Delivering a hard-fought victory in President Barack Obama's yearlong pursuit of a national health care overhaul, a divided House narrowly approved legislation Sunday night that could reshape the way Americans deal with wellness and illness.
House Democratic leaders proved they could hold the majority caucus together, passing the Senate version of the health care legislation, 219-212, after weeks of arm-twisting and politicking.
A reconciliation package of amendments also passed the House on Sunday night. That measure, which will resolve disagreements between the House and Senate bills, will have to go to the Senate under a "budget reconciliation" process. It can be passed by a simple majority and cannot be filibustered.
Led by Obama, Democrats made health care the centerpiece of their domestic agenda in this midterm election year.
Republicans oppose the legislation, arguing it is too expensive and broadens government powers too much. They argue the majority Democrats have rammed the bill through, avoiding GOP policy suggestions.
Democrats accuse the Republicans of refusing to negotiate in order to hand Obama a major political defeat. Democrats also say they have incorporated some Republican suggestions into the final legislation.
Democratic leaders hailed the health care overhaul as historic legislation on par with the enactment of Social Security during the Great Depression and Medicare in the 1960s.
Underscoring that sense of history, House Rules Chairwoman Louise Slaughter, D-N.Y., brought to the floor and read from a copy of the typed 1939 letter President Franklin D. Roosevelt sent to Congress asking it to make a national health care program part of the Social Security Act.
"This is a historic day, and we are happy warriors," said Rep. John Larson, D-Conn., in an appearance on CNN's "State of the Union." "We will be a part of history, joining Franklin Delano Roosevelt's passage of Social Security, Lyndon Johnson's passage of Medicare and now Barack Obama's passage of health care."
Republicans didn't see it that way.
"Some say we're making history. I say we're breaking history," said Rep. Mike Pence, R-Ind.
"Only in Washington, D.C., could you say you're going to spend $1 trillion and save the taxpayers money," he said. "This Congress is poised to ignore the will of the majority of the American people. ... This is the people's House, and the people don't want a government takeover of health care."
"This trillion-dollar tragedy is just bad medicine," Rep. Lee Terry, R-Neb., said.
A key development in the legislative fight occurred Sunday afternoon, when the White House announced Obama would issue an executive order asserting the health care bill would not interfere with an existing ban on federal funding for abortions.
"While the legislation as written maintains current law," White House spokesman Dan Pfeiffer said in a statement, "the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and the health care legislation's restrictions against the public funding of abortions cannot be circumvented."
The move was intended as a signal to conservative Democrats in the House, led by Rep. Bart Stupak of Michigan, that they can lend their votes to health care legislation.
In a news conference after the White House announcement, Stupak and six of his Democratic colleagues said they would vote for the bill. Making no apologies for holding the bill up until the agreement was reached, Stupak said: "We've all stood on principle. ... We've always said we were for health care reform, but there was a principle that means more to us than anything - the sanctity of life."
Republicans urged abortion opponents not to be swayed.
"An executive order is not law," Rep. Dan Lungren, R-Calif., argued on the House floor.
Under the legislation, most Americans for the first time would be required to purchase insurance, and they would face penalties if they failed to do so. The bill includes billions of dollars in subsidies and tax breaks to make insurance more affordable, and it also provides for an expansion of Medicaid, the government health care program for the poor.
The health care legislation would extend coverage to about 32 million uninsured people and would impose new rules on insurance companies to prevent them from denying benefits because of preexisting conditions. To help those who must buy their own insurance, it would establish insurance exchanges to increase competition among insurance companies.
It calls for new taxes and fees as well as cuts in Medicare, the insurance program for the elderly.
Democrats argue the cuts would eliminate waste, fraud and abuse, and Republicans contend the cuts would decrease services for the aged.
The health care plan would cost $940 billion over 10 years, according to the Congressional Budget Office. But Republicans disputed the numbers.
"The oldest trick in the book in Washington is you can manipulate a bill to manipulate the results," Rep. Paul Ryan, R-Wis., told the House. "This bill is a fiscal Frankenstein."
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