House Passes Historic Health Care BillNovember 7, 2009 - by Donny Shaw
The House of Representatives on Saturday night approved landmark legislation designed to accomplish President Obama’s goals of reducing health care costs, increasing choices for consumers and guaranteeing access to quality, affordable insurance for all Americans. The final vote tally was 220-215. Thirty-nine Democrats broke with their party to vote against the bill, and only one Republican, Rep. Anh Cao [R, LA-2], voted in favor.
Previous Congresses and Administrations have tried several times over the past 40 years to revamp the U.S. health care system, but they have never come this far. The bill passed in the House represents the biggest change to the health care system and the biggest expansion in coverage since Congress created Medicare and Medicaid in 1965.
The bill’s passage was secured in large part by a vote that took place earlier in the evening on an amendment from Rep. Bart Stupak [D, MI-1] to strengthen language in the bill banning the use of federal funds for abortions. The amendment, which was approved by a vote of 240-194, essentially restricts all low and middle-income people purchasing insurance with federal subsidies from buying a plan that covers abortions besides those resulting from rape or incest, or in cases where the mother’s life is endangered. A bloc of about forty conservative Democrats had been threatening for weeks to vote en masse to kill the bill if they weren’t allowed to vote on Stupak’s amendment.
President Obama also threw his full support behind the bill today in a plea to help House Democrats round up the final few votes they needed to get it passed. Speaking to the full House Democratic Caucus but gearing his remarks towards conservative Democrats, Obama said that voting against the bill wouldn’t protect them from partisan attacks. “None of you can expect the Republicans not to go after you if you vote against this bill,” Obama said at the meeting according to Rep. Henry Waxman [D, CA-30]. “They want this bill to go down for their own partisan reasons.”
The bill – known as the Affordable Health Care for America Act – seeks to expand health care coverage to the approximately 40 million Americans who are currently uninsured by lowering the cost of health care and making the system more efficient. To that end, it includes a new government-run insurance plan to compete with the private companies, a requirement that all Americans have health insurance, a ban on denying coverage because of a pre-existing condition and, to pay for it all, a surtax on individuals with incomes above $500,000. More thorough summaries of the bill can be found here.
The Senate is still weeks away from beginning debate on their own health care bill. The final details of their bill are still being negotiated, but whatever bill comes out of the Senate will be more conservative than the House’s bill in several ways. It is not clear that the Senate bill will end up containing a public option, and if it does, unlike the House bill it will allow individual states to opt out of offering it to their residents. The Senate’s bill will also provide fewer subsidies to help low and middle-income people buy insurance, and it will not include a surtax on the rich to offset its new spending.
The abortion issue that threatened to bring down the House bill so far has not been a problem in the Senate. Pro-choice Democrats are hoping to keep the Senate’s bill containing language that would allow people to use affordability credits to buy insurance that covers abortions, provided that the abortion part of the plan is fully paid for by individual premiums. The Senate language would then have to be reconciled with the House’s more conservative language by a joint-chamber conference committee that would be in charge of producing a final, merged bill. The final version will need one more vote from each chamber before it can be sent to President Obama to be signed into law.