In a legislative accomplishment that seemed unthinkable two months ago, House Democrats Sunday night passed President Obama’s health care reform into law, in a historic vote that will dramatically impact the nation over the long term and in the near term play a potentially decisive role in this fall’s elections.
The House of Representatives approved a sweeping $940 billion overhaul of the nation’s health care system by a vote of 219 to 212, with 34 Democrats voting against the measure along with all 178 Republicans.
Moments later, the House passed a “reconciliation” piece of legislation, 220 to 211, that will alter the Senate-passed bill if and when the Senate passes the reconciliation legislation.
Obama, speaking at the White House after the vote, declared the expansion of health care coverage to roughly 32 million Americans without it a fulfillment of his 2008 campaign for the presidency.
“This is what change looks like,” he said.
“This isn’t radical reform, but it is major reform,” Obama said, addressing the concerns of Republicans that the legislation is a major step toward government-run health care.
It is an enormous political victory for the president, who staked everything on getting his top legislative goal passed into law, and was finally successful after many near-failures. His health care agenda looked stalled, possibly permanently, following Democrats’ loss of the Massachusetts Senate seat in January.
The victory will stand in the history books but may inflict a heavy political damage this fall, as the legislation has been deeply unpopular in national polls for many months and was met with loud and sustained protests outside the Capitol for two days.
But Democrats made a political calculation that it will be better to run on a passed piece of legislation than to have passed nothing at all, and they will immediately begin emphasizing benefits that kick in immediately, unlike the most sweeping portions of the plan, which do not begin until 2014.
Speaker Nancy Pelosi hailed the passage of “health care for all Americans.”
“This is an American proposal that honors the traditions of our country,” she said in a speech on the House floor moments before the vote.
Republicans said it was the opposite.
Rep. Paul Ryan, Wisconsin Republican, said the vote was a step toward a European social welfare model of government.
“This is not who we are and it is not who we should become,” Ryan said in a floor speech.
House Minority Whip Eric Cantor, Virginia Republican, said in his floor speech that the vote was part of “an agenda that is being forced upon the American people that attempts to seize more control over the economy and our lives.”
The bill will mandate that all Americans purchase health insurance, at the threat of financial penalties, and will provide government subsidies to families making up to $88,000 for that purpose.
It will also set up exchanges under federal government guidelines in which individuals and small businesses can pool together to purchase their insurance.
It is a large expansion of Medicaid, giving coverage for families of four making up to $29,327 a year. Children will be able to stay on their parent’s insurance up to age 26.
The provision is paid for with over $400 billion in higher taxes over the next 10 years, much of it coming from a new Medicare payroll tax on individuals making $200,000 a year and families making $250,000 and up.
The bill also cuts about $500 billion from Medicare. Democrats argued they are getting rid of waste in the system.
Republicans decried the passage of a law that they said gives the government too much control over health care, citing the requirement that health plans meet government-prescribed conditions. They also cited the nearly $1 trillion price tag.
But Obama said the bill, which he is expected to sign Tuesday, will rein in insurance company abuses, drive down prices for small businesses and individuals, extend the solvency of Medicare and reduce the deficit.
The passage of the bill ended a more than year-long political drama that threatened to inflict terminal damage on the Obama presidency.
The political theater was heightened in the days leading up to the vote in the House, as a pro-life group of Democrats led by Rep. Bart Stupak, Michigan Democrat, became the pivotal bloc of votes needed to pass the bill.
Stupak’s concerns that the bill not allow the use of federal funds to pay for abortion were allayed in the end by an executive order issued by the president.
Republicans said the executive order had very little actual force and would not stop the use of government money going toward abortion. But Stupak insisted it would, and in the end, his decision a few hours before the vote to support the bill swung a key bloc of around six votes toward the bill that made the difference.