House Democrats passed their landmark health care overhaul on a party-line 219-212 vote late Sunday night, marking a stunning turnaround for an undertaking on the brink of collapse just weeks ago and an achievement that leaders said was akin to the enactment of Social Security and Medicare.
The vote sends the Senate’s health care bill to the president for his signature following a weekend of high drama. After days of an all-out whip effort led by Speaker Nancy Pelosi (D-Calif.) and President Barack Obama, the outcome was still in doubt until the White House cut a deal Sunday afternoon with a bloc of anti-abortion-rights Democrats led by Rep. Bart Stupak (Mich.) by drafting an executive order reiterating that no federal funding would pay for elective abortions.
The House also approved a package of reconciliation "fixes" to the Senate version of the bill, which will be considered this week by the Senate. A majority of Senators, all Democrats, have agreed to support the reconciliation measure.
Purely in terms of stagecraft, the day’s most dramatic moment came after a midday Democratic Caucus — the final in scores the majority has held over the past year to wrestle with health care. During that meeting, House Democratic Caucus Chairman John Larson (Conn.) and Rep. John Lewis (D-Ga.) placed the issue in the context of the civil rights struggle, and both spoke about Lewis’ experience 45 years ago leading civil rights marchers across the Edmund Pettus Bridge outside Selma, Ala., where they were assaulted by state troopers. When the Caucus meeting ended, Pelosi, backed by her leadership team, emerged from the Cannon House Office Building room holding the oversized ceremonial gavel that Rep. John Dingell (D-Mich.) had used to call the vote when the Medicare bill was passed in 1965.
“I will use it this evening when we cast a very successful vote for this important legislation,” Pelosi said. “We’re doing this one for the American people.”
Pelosi, Lewis and other Democratic leaders then linked arms and walked out of Cannon and across the street to the Capitol, through a gauntlet of anti-reform tea party protesters shouting “kill the bill!” and a smattering of pro-reform supporters shouting “We vote yes!”
“I think I will remember the walk across the street with John Lewis for the rest of my life,” said Rep. Brad Miller (D-N.C.).
The health care reform bill’s passage comes after a year of seemingly intractable party infighting. And it comes two months after the effort appeared all but dead following the upset victory of Sen. Scott Brown (R-Mass.) in the special Senate election to replace Sen. Edward Kennedy (D). As he neared the end of his life last summer, Kennedy, the former chairman of the Health, Education, Labor and Pensions Committee, called health reform the cause of his life.
But Pelosi, Obama and Senate Majority Leader Harry Reid (D-Nev.) quickly regrouped, brushing aside Democrats who urged them to scale back the effort and finding a way to appease House Members who had a profound distaste for the Senate bill, in particular its tax on high-cost health insurance plans and a series of special deals cut individual Senators.
Several of those deals will be deleted if the reconciliation package passes the Senate and the “Cadillac” tax will be dramatically scaled back and delayed until 2018 – two presidential elections away. The reconciliation bill also boosts affordability credits for buying insurance plans.
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