House Democrats mustered the votes needed last night to pass landmark health care legislation, a climactic chapter in a century-long quest for near-universal coverage and a victory for President Barack Obama.
The House argued its way through a thicket of Republican objections before the late-evening 219-212 vote to approve the bill to extend coverage to 32 million Americans who lack it, ban insurers from denying coverage on the basis of pre-existing medical conditions and cut deficits by an estimated $138 billion over a decade.
Under the order of the day, set down by Democrats, the House voted first on the Senate-passed bill, sending it to Obama for his signature. A final vote on the bill of revisions to the plan was to follow. Its passage sets up a final showdown in the Senate, where Senate Majority Leader Harry Reid (D-Nev.) says the votes are in hand for its final approval.
Earlier, Rep. John Dingell of Michigan, a member of Congress since 1955, said, "Today is the day that is going to rank with the day we passed the civil rights bill in 1964. Today we're doing something that ranks with what we did with Social Security or Medicare. This is a day of which we can all be proud if we vote for that legislation."
Republicans said it was nothing of the sort, warning of a government takeover of the health care system, financed by a trillion dollars in higher taxes and Medicare cuts combined.
"There is dirty deal after dirty deal after dirty deal in the bill this House will vote on," said Rep. Mike Rogers of Michigan. "It is a disgrace."
The measure cleared a critical early test vote, 224-206, a few hours after Obama and Democratic leaders struck a compromise with anti-abortion lawmakers whose votes had left the outcome in doubt.
The president issued an executive order pledging that no federal funds would be used for elective abortion.
Rep. Bart Stupak (D-Mich.) and a handful of fellow abortion opponents said they were satisfied and announced their support for the bill. A spokesman for the U.S. Conference of Catholic Bishops expressed skepticism that the presidential order would satisfy the church's objections.
About 300 shouting protesters outside the Capitol dramatized their opposition, and one man stood up in the House visitor's gallery shouting, "Kill the bill" before he was ushered out - evidence of the passions the yearlong debate over health care has stirred.
Passage of a central health care bill already cleared by the Senate would send it to Obama for his signature. That still would leave one more step, a companionpackage of changes that would go to the Senate for passage.
Republicans opposed the measure as a takeover of government health care that would cut Medicare and raise taxes by nearly $1 trillion combined.
The 44th president's quest to succeed where others have failed seemed at a dead end two months ago, when Republicans won a special election for a Massachusetts Senate seat, and with it the votes to prevent a final vote.
But the White House, House Speaker Nancy Pelosi (D-Calif.) and Reid (D-Nev.) soon came up with a rescue plan that required the House to approve the Senate-passed measure despite opposition to many of its provisions, then have both houses pass a fix-it measure incorporating numerous changes.
Under the legislation, most Americans would be required to purchase insurance, and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.