WASHINGTON — House Democrats approved a far-reaching overhaul of the
nation’s health system on Sunday, voting over unanimous Republican
opposition to provide medical coverage to tens of millions of uninsured
Americans after an epic political battle that could define the
differences between the parties for years.
With the 219-to-212 vote, the House gave final approval to legislation
passed by the Senate on Christmas Eve. Thirty-four Democrats joined
Republicans in voting against the bill. The vote sent the measure to President Obama, whose yearlong push for the legislation has been the centerpiece of his agenda and a test of his political power.
The president intends to sign the measure on Tuesday.
After approving the bill, the House adopted a package of changes to it
by a vote of 220 to 211. That package — agreed to in negotiations among
House and Senate Democrats and the White House — now goes to the Senate
for action as soon as this week. It would be the final step in a bitter
legislative fight that has highlighted the nation’s deep partisan and
ideological divisions.
On a sun-splashed day outside the Capitol, protesters, urged on by
House Republicans, chanted “Kill the bill” and waved yellow flags
declaring “Don’t Tread on Me.” They carried signs saying “Doctors, Not
Dictators.”
Inside, Democrats hailed the votes as a historic advance in social justice, comparable to the establishment of Medicare and Social Security. They said the bill would also put pressure on rising health care costs and rein in federal budget deficits.
“This is the Civil Rights Act of the 21st century,” said Representative
James E. Clyburn of South Carolina, the No. 3 Democrat in the House.
Mr. Obama celebrated the House action in remarks at the White House.
“We pushed back on the undue influence of special interests,” Mr. Obama
said. “We didn’t give in to mistrust or to cynicism or to fear.
Instead, we proved that we are still a people capable of doing big
things.”
“This isn’t radical reform,” he added, “but it is major reform.”
After a year of combat and weeks of legislative brinksmanship, House
Democrats and the White House clinched their victory only hours before
the voting started on Sunday. They agreed to a deal with opponents of abortion
rights within their party to reiterate in an executive order that
federal money provided by the bill could not be used for abortions,
securing for Democrats the final handful of votes they needed to assure
passage.
Winding up the debate, Speaker Nancy Pelosi
said: “After a year of debate and hearing the calls of millions of
Americans, we have come to this historic moment. Today we have the
opportunity to complete the great unfinished business of our society
and pass health insurance reform for all Americans that is a right and not a privilege.”
The House Republican leader, Representative John A. Boehner
of Ohio, said lawmakers were defying the wishes of their constituents.
“The American people are angry,” Mr. Boehner said. “This body moves
forward against their will. Shame on us.”
Republicans said the plan would saddle the nation with unaffordable
levels of debt, leave states with expensive new obligations, weaken
Medicare and give the government a huge new role in the health care
system.
The debate on the legislation set up a bitter midterm campaign season,
with Republicans promising an effort to repeal the legislation,
challenge its constitutionality or block its provisions in the states.
Representative Paul D. Ryan, Republican of Wisconsin, denounced the
bill as “a fiscal Frankenstein.” Representative Lincoln Diaz-Balart,
Republican of Florida, called it “a decisive step in the weakening of
the United States.” Representative Virginia Foxx, Republican of North
Carolina, said it was “one of the most offensive pieces of social
engineering legislation in the history of the United States.”
But Representative Marcy Kaptur,
Democrat of Ohio, said the bill heralded “a new day in America.”
Representative Doris Matsui, Democrat of California, said it would
“improve the quality of life for millions of American families.”
The health care bill would require most Americans to have health insurance, would add 16 million people to the Medicaid
rolls and would subsidize private coverage for low- and middle-income
people, at a cost to the government of $938 billion over 10 years, the Congressional Budget Office said.
The bill would require many employers to offer coverage to employees or
pay a penalty. Each state would set up a marketplace, or exchange,
where consumers without such coverage could shop for insurance meeting
federal standards.
The budget office estimates that the bill would provide coverage to 32
million uninsured people, but still leave 23 million uninsured in 2019.
One-third of those remaining uninsured would be illegal immigrants.
The new costs, according to the budget office, would be more than
offset by savings in Medicare and by new taxes and fees, including a
tax on high-cost employer-sponsored health plans and a tax on the
investment income of the most affluent Americans. CONTINUE READING
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