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House Passes Democrats' Health Care Overhaul Package

By Edward Epstein, CQ Staff

March 22, 2010 -- The House passed an historic health care overhaul package late Sunday, clearing a bill to expand coverage to an estimated 32 million more Americans and passing a separate measure making significant changes to that bill.

The debate was hard-fought and Sunday's roll calls followed months of intense negotiations and legislative haggling that finally gave Democrats a victory the party has sought for nearly five decades.

President Obama applauded the action and praised Democrats for taking what he acknowledged was a tough vote for some. "This is what change looks like," said Obama a short time after in televised remarks from the East Room of the White House.

"At a time when the pundits said it was no longer possible, we rose above the weight of our politics," he said, adding, "We didn't give into mistrust or cynicism or fear. Instead we proved we are a people still capable of big things."

House Speaker Nancy Pelosi then celebrated with her leadership team and called the action "a great act of patriotism" and stressed the legislation as "fiscally sound."

The two measures were pushed forward without the help of a single Republican. By 219-212, the House first cleared the Senate-passed health bill (HR 3590) for Obama's promised signature. Thirty-four Democrats joined all 178 Republicans in opposing the Senate bill.

Republicans then attempted unsuccessfully to shelve the reconciliation measure. The House defeated, 199-232, the GOP motion to send that bill (HR 4872) back to the Budget Committee to add tougher language on abortion funding that was part of a House-passed health bill (HR 3962). Twenty-one Democrats voted with the GOP.

Democrats then turned to the reconciliation bill that reflects deals reached by congressional Democrats and the White House to modify the version earlier passed by the Senate, passing it on a vote of 220-211. Thirty-three Democrats joined Republicans in opposition.

The Senate is expected to take up the bill as early as Tuesday under special budget reconciliation rules that will shield it from filibusters, but not from a blizzard of GOP-sponsored amendments.

For House Democrats, the vote to send Obama the Senate-passed health care bill was a painful one. The legislation offers less generous subsidies than they wanted to help individuals buy health insurance and contains a number of special provisions that critics have assailed as sweetheart deals designed to buy off votes in the Senate the first time around.

Republicans said they will continue to accuse everyone who voted for the bill of supporting the "Cornhusker Kickback," the "Louisiana Purchase," "Gator Aid" and similar provisions that offer some states more Medicaid payments than others. The reconciliation bill would strip some but not all of those provisions.

But once Democrats discovered there was no way to vote on the reconciliation bill ahead of the Senate-passed measure, they accepted the risks and cast their votes.

Long Debate Draws To Close
In closing the rare Sunday debate, Pelosi, D-Calif., cast the vote in historic terms. "Today we have the opportunity to complete the great unfinished business of our society by passing health care reform that is a right, not a privilege for all American citizens," she said.

She also pushed back against Republican criticism that the legislation is socialist or un-American. "This is an American proposal that honors the traditions of our country," she said.

Minority Leader John A. Boehner, R-Ohio, accused the Democrats of recklessly disregarding the will of the American people, who, he said, reject the majority's ideas. "We have failed to listen to America and we have failed to reflect the will of our constituents," he said.

And Boehner had a warning for the Democratic majority: "In a democracy you can defy the will of the people for only so long."

"Shame on you for substituting your will for that of your countrymen," he added.

In floor statements, members on both sides were clearly aware that the more than a year-long fight over health care was drawing to a close.

Majority Leader Steny H. Hoyer, D-Md., said the attacks of Republicans and other opponents of the health package were as wrong as Republican attacks on Social Security, passed in 1935, and Medicare, enacted in 1965. "Those slurs were false in 1935; they were false in 1965; they are false in 2010. And this bill will stand in the same company — for the misguided outrage of its opposition, and for its lasting accomplishment for the American people," he said.

Another Democrat, Debbie Wasserman Schultz of Florida, said the bill was essential and urgently needed. "Our current system is broken. It's un-American. The nightmare ends tonight," she said.

Republicans warned that the bill would saddle businesses with new taxes and force all Americans to buy coverage they may not want. "This bill is not what the American people want," said John Kline of Minnesota, ranking Education and Labor Committee member. "They are imploring us to start over.

"This is our last chance to stand with the American people who sent us here and start over," Kline added.

Referring to the bill, Peter Roskam, R-Ill., said, "Just because it's historic doesn't mean it's good."

Throughout the debate, Democrats took turns touting bill's provisions they are gambling will become popular — expanding health care coverage, controlling the spiralling cost of insurance and promising the legislation will protect consumers from insurance company abuse.

"There are times in history when action is required," said Jim McDermott, D-Wash. Joseph Crowley, D-N.Y., called it "a crisis that has to be dealt with."

Republicans rejected the legislation as a high-cost government takeover that would impose hardships on employers and cripple the economy. Many called it a "budget-buster," and "Pelosicare."

"The American people have spoken. They don't want a government takeover of health care," said Dave Reichert, R-Wash.

Support for Rule
In the day's first real test, the House adopted a rule for debate paving the way for Sunday's climactic votes. The rule was adopted on a 224-206 tally.

Democratic leaders were all but assured of victory on their health care legislation when they and the White House struck a deal Sunday afternoon with Bart Stupak, D-Mich., leader of a holdout group of anti-abortion Democrats who wanted assurances that nothing in the legislation would permit use of federal funds to cover abortions.

The holdouts agreed to vote for the package after Obama promised to issue an executive order once the legislation is enacted that offered the reassurance they sought.

The deal, according to Stupak, put the Democrats' vote tally "well past 216," the total needed for passage.

Still, the vote on the rule (H Res 1203) was the first on which members had to actually go on record in a chain of decisions that will have ramifications not only for the nation but also for their own political survival.

Indeed, GOP members kept up a barrage of attacks on the legislation even as hundreds of protestors massed outside the Capitol shouting, "Kill the bill!"

Democratic leaders had hoped to spare their members a direct vote on the Senate bill (HR 3590). For days, there had been speculation that the House Rules Committee would issue a self-executing rule that would have deemed the unpopular Senate bill passed once the House passed the reconciliation bill reflecting changes negotiated by House Democrats, their Senate counterparts and the White House.

But on Saturday, Democrats scrapped that idea after they said the Senate parliamentarian ruled that they could not vote on the reconciliation bill before they cleared the Senate bill. The Congressional Budget Office told the House leadership that it would be impossible for it to score the legislation if it were enacted in that order.

At that point, Democrats reverted to a more straightforward order of consideration for the bills — bracing for GOP attacks on them for supporting a bill that contained special deals, even though many of those deals would be removed if the Senate clears the reconciliation bill and the president signs that measure too, as he has promised.

Republican members pounced as expected, as the rule was considered. "This bill has special deals for special folks," said Ted Poe, R-Texas.

Others taunted the Democrats, warning the only thing they could be sure of at this point was enactment of the Senate bill they dislike. Shouting matches erupted on the floor.

Democrats weren't swayed, however much they may have rued the state of play. The finish line is in sight, they held fast.

First posted March 21, 2010 6:44 p.m.

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