The vote is being touted as the single most significant piece of domestic legislation to be passed by Congress since Medicare in 1965. Though Democrats and Republicans disagreed on whether it was for good or ill, most acknowledged that it was a historic day in American politics.
The $940 billion bill will cover 32 million uninsured Americans and ban the denial of coverage for preexisting conditions, phasing in taxes on the rich to pay for this expansion of coverage.
Day of wrangling
Sunday’s vote ended a day of intense negotiations among Democrats and repeated procedural attempts to kill the bill by Republicans.
In the end, not a single Republican voted for the bill. But Democrats were able to cobble together enough votes to win by striking deals with two groups of Democrats who were on the fence: anti-abortion Democrats and Democrats concerned that the funding mechanisms for the bill were unfair to certain states.
Mr. Obama will now sign a bill that many of the people who voted for it say is flawed. Regardless of what happens next, that bill will become law when Obama signs it, perhaps on Tuesday.
How to fix the bill
But Democrats want to fix it – removing some unpopular deals struck to win the votes of Senators when it passed the Senate on Christmas Eve. The House passed its package of fixes Sunday night. In order for Obama to sign those fixes into law, though, they must also be passed by the Senate – a strategy that involves a great deal of trust between House and Senate Democrats
This is because Democrats lost their filibuster-proof majority in the Senate with the election of Sen. Scott Brown (R) of Massachusetts in January. That means they can only pass the fixes by a simple majority, and that will likely only be possible through the controversial process of reconciliation.
That process is expected to begin as early as Wednesday, and it involves taking the entire package of fixes apart – provision by provision – and determining whether each serves the purpose of reducing the deficit, which is a prerequisite of any reconciliation measure.
If any provision is thrown out on this basis, the entire package of fixed could be jeopardized. With Republicans likely to provide strong resistance, the process could take weeks.
Back to work
Sunday night, however, was a political victory for Obama and particularly House Speaker Nancy Pelosi, who persisted even after the election of Senator Brown.
With opinion polls showing that a majority of Americans oppose the bill – and with many members of the House putting their careers on the line for the reform – Obama now faces the task of selling reform to a skeptical nation.
He is expected to begin a traveling tour to persuade Americans of the benefits of health care reform as early as this week.