Author: By John Whitesides and Donna Smith
On a narrow 220-215 vote, including the support of one Republican, the House
endorsed a bill that would expand coverage to nearly all Americans and bar
insurance practices such as refusing to cover people with pre-existing
Most Republicans criticized its $1 trillion (£600bn) price tag, new taxes on
the wealthy and what they said was excessive government interference in the
private health sector.
The battle over Obama’s top domestic priority now moves to the US Senate,
where work on its own version has stalled for weeks as Senate Democratic
leader Harry Reid searches for an approach that can win the 60 votes he
Any differences between the Senate and House bills ultimately will have to be
reconciled, and a final bill passed again by both before going to Obama for
“Thanks to the hard work of the House, we are just two steps away from
achieving health insurance reform in America. Now the United States Senate
must follow suit and pass its version of the legislation,” Obama said
in a statement after the vote.
“I am absolutely confident it will, and I look forward to signing
comprehensive health insurance reform into law by the end of the year,”
The overhaul would spark the biggest changes in the $2.5trillion (£1.5tr) US
healthcare system, which accounts for one sixth of the US economy, since the
creation of the Medicare government health program for the elderly in 1965.
The vote followed days of heavy lobbying of undecided Democrats by Obama, his
top aides and House leaders. The narrow victory was clinched early on
Saturday by a deal designed to mollify about 40 Democratic opponents of
Democrats had a cushion of 40 of their 258 House members they could lose and
still pass the bill. In the end, 39 Democrats sided with Republicans against
The lone Republican to vote in favor of it was first-term Representative Anh
Cao of Louisiana. “It was a bipartisan vote,” Democratic leader
Steny Hoyer said to laughter among fellow Democrats afterward.
The landmark vote was a huge step for Obama, who has staked much of his
political capital on the healthcare battle. A loss in the House would have
ended the fight, impaired the rest of his legislative agenda and left
Democrats vulnerable to big losses in next year’s congressional elections.
Obama traveled to Capitol Hill yesterday morning to meet with House Democrats
and emphasise the vital need for the healthcare reform bill.
Republicans and Democrats battled in sometimes testy debate through the day
and into the night over the bill, which would require individuals to have
insurance and all but the smallest employers to offer health coverage to
It would set up exchanges where people could choose to purchase private plans
or a government-run insurance option bitterly opposed by the insurance
industry, and it would offer subsidies to help low-income Americans buy
Congressional budget analysts say the bill would extend coverage to 36 million
uninsured people living in the United States, covering about 96 percent of
the population, and would reduce the budget deficit by about $100bn (£60bn)
over 10 years.
“We can’t afford this bill,” said Republican Representative Roy
Blunt. “It’s a 2,000-page road map to a government takeover of
Democrats rejected on a 258-176 vote the much smaller Republican healthcare
plan, which focused on cost controls and curbing medical malpractice
lawsuits but did not include many of the insurance reforms of the Democratic
The House also approved on a 240-194 vote an amendment that would impose
tighter restrictions on using federal funds to pay for abortions.
House Democratic leaders agreed to allow a vote on the amendment to mollify
about 40 moderate House Democrats who threatened to oppose the overhaul
without changes to ensure federal subsidies in the bill for insurance
purchases were not used on abortion.
The move enraged Democratic abortions rights supporters, but they largely
voted in favor of the bill in hopes they can remove the language later in
the legislative process.
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