Health Insurance Reform - One More Hurdle!

House Passes Health-Care Bill in Historic Vote

By JANET ADAMY and NAFTALI  BENDAVID (Edited by Kitty)
WASHINGTON --
The House narrowly passed its sweeping health bill late Saturday, marking the biggest victory yet for Democrats in their drive to create near-universal health insurance.The bill passed by a 220-215 margin after fractious debate and garnered the unexpected backing of only one Republican, Rep. Joseph  Cao of Louisiana. Thirty-nine Democrats voted against the measure. The narrow passage in the House, where the Democrats have a large majority, underscores the divisiveness of the legislation.

The vote was a victory for President Barack Obama and House Speaker Nancy Pelosi (D., Calif.), and moved them toward a goal that has eluded presidents for decades. Mr. Obama came to the Capitol on Saturday morning and assured Democrats they would remember the vote as their finest moment in politics should he sign it into law. "Opportunities like this come around maybe once in a generation," he said. Its passage pushes Congress closer to the largest social safety net expansion since 1965, when the government created the Medicare insurance program for the elderly. The measure spends slightly more than $1 trillion over a decade to provide health insurance to an additional 36 million Americans and creates a new public insurance plan to compete with private insurers by 2013. It requires most Americans to carry insurance, creates a new exchange where they can shop for it and gives the lowest earners tax credits to help them pay for it.


As the vote count hit the 218 needed to secure passage, Democrats erupted in cheers. They turned to hug and kiss each other and then shouted out a countdown of the last 10 seconds before the vote closed. Republicans were silent. On the rest of the bill, Republicans offered nothing but sharp opposition. Democrats easily voted down Republicans' attempt to pass their own bill, which would have more narrowly expanded health insurance and cost $61 billion over a decade.

Democrats portrayed their legislation as a moral imperative that would achieve a goal sought by presidents since Theodore Roosevelt. They argued it would fix the worst aspects of the medical system by preventing insurers from denying coverage to the sick and protecting consumers from financial ruin caused by medical bills. "It is testimony to how we care for our fellow citizens," said John Larson (D., Conn.). "It is at the very core of all that America stands for, and why we came here to serve."

The vote was perhaps the most far-reaching consequence of the Democrats' sweeping election victories in 2006 and 2008. Democrats have felt pressure to produce results to show for those victories.The health vote also put newly elected Democrats from conservative areas in a tough political position, caught between party leaders and their election prospects in 2010.


One of the day's most dramatic scenes  of the day came when lawmakers sparred over an amendment that would exclude coverage of abortion for those gaining new health insurance under the overhaul. The 240-194 vote to pass the amendment flipped the usual voting lineup, with 176 Republicans joining 64 Democrats in favor.  The block of ANTI-ABORTION  Democrats led by Rep. Bart Stupak (D., Mich.) refused to sign onto the legislation unless House leaders agreed to take up an amendment preventing anyone who gets a government tax credit to buy insurance from enrolling in a plan that covers abortion. 

The U.S. Conference of Catholic Bishops threatened to withhold its support from the entire legislation unless House leaders took up the amendment. Anti-abortion advocates lauded the change and described it as the most significant House vote on the issue in more than a decade. They said it preserves existing abortion laws that restrict the government from funding the procedure.

 Mr. Stupak  argued that the bill "in no way prohibits any individual from purchasing a supplemental abortion coverage. ABORTION -RIGHTS SUPPORTERS  were stunned by the change and argued it erodes existing laws that protect women's access to abortion. Those who receive an insurance subsidy and want coverage for abortion would need to buy a rider policy since private plans wouldn't include it in their coverage. "What woman would buy a plan for an unplanned pregnancy?" asked Laurie Rubiner, vice president for public policy for the Planned Parenthood Federation of America.

The Congressional Budget Office estimates that by 2019, the bill would leave about 96% of legal residents with health insurance, up from 83% now. To pay for expanding insurance coverage, the bill calls for hundreds of billions of dollars in cuts to Medicare aimed at eliminating its wasteful spending. It levies a 5.4% tax on the wealthy that targets individuals earning more than $500,000 a year and couples earning more than $1 million a year. All employers would be required to provide insurance and pay for most of the premium, or they would face a fine of up to 8% of their payroll. The small businesses would not be required.



The focus now turns to the Senate. Majority Leader Harry Reid (D., Nev.) said Saturday that he expects to get cost estimates for the Senate bill from the Congressional Budget Office in the next couple of days, and that he hopes to bring a bill to the Senate floor "as soon as possible.

Democratic leaders had aimed to deliver a bill to the president this year but have effectively acknowledged that deadline could slip into 2010. The challenges are facing Senate Democrats, who will be working with no Republican nor Democrats support to hold together a fragile coalition.

The challenge in the Senate is greater, since Mr. Reid must cobble together 60 votes out of 100 to proceed to a final vote, rather than a simple majority. (100 Senators; 58 Democrats, 40 Republicans and 2 Independence) Independent Sen. Joe Lieberman(Conn.) has already planned to oppose any legislation that includes a government-run health-insurance plan like the one in the House bill.


The health overhaul still has before it can become law, and its final passage is far from assured. The Senate must pass its own bill and meld it with the House bill before sending it to President Obama's desk. It's more difficult to pass legislation through the Senate, and despite Democrats' wide majority there, leaders are straining to bring together their fractious coalition. 

Any final bill is likely to be more moderate, and possibly less ambitious, than what passed through the more liberal House. It faces a tougher fight in the Senate where Republicans and some Democrats argue that the bill is too costly and won't achieve its goals.

The abortion issue is likely to arise in the Senate as well. And because rules in the Senate give more power to individual lawmakers, the debate is likely to take weeks, rather than hours.


Information on the bill - 

http://www.opencongress.org/bill/111-h3200/show