In historic vote, House approves health care bill
Only one Republican joins Democrats in 220-215 tally
WASHINGTON — For the first time ever, the House late Saturday passed comprehensive legislation aimed at remaking the American health care system to provide coverage for all.
After a daylong debate, the bill passed, 220-215, prompting raucous cheers and hugs among Democrats, who have pushed such measures without success for decades.
Some 219 Democrats and one Republican, Joseph Cao of Louisiana, voted for the bill, with 39 Democrats joining 176 Republicans in opposition. A Republican alternative, built around medical liability reform, failed by a vote of 258 to 176.
Passage of the $1.2 trillion bill was a huge step forward for a landmark measure that still needs to be approved by the Senate. The bill then must survive a House-Senate conference and two more congressional votes before going to President Obama for his signature.
But Obama, who visited Capitol Hill at midday to lobby for the bill, seemed confident that his top domestic policy priority would soon become law.
"What's in our grasp right now is a chance to prevent a future where every day, 14,000 Americans continue to lose their health insurance, and every year, 18,000 Americans die because they don't have it," Obama said later at the White House.
Republicans, meanwhile, argued that the bill's taxes would kill jobs when America could least afford it.
"It has job-killing mandates in it, big cuts to Medicare — exactly the kinds of things that the American people don't want," said House Republican Leader John Boehner of Ohio.
The real action that led to the bill's passage took place not during the debate, but early Saturday, when House Speaker Nancy Pelosi, D-Calif., quelled a rebellion among anti-abortion Democrats by allowing them to present an amendment on the House floor.
Sponsored by Rep. Bart Stupak, D-Mich., the amendment prohibits anyone who gets federal insurance subsidies or buys a government policy from getting abortion coverage, except if the mother's life is in danger or in cases of incest or rape.
"We wish to maintain current law, which says no public funding for abortion," Stupak said.
The amendment passed by a 240-194 margin, with 64 Democrats joining 176 Republicans in favoring it. Of Western New York's representatives, only Rep. Chris Lee, R-Clarence, voted for the abortion restriction.
Although Pelosi had to allow the vote on the anti-abortion amendment in order to ensure the larger bill's passage, abortion-rights supporters were aghast at the new limits.
"We are driving now, I am afraid, young women, poor women who cannot afford to buy their own insurance policy out of their own pocket back to the back alley," said Rep. Louise M. Slaughter, D-Fairport.
Nevertheless, Slaughter remained a strong supporter of the overall measure.
"With this bill we can end the constant worry by people that don't have insurance to cover a sudden illness or accident," she said.
The bill aims to add up to 36 million people to the insurance rolls, in part by creating a "public option" government-run insurance plan to compete with private insurers.
In addition, the bill mandates that all Americans get health care coverage — and fines those who don't. Lower-income people would get government subsidies to buy insurance through purchasing exchanges.
The legislation also bans insurance companies from denying coverage to people because of pre-existing conditions.
It amounts to a government takeover of health care, Lee said.
"The way the bill is structured, the public option is favored in every way," Lee said. "Eventually it will push the private plans out of business."
Republicans also argued that the bill would gut Medicare because it would get half of its funding from cuts in the program. Subsidies for "Medicare Advantage" HMOs would be cut dramatically.
But both the Democrats and AARP, the nation's largest organization for people older than 50, said the bill would strengthen Medicare. The bill would close the payment "doughnut hole" that forces many seniors to pay for prescriptions, and extends the life of the Medicare Trust Fund by five years, AARP said.
The bill continues to face a grass-roots rebellion from conservatives, who clogged House phone lines and email baskets Saturday to decry the measure.
Some 40,000 "tea party" activists protested the bill outside the Capitol on Thursday, and some stragglers remained two days later, shouting at Obama's motorcade as it moved from the Capitol to the White House.
Republicans brought the tea-party spirit to the House debate, shouting down Democrats with objections as Slaughter, who chairs the House Rules Committee, managed the procedural vote setting up debate.
Later in the day, Rep. John Shadegg, R-Ariz., appeared on the House floor with 7-month-old Maddie Thompson, the daughter of Shadegg's chief of staff, on his arm.
"This is Maddie," he said. "Maddie believes in freedom. ... She doesn't want the government to take over health care."
Yet it was opponents like Rep. Eric Massa, D-Corning, who ensured the vote was close despite the Democrats' 81-seat advantage in the 435-member House.
Massa said the bill would not do enough to control costs. He suggested a piece-by-piece approach to health reform.
"It's just too big," Massa said. "It's not going to work."
The vast majority of Democrats disagreed, with many lawmakers echoing the thoughts of Rep Brian Higgins, D-Buffalo.
World Health Organization statistics show the U.S. ranking 37th overall in health quality, Higgins noted. Meanwhile, insurance premiums continue to increase at double-digit rates.
"We're getting ripped off," said Higgins, who called the bill's passage "a great thing."
"It's epic, a historic moment," Higgins added.
News wire services contributed to this report.
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