House approves Senate health-care bill, separate package of amendments 21MAR10

I watched the debates and the votes and I am so proud of the House, especially Speaker Nancy Pelosi and Rep. Bart Stupak! Thank God this passed!!!!!!

By William Branigin, Shailagh Murray and Paul Kane
Washington Post Staff Writer
Sunday, March 21, 2010; 11:34 PM

The House of Representatives passed landmark legislation Sunday night to overhaul the nation's health-care system, approving a Senate bill and a separate package of amendments after President Obama allayed the concerns of anti-abortion Democrats and secured their support.

By a vote of 219 to 212, the House approved the $940 billion Senate bill, then turned its attention to remaining matters, including the package of fixes, known as a reconciliation bill, that is to be taken up in the Senate this coming week. The amendments were aimed at making the final bill more palatable to House members.

After 9 1/2 hours of often contentious floor debate, parliamentary maneuvers and procedural votes, the House reached a major milestone in Obama's year-long effort to overhaul the nation's $2.5 trillion health-care system.

"Today we have opportunity to complete the great unfinished business of our society and pass health-insurance reform for all Americans," House Speaker Nancy Pelosi (D-Calif.) said moments before the vote.

"With this action tonight," she said, "32 million more Americans will have health-care insurance," and those who already have coverage "will be spared" from abusive insurance industry practices and "obscene" premium increases.

But House Republican Leader John A. Boehner (Ohio) charged that "we have failed to listen to America, and we have failed to reflect the will of our constituents."

Asking rhetorically whether lawmakers could say the legislation was arrived at openly and without "backroom deals," he declared, "Hell no, you can't!" He then asked if lawmakers had read the Senate bill and the reconciliation bill. "Hell no, you haven't!" he shouted.

After the vote on the Senate bill, the House turned back a Republican attempt to scuttle the package by offering an anti-abortion amendment originally proposed by Rep. Bart Stupak (D-Mich.), the leader of a bloc of Democrats who had stood against the Senate bill until Obama met their concerns. The House voted 199 to 232 on the amendment, which was widely viewed as unacceptable to the Senate.

"This motion is nothing more than an opportunity to continue to deny 32 million Americans health care," Stupak said in an impassioned floor speech that was repeatedly interrupted by catcalls from Republicans. "This motion is really a last-ditch effort of 98 years of denying Americans health care. . . . This motion is really to politicize life, not to prioritize life."

Following the House votes, Obama planned to launch a campaign aimed at countering conservatives' criticisms of the health-care bill, aides said.

Rallying last-minute support for the overhaul, Obama announced Sunday afternoon that he would issue an executive order after passage, attesting that the bill is consistent with longstanding restrictions on the use of federal funds for abortions.

The arrangement won the support of a key bloc of anti-abortion House Democrats, whose leader, Stupak, said at a news conference, "I'm pleased to announce we have an agreement."

Appearing with Stupak were half a dozen other holdout Democrats. With them on board, "we're well past" the 216 votes needed in the House to approve the health-care legislation, Stupak said.

White House officials said they believe the addition of the anti-abortion Democrats to the "yes" column will provide House Democratic leaders considerable breathing room as they head toward critical votes. Before Stupak's announcement, a top Obama adviser had said that without a deal, passage appeared possible but would have been extremely close. In the wake of the agreement, West Wing aides appeared relieved.

"While the legislation as written maintains current law, the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation's restrictions against the public funding of abortions cannot be circumvented," White House Communications Director Dan Pfeiffer said in a statement. "The president has said from the start that this health insurance reform should not be the forum to upset longstanding precedent. The health care legislation and this executive order are consistent with this principle."

The announcement promptly came under fire from both sides of the abortion debate. Abortion rights groups blasted Obama for what they described as his appeasement of anti-abortion forces, while a leading anti-abortion organization charged that the promised executive order "changes nothing" about what it called "a pro-abortion bill."

The National Organization for Women said it was "incensed" that Obama was appeasing "a handful of anti-choice Democrats" and lending the weight of the executive branch to "the anti-abortion measures included in the Senate bill." The Planned Parenthood Federation of America expressed similar regrets.

But the National Right to Life Committee said the executive order is being issued "for political effect" and "does not correct any of the serious pro-abortion provisions in the bill."

The deal came despite warnings from Republicans on the House floor that such an executive order would be ineffective.

In a strongly worded statement after the announcement, Boehner argued that no executive order can trump "the law of the land" or "direct the private sector." He warned, "Make no mistake, a 'yes' vote on the Democrats' health-care bill is a vote for taxpayer-funded abortions."

The impasse-breaking deal was announced as the House engaged in its final health-care debate in preparation for a vote culminating a year-long political battle on Obama's signature domestic initiative.

"We have before us a bill to change an unsustainable course," House Majority Leader Steny H. Hoyer (D-Md.) said Sunday night. Denouncing what he called the GOP's "campaign of fear" against the bill, he challenged those who claim it represents a "government takeover" of health care to support repeal of veterans' health care and Medicare.

Rep. John Dingell (D-Mich.), 83, the longest-serving House member and the lawmaker who presided over the passage of Medicare in 1965, said Sunday's vote on the health-care legislation would rank with historic votes on civil rights, Social Security and Medicare in decades past. He brought with him the gavel that he used to pass Medicare and said he expected Pelosi to use it mark the passage of the health-care bill.

Rep. Nathan Deal (R-Ga.), who is retiring to run for governor of Georgia, argued that the bill is historic in a different way, saying it imposes "unprecedented and unconstitutional mandates on our states." If the bill becomes law and he is elected governor, he vowed, "I will devote my efforts to making sure the people of my state . . . are not subject to an unconstitutional mandate to expand our Medicaid role."

In one of a series of procedural votes earlier in the rare Sunday session, the House voted mainly along party lines to shelve a Republican challenge to the legislation, rejecting a bid to declare that the bill imposes an "unfunded mandate" on the states. The vote was 228 to 195. Key votes on final passage of the Senate-passed bill and a package of House fixes were expected later in the day.

As the debate and a series of votes went ahead, Democratic leaders and the White House continued their efforts to come up with a deal to assuage some Democrats' concerns over abortion funding through an executive order to be issued by Obama affirming his commitment to a long-standing ban on public funding of abortion except in cases of rape or incest or to save the life of the mother.

Pelosi gaveled the chamber into session shortly after 1 p.m. Eastern time, and Democratic and Republican members began a back-and-forth on the pros and cons of the $940 billion package in a series of one-minute speeches.

Earlier, Democratic leaders expressed confidence that sufficient support would materialize by the time the House votes, but they acknowledged that they were still trying to secure commitments to reach the bare majority needed to approve the package.

One key holdout on abortion, Rep. Marcy Kaptur (D-Ohio), gave the effort a boost when she announced on a Toledo television program Sunday morning that she would vote for the bill even though a deal on abortion funding was still being hammered out.

At the White House, Obama was in the West Wing, getting updates on the vote-wrangling and making calls to lawmakers as the House moved toward a vote, an aide said. In one of the series of speeches after the House session began, Rep. Louie Gohmert (R-Tex.) tried to dissuade anti-abortion Democrats from going along with a deal. "The executive order won't work," and the holdout Democrats' stand ultimately "will mean nothing," he said, adding, "You can't say you weren't warned."

Among the Democrats who spoke in favor of health-care reform, Steve Kagen (Wis.) told the chamber, "This bill will save lives and save jobs."

At one point during the initial series of votes, two protesters in the House gallery disrupted the chamber, standing and yelling, "Kill the bill!" as startled members looked on. Several Republicans on the House floor stood up and cheered the protesters, prompting a rebuke from Rep. Barney Frank (D-Mass.), who called the Republicans "clowns."

After the disruption, the two protesters were arrested and charged with disruption of Congress, according to Lt. Raymond Howell of the Capitol Police. He said neither resisted removal from the gallery. Disruption of Congress is a misdemeanor.

House Republican Conference Chairman Mike Pence (Ind.), though complimentary of the protests outside the Capitol, said he and his colleagues did not condone demonstrations inside the building.

"Outbursts of that nature are not appropriate on the floor of the House," he said.

Several Republican lawmakers waved "kill the bill" signs off the balcony of the Capitol to cheering protesters outside.

As several hundred conservative protesters on the lawn of the Capitol shouted slogans such as "Nancy, you will burn in hell for this," GOP lawmakers came onto the balcony to egg them on. Rep. John Carter (R-Tex.) held up a copy of the 2,700-page legislation, prompting boos from crowd. The protesters cheered when Rep. Geoff Davis (R-Ky.) waved a "Don't Tread on Me" flag.

Rep. Paul Ryan (D-Wis.) challenged the health-care bill on a "point of order" that it imposes an unfunded mandate. He charged that the Congressional Budget Office's assessment that it reduces the federal deficit by more than $1.3 trillion over two decades was achieved through "double counting and gimmicks and smoke and mirrors."

"This bill explodes the deficit; it explodes the debt," Ryan said. "This bill is a fiscal Frankenstein. It's a government takeover. It's not democratic."

He told lawmakers, "It's not too late to get it right. Let's start over. Let's defeat this bill."

Rep. Sheila Jackson Lee (D-Tex.) countered, "This is not an unfunded mandate." She displayed a poster saying that 45,000 Americans die every year because they lack health insurance.

"Today we will heal this land, and we will vote for the health-care bill," she declared.

The continued wrangling came after House Democratic leaders decided Saturday to stage a vote on the Senate's health-care bill, dropping a much-criticized strategy of allowing lawmakers to "deem" the landmark legislation into law.

But until Sunday's deal was announced, the outcome of that vote remained in doubt as a pivotal bloc of Democrats withheld its support over fears that the bill would open the door to the federal funding of abortion.

Pelosi's decision to have the House hold two votes, one on the Senate bill and one on a separate package of revisions, reversed an apparent plan laid earlier in the week, when Pelosi said she preferred not to force rank-and-file Democrats to cast a separate vote on the unpopular Senate bill. Republicans had accused her of trying to dodge responsibility for health-care reform, and even some Democrats complained about the move.

House passage would immediately send the slightly narrower Senate version of the health bill to the White House for Obama's signature, allowing the president to claim victory on his most important domestic initiative. The package of revisions would go to the Senate for action next week under special rules that protect it from a GOP filibuster. On Saturday, Senate Majority Leader Harry M. Reid (D-Nev.) publicly assured House Democrats that he has the votes to approve their changes, making "a good law even better."

The compromise package would spend $940 billion to extend coverage to 32 million Americans over the next decade, leaving only about 5 percent of non-elderly citizens without coverage, according to projections by the nonpartisan Congressional Budget Office. Millions of people would be added to the rolls of Medicaid, the government health program for the poor, while millions more who lack access to affordable coverage through the workplace would receive federal tax credits to buy insurance.

For the first time, every American would be required to obtain coverage or face a penalty of at least $695 a year. Employers, too, would have a new responsibility: to offer coverage or face penalties of $2,000 a worker. By cutting more than $500 billion from Medicare over the next decade and raising taxes on the well-insured and high-earners, the package would trim deficits by $138 billion over the next decade and by around $1.2 trillion in the decade thereafter, the CBO said.

Republicans questioned assertions of deficit-reduction, predicting that Democrats would abandon the measure's primary funding mechanisms when seniors begin to feel the pinch of Medicare cuts, or when union families fall victim to a new 40 percent tax on the most generous insurance policies set to take effect in 2018. If those and other politically painful provisions were removed, the CBO said, the measure would increase deficits.

Staff writers Lori Montgomery, Michael D. Shear, Ben Pershing, R. Jeffrey Smith and Perry Bacon Jr. contributed to this report.