House OKs health care bill: Vote narrowly passeS with help from compromise with anti-abortion Democrats

By Chris Casteel, The Oklahoman, Oklahoma City

Nov. 8--WASHINGTON -- The U.S. House voted Saturday to remake the nation's health insurance system and take a major step toward universal coverage.

Meeting in a rare weekend session that lasted more than 14 hours, the House approved a Democratic bill 220 to 215 that includes new mandates for benefits and a government-run plan for those who can't afford private insurance.

Democratic leaders, who worked for weeks to round up enough votes, got help Saturday from President Barack Obama -- who went to Capitol Hill to give a pep talk -- and from a compromise with anti-abortion Democrats who wanted the bill to contain explicit prohibitions on government money being used to pay for abortions.

All five House members from Oklahoma voted against the bill and against the procedural "rule" allowing debate. Only one of the 177 Republicans in the House voted for the bill -- Rep. Joseph Cao, of Louisiana -- while 39 Democrats opposed it.

Hours before the vote, Obama met behind closed doors with Democratic lawmakers and urged them to make history.

"Most public servants pass through their entire careers without a chance to make as important a difference in the lives of their constituents and the life of this country," Obama said at the White House after that meeting. "I urge members of Congress to rise to this moment."

Though passage of the ambitious legislation marked a major milestone in the decades-long effort to achieve universal health care coverage, the bill is a long way from becoming law. Attention now shifts to the Senate, where prospects for a government-run health care plan, commonly referred to as a public option, are thought to be dim. The Senate could be weeks away from taking up its version of health care reform.

The House bill would expand greatly the number of Americans with health care coverage through a combination of mandates on businesses and individuals and through expansion of Medicaid, the federal-state health program for the nation's poor.

Under the bill, businesses with annual payrolls exceeding $500,000 would have to provide coverage to their employees or pay a tax. That tax would reach 8 percent of payroll for businesses with annual payrolls greater than $750,000. Individuals also would have to buy insurance or pay a penalty.

Medicaid coverage would be extended to all those with incomes 150 percent above the poverty level (currently about $33,000 per year for a family of four) and the federal government would pick up most of the additional costs.

An official congressional estimate says 96 percent of people in the country ultimately would have coverage because of the House bill. The U.S. Census Bureau reported in September that more than 46 million people lack health insurance, but that figure may be low since it came from a survey taken before joblessness skyrocketed to its current rate of 10.2 percent.

New taxes on businesses and the wealthy would pay for some of the bill's $1.2 trillion cost over 10 years. The bill also calls for cutting federal subsidies to Medicare Advantage programs and trimming other payments in that entitlement program.

Democrats said the bill would create a system in which insurance would be more "portable" and in which no one could be denied coverage for having a pre-existing condition. Private insurers no longer could place lifetime caps on benefits, and annual out-of-pocket expenses would be limited.

"Never again will you be denied coverage because you have diabetes or asthma, or because you are pregnant, or because you have anything else your insurer decides is a pre-existing condition," House Majority Leader Steny Hoyer, D-Md., said during debate on the floor. "Never again will your coverage run out. Nor will you find that coverage you thought you paid for was actually not there at all. And never again can insurance companies drive out competition and set premiums as high as they like because there will be a public insurance option and a transparent marketplace to keep them honest."

But Republicans argued that the bill ultimately would drive many employers to drop their insurance plans and leave their workers to buy coverage from the public plan.

Rep. Joe Barton, R-Texas, said there would be a two-tiered system in which only the "elites" could afford private coverage and the rest of Americans would buy insurance from the federal government. Other Republicans warned that the public option eventually would be the only option.

Rep. Mary Fallin, R-Oklahoma City, said Americans want reform but don't want "socialized medicine" and "more federal deficit spending on the backs of our children."

The debate over major health care changes has roiled the country, just as it did when former President Bill Clinton tried to take on the issue in the early 1990s. This past summer, congressional town hall meetings drew large crowds of people irate over the idea that the government would become more involved in health care. On Saturday, just as earlier in the week, protesters outside the U.S. Capitol yelled, "Kill the bill."

Though large organizations such as the AARP and the American Medical Association backed the bill, the most important group at the end may have been the U.S. Conference of Catholic Bishops, which wanted a longstanding ban on federally-funded abortion maintained.

Democratic leaders agreed Friday night to allow a vote on stringent prohibitions against abortion services when any kind of federal subsidies are involved. The House approved the anti-abortion amendment 240-194, despite objections from several Democratic women lawmakers who said it was unnecessary.

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