The US Congress narrowly passed an historic healthcare overhaul, taking the US closer to universal medical care and handing US President Barack Obama the biggest triumph of his presidency.
After weeks of behind the scenes wheeler-dealing and bitter debate, the Democrat-held House of Representatives voted 219 to 212 late on Sunday to approve a bill extending health coverage to 32 million more Americans in the most sweeping social policy shift in four decades.
“Tonight, we answered the call of history as so many Americans have before us. We did not avoid our responsibility, we embraced it. We did not fear our future, we shaped it,” Obama said after the vote.
No Republicans voted for the bill, already passed by the Senate, and they have warned that Obama would face a political backlash for the measure that will cost hundreds of billions of dollars over the next decade.
The president, who was expected to sign the bill into law within days, however, praised lawmakers for defying the predictions that the mammoth legislation would collapse in the face of political setbacks and unyielding partisan rifts.
Tired after a week in which he met or spoke to nearly 100 lawmakers, but evidently savoring the hard-fought triumph on his top domestic goal, Obama told the US public: “This is what change looks like.”
As the vote count crept past the 216 needed to ensure passage, Democrats clapped, cheered, hugged and called out Obama’s “Yes, we can” 2008 campaign slogan.
All 178 Republicans and 34 conservative Democrats opposed the measure, spurred on by hundreds of protesters who chanted “Kill the bill” during a vigil outside.
Obama acknowledged Republican warnings that Democrats would pay a political price in November mid-term elections that would decide control of Congress.
“I know this wasn’t an easy vote for a lot of people, but it was the right vote,” said the president, who has promised to help Democrats in swing districts win re-election.
The Senate now takes up a freestanding package of changes, which the House approved 220 to 211, as early as today in a bid to complete its work on the overhaul.
Together, the Senate bill and changes would remake US healthcare a century after US former president Teddy Roosevelt called for a national approach, extending coverage to 95 percent of the under-65 population.
The bill bans insurance company practices like denying care for pre-existing conditions, imposing lifetime caps on coverage, while providing subsidies to buy private insurance in newly created marketplaces called “exchanges.”
It also raises some taxes on the more wealthy, while expanding a government-run program for needy Americans.
“This bill is complicated, but it’s also very simple: Illness and infirmity are universal, and we are stronger against them together than we are alone,” Democratic House Majority Leader Steny Hoyer said before the vote.
Republican Minority Leader John Boehner, however, said that by voting in support of the reform package, lawmakers were disgracing the fundamental values put forward by the founding fathers of the US.
“Shame on each and every one of you who substitutes your will and your desires above those of your fellow countrymen,” he said.
Republicans also vowed to keep up the fight in the Senate and repeal the broadly unpopular bill if they win back majorities in November.
Reaction outside Congress followed traditional political divides.
The New York Times, a left-leaning newspaper, called the approved measure “an accomplishment of historic proportions.”
The conservative Wall Street Journal, however, said the reform amounted to a “federal takeover of the US healthcare system” that would result in “much higher taxes, slower economic growth and worse medical care.”
After a year of often bitter debate, Obama cleared the way to his victory with an 11th-hour deal to sign an executive order reaffirming a longstanding US ban on government funding for abortions, winning support for the bill from a group of conservative Democratic holdouts.
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