House Approves Health Overhaul, Sending Landmark Bill to Obama

By a vote of 219 to 212, the House passed the bill after a day of tumultuous debate that echoed the epic struggle of the last year. The action sent the bill to President Obama, whose crusade for such legislation has been a hallmark of his presidency.

“This isn’t radical reform, but it is major reform,” Mr. Obama said after the vote. “This legislation will not fix everything that ails our health care system, but it moves us decisively in the right direction. This is what change looks like.”

Minutes after thebill was approved, the House passed a package of changes to it and sent it to the Senate. The Senate majority leader, Harry Reid of Nevada, has promised House Democrats that the Senate would quickly take up the reconciliation bill with the changes in it, and that he had secured the votes to pass it.

But while the Senate is bracing for a fierce floor fight over the reconciliation measure, the landscape was permanently altered by passage of the original Senate bill. Should the reconciliation bill, which cannot be filibustered, collapse for any reason, the core components of the Democrats’ health care overhaul would move forward. Indeed, Senate Republicans were quickly faced with a need to recalibrate their message from one aimed at stopping the legislation to one focused on winning back a sufficient number of seats in Congress to repeal it.

Mr. Obama urged the Senate to quickly complete the final pieces of the legislation. “Some have predicted another siege of parliamentary maneuvering in order to delay it,” he said in a short speech from the White House. “I hope that’s not the case.”

“It’s time to bring this debate to a close and begin the hard work of implementing this reform properly on behalf of the American people.”

Mr. Obama watched the roll call with Vice President Joseph R. Biden Jr. in the Roosevelt Room inside the White House. Since Monday, the president had spoken with 92 lawmakers, either in person or by telephone, the White House said.

“We rose above the weight of our politics,” Mr. Obama said from the East Room, where he made his statement shortly before midnight. “We proved that we are still a people capable of doing big things and tackling our biggest challenges.”

“Tonight’s vote is not a victory for any one party,” he continued. “It’s a victory for the American people and it’s a victory for common sense.”

Democrats hailed the votes as historic, comparable to the establishment of Medicare and Social Security and a long overdue step forward in social justice. “This is the civil rights act of the 21st century,” said Representative James E. Clyburn of South Carolina, the No. 3 Democrat in the House.

After a year of partisan combat and weeks of legislative brinksmanship, House Democrats and the White House clinched their victory only hours before the voting started on Sunday. They agreed to a deal with opponents of abortion rights within their party to reiterate in an executive order that federal money provided by the bill could not be used for abortions, giving the Democrats the final votes. Democrats said that in expanding access to health coverage for uninsured Americans, they were creating a new program every bit as important as Social Security and Medicare, while also putting downward pressure on rising health care costs and reining in federal budget deficits.

Republicans said the plan would saddle the nation with unaffordable levels of debt, leave states with expensive new obligations, weaken Medicare and give the government a huge new role in the health care system.

The debate on the legislation has highlighted the deep partisan and ideological divides in the nation and set up a bitter midterm Congressional election campaign, with Republicans promising an effort to repeal it or block its provisions in the states.

Representative Marcy Kaptur, Democrat of Ohio, said the bill heralded “a new day in America.” Representative Doris Matsui, Democrat of California, said it would “improve the quality of life for millions of American families.”

But Representative Paul D. Ryan, Republican of Wisconsin, denounced the bill as “a fiscal Frankenstein.” Representative Lincoln Diaz-Balart, Republican of Florida, called it “a decisive step in the weakening of the United States.” Representative Virginia Foxx, Republican of North Carolina, said it was “one of the most offensive pieces of social engineering legislation in the history of the United States.”

The passions swirling round the bill were evident Sunday on the sun-splashed lawn south of the Capitol. Hundreds of protesters chanted, “Kill the bill” and waved yellow flags declaring, “Don’t Tread on Me.” They carried signs saying, “Doctors, Not Dictators.”

The health care bill would require most Americans to have health insurance, would add 16 million people to the Medicaid rolls and would subsidize private coverage for low- and middle-income people, at a cost to the government of $938 billion over 10 years, the Congressional Budget Office said.

The bill would require many employers to offer coverage to employees or pay a penalty. Each state would set up a marketplace, or exchange, where consumers without such coverage could shop for insurance meeting federal standards.

Surce: NY times, Carl Hulse and Jeff Zeleny