The Bill would cost more than $1 trillion over 10 years
The US House approved the most far-reaching changes to the nation’s health-care system in four decades, voting to require all Americans to get coverage and to subject insurers to new restrictions and new competition from a government programme.
The House voted 220-215 last night to approve the measure, which would cost more than $1 trillion over 10 years. Just one Republican, Representative Joseph Cao of Louisiana, backed the plan, and 39 Democrats broke ranks to oppose it.
Lawmakers hailed the step as a historic follow-on to the 1965 creation of the Medicare programme for the elderly and disabled. They said the bill would cover 36 million uninsured Americans and curb costs. New rules would prevent insurers from denying coverage to people with preexisting conditions, and seniors would get help obtaining preventive care and medicine.
“The House of Representatives passed a bill that would finally make real the promise of quality, affordable health care for the American people,” President Barack Obama said in a statement after the vote. He urged the Senate to act as well to get him legislation to sign by the end of the year.
House Speaker Nancy Pelosi told reporters she spoke to Obama after the vote, which he helped cement with a visit to Capitol Hill earlier in the day. “He provided the vision and the momentum for us to get the job done,” Pelosi said.
With the House vote, Congress moved closer than ever to a goal of universal access to health care. Former President Bill Clinton and first lady Hillary Clinton, now secretary of state, never got past committee work in the early 1990s.
Even so, “much work remains”, said Maryland Representative Steny Hoyer, the No.2 House Democrat.
The spotlight now moves to the Senate, where Majority Leader Harry Reid is struggling to get the votes to even begin debate on his version. Once the Senate passes a bill, lawmakers from each chamber would work together on a compromise for a new round of votes, a process likely to take months.
Reid last week wouldn’t commit to meeting Obama’s goal of signing a health-care bill into law by the end of the year. Already, it has been almost four months since four of the five congressional committees assigned to work on health care passed their versions of bills.
And House leaders can’t be sure of retaining all the votes they won last night. The bill passed over the objections of Democrats who favor abortion rights after an amendment put restrictions on the use of federal funds for the procedure for people using new insurance purchasing exchanges. Some Democrats said they wouldn’t support final legislation with the provision.
The House vote came after a daylong session in which the battle over abortion funding threatened to derail the bill’s chances, and disputes over everything from illegal immigrants to the cost of the legislation peeled away enough Democrats to make the balloting close. Republicans attacked the bill, with leader John Boehner calling it a “government takeover of health care”.
The margin was narrow enough to prompt last-minute lobbying from Obama, who pressed lawmakers to “rise to this moment, answer the call of history” and pass his signature initiative.
Cao broke ranks with fellow Republicans and voted for the measure after speaking earlier in the day with Obama.
“I have always said that I would put aside partisan wrangling to do the business of the people,” said Cao, one of the most vulnerable freshmen. “My vote tonight was based on my priority of doing what is best for my constituents.”
The day began with a raucous debate over the ground rules for considering the legislation. Michigan Representative John Dingell, 83, presided over the proceedings, wielding the same gavel he used during the debate that led to the creation of Medicare to calm down lawmakers shouting over each other.
After more than 5 1/2 hours of general debate, the lawmakers turned to an amendment from Michigan Democrat Bart Stupak to further limit the use of federal dollars for abortions. It passed on a 240-194 vote.
