance company
participating in the exchange program from covering the procedure.
Stupak’s amendment passed with a vote of 240 -194-1. Republican Rep. John Shadegg of Arizona was the one present vote.
The two sides engaged in a fevered debate on the House floor hours
before the House approved the overarching health care bill, with
DeGette calling the amendment “a wolf in sheep’s clothing” and
Connecticut Rep. Rosa DeLauro, a Pelosi ally, saying, “It attempts an
unprecedented overreach.”
But in the end, Democrats, like DeGette, subverted their political
prerogatives and personal anger for a bigger goal – providing health
care to 97 percent of the country.
“I don't believe any of us believe we can hold up what we've been
fighting for ... and that's health care," said Rules Committee
Chairwoman Louise Slaughter (D-N.Y.), who left her own chamber when the
panel granted Stupak his vote.
The bill would expand coverage to 36 million uninsured Americans
through a mix of subsidies and incentives and mandates on individuals
and businesses. Under the plan, individuals would have to secure
insurance through their employers or through an insurance exchange
established by the bill. Authors set aside subsidies to help lower- and
middle-income Americans who don’t qualify for Medicaid pay for that
insurance.
In an effort to lower premiums across the marketplace, House Democrats
would create a government insurance option to compete with private
insurers that would operate in the exchange. And businesses with more
than $500,000 in annual payroll would be required to cover their
employees or pay a penalty of as much as 8 percent of the combined
salaries.