Rep. Murphy one of 39 Democrats to vote against measure
WASINGTON -- Hours after President Barack Obama exhorted Democratic lawmakers to "answer the call of history," the House hit an unprecedented milestone on the path to health-care reform, approving a trillion-dollar package late Saturday that seeks to overhaul private insurance practices and guarantee comprehensive and affordable coverage to almost every American.
After months of acrimonious partisanship, Democrats closed ranks on a 220-215 vote despite 39 defections, mostly from the party's conservative ranks.
Rep. Scott Murphy, D-Glens Falls, was one of the 39 House Democrats to vote against the bill.
Newly minted Rep. Bill Owens, who won the special election on Tuesday in the 23rd Congressional District, voted for the plan.
The bill attracted a surprise Republican convert: Rep. Anh "Joseph" Cao of Louisiana, who represents the Democratic-leaning district of New Orleans and had been the target of a last-minute White House lobbying campaign. GOP House leaders had predicted their members would unanimously oppose the bill.
Democrats have sought for decades to provide universal health care, but not since the 1965 passage of Medicare and Medicaid has a chamber of Congress approved such a vast expansion of coverage. Action now shifts to the Senate, which could spend the rest of the year debating its version of the health-care overhaul. Majority Leader Harry Reid, D-Nev., hopes to bring a measure to the floor before Thanksgiving, but legislation may not reach Obama's desk before the new year.
The debate on the House floor extended for about 12 hours and settled into a civil, if predictable, pattern, after a heated start.
Republicans had blasted the 1,990-page bill as an ominous blueprint for a budget-busting government takeover of the private health-care system that would impose unprecedented mandates on individuals and employers, raise an array of taxes and slash projected spending on Medicare, the federal health program for the elderly. At a time of record budget deficits, Republicans argued that the country could ill-afford a new entitlement program that would cost an estimated $1.05 trillion over the next decade.
Pelosi focused on corralling at least 218 of 258 Democrats to push the bill across the finish line. That task appeared to grow easier after party leaders broke a weeks-long impasse over abortion by agreeing to hold a vote on an amendment - offered by antiabortion Democrats - that would explicitly bar the public plan from covering the procedure. The amendment, approved 240 to 194, with 64 Democrats in favor, also would prohibit people who received insurance subsidies from purchasing private plans that covered abortion.
The deal cleared the way for dozens of antiabortion Democrats to back the package. The most passionate advocates of abortion rights were not happy, but few were prepared to vote down legislation that promises to achieve so many long-held party goals.
The complex package would affect virtually every American and fundamentally alter vast swaths of the health insurance industry. Starting next year, private insurers could no longer deny anyone coverage based on pre-existing conditions, place lifetime limits on coverage or abandon people when they become ill. Insurers would be required to disclose and justify proposed premium increases to regulators, and could not remove adult children younger than 27 from their parents' family policies.
For the elderly, the group that has been most skeptical of Obama's initiative, the House package would immediately offer discounts on prescription drugs and reduce a gap in Medicare prescription drug coverage, closing it entirely by 2019. Uninsured people who cannot get coverage could join temporary high-risk insurance pools, and unemployed workers would be permitted to keep their COBRA benefits until the public plan and insurance exchanges started in 2013.
In four years, the measure would establish a new insurance system. Businesses with payrolls exceeding $500,000 would be required to offer their workers insurance or pay a fine of as much as 8 percent of payroll. Individuals would be required to obtain insurance or pay a fine of as much as 2.5 percent of income. States would be required to extend Medicaid coverage to as many as 15 million additional people. Low- and middle-income individuals who still could not afford coverage could apply for federal subsidies through an insurance marketplace that would negotiate with private insurers to provide comprehensive policies alongside a government-run "public option."