Democratic leaders appeared confident they had the votes needed to pass the landmark legislation yesterday, a day after US President Barack Obama called on them to make history by bringing health insurance to millions of struggling families.
On Saturday, Democratic leaders frenetically hunted for votes inside the Capitol as angry protesters gathered outside with some hurling racial insults at black members of Congress.
Obama can rely only on Democrats to gain passage of his top domestic priority in a make-or-break vote for his presidency. He faces unanimous opposition from Republicans, who say the plan amounts to a government takeover of health care that will lead to higher deficits and taxes. Some moderate House Democrats are also wary about the plan’s costs and abortion provisions.
“I know this is a tough vote,” the president told House Democrats at a meeting on Capitol Hill, adding that he also believed “it will end up being the smart thing to do politically.”
“It is in your hands,” Obama said, bringing lawmakers to their feet. “It is time to pass health care reform for America and I am confident that you are going to do it tomorrow.”
The US is alone among developed nations in not offering its citizens comprehensive health care, with nearly 50 million Americans uninsured.
Although the bill before Congress does not provide universal health care, it should expand coverage to about 95 percent of Americans. It would require most Americans to carry insurance with subsidies for those who can’t afford it, expand the government-run Medicaid program for the poor and create new places to buy health care.
Even so, the reform is likely to be judged alongside the boldest acts of presidents and Congress in domestic affairs. While national health care has long been a goal of politicians and presidents stretching back decades, it has proved elusive, in part because self-reliance and suspicion of a strong central government remain strong in the US.
It may still elude Obama, too. A series of last-minute flare-ups threatened to slow the Democrats’ march to passage after more than a year of grueling effort and a turbulent debate that has left the country deeply divided.
The most intense focus was on a small group of Democrats concerned that abortion funding restrictions in the legislation did not go far enough. Determined to avoid votes on such a charged issue, Democratic leaders raised the possibility of an executive order from Obama that reaffirms existing federal law barring taxpayer-funded abortions except in cases of rape, incest or to save the life of the mother.
House Democratic leaders abandoned a much-challenged procedure for passing the legislation after an outcry from Republicans and protest from some of their members. According to the new plan, the House will vote separately on the health care bill passed by the Senate on Christmas Eve as well as a package of changes.
The Senate bill would then go to Obama for his signature, the companion fix-it measure to the Senate, which hopes to pass it within the week under a procedure called reconciliation that requires only 50 votes in the 100-member body.
The parliamentary maneuvers became necessary after January’s special election in Massachusetts when a Republican won the seat held for decades by the late senator Edward Kennedy, a champion of health care reform. That deprived the Democrats of their 60-vote Senate supermajority required to block Republican legislative delaying maneuvers.
The 10-year, US$940 billion measure represents the biggest expansion of the social safety net since Medicare and Medicaid were enacted in the 1960s to provide government-funded health care coverage to the elderly and poor.
The sweeping legislation, affecting virtually every American and impacting one-sixth of the US economy, provides health coverage to 32 million people now uninsured, bars insurance companies from denying coverage to those in poor health and sets up new marketplaces where self-employed people and small businesses can pool together to buy coverage.
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