On Saturday night, around the eleventh minute after 11 p.m., in the eleventh month of the year, in a bid to overcome part of government’s pre-existing condition of institutional inertia, the House of Representatives voted 220-215, to approve HR 3962, the Affordable Health Care for America Act, the most sweeping health-care legislation since Medicare and Medicaid in 1965.
The legislation about to advance to the Senate is the first (and mostly unmitigated) domestic-policy triumph for President Obama; for Rep. John Dingell, the Ohio Democrat whose father was a pioneering congressional champion of health-care reform in the 1940’s; and, poignantly, for the late Massachusetts Sen. Edward Kennedy, whose death 74 days earlier gave the lion of the Senate a best last hurrah after the fact.
The bill’s passage — sweetly achieved on the third anniversary of the Democratic takeover of the House — advances a plan that would cost more than $1.1 trillion over the next 10 years, and cover an estimated 96 percent of the population with health care that would include the much-debated, insurance industry-vilified public option. All working Americans would be required to buy a health insurance plan, and businesses would be required to offer it to their employees.
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But really, to call it a “triumph” may be something of an understatement. If it clears the Senate, this would be a capstone on the first year of a presidency unprecedented in modern times. Universal health care, or something at least approaching it, has been an elusive goal of presidents going back to Roosevelt. Teddy Roosevelt. President Obama stands on the edge of achieving, less than a year in office, the Holy Grail of domestic-policy initiatives ardently pursued since T.R. proposed the idea in 1912.
In the Rose Garden this morning, Obama made his final pitch. “Most public servants pass through their entire careers without the chance to make as important a difference in the lives of their constituents, and the life of this country. This is their moment, this is our moment to live up to the trust that the American people placed in us even when it’s hard. Especially when it’s hard. This is our moment to deliver.”
Hours later, the House did just that.
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It wasn’t all a high-five moment. Progressives who support abortion rights were seriously disappointed with tonight’s vote.
In the brutal calculus of horse-trading on Capitol Hill, House Speaker Nancy Pelosi negotiated an eleventh-hour concession to some Democrats who threatened to walk away from the bill. Pelosi opted to let anti-abortion Democrats to try to further curb restrictions on coverage for abortions under any insurance plans receiving federal money.
That bitter pill of a concession left progressives facing a devil-and-the-deep-blue-sea choice of supporting an amendment they opposed, or trashing the bill outright, despite all its favorable components.
Tonight, with Democrats swallowing hard, the House approved an amendment by Democratic Rep. Bart Stupak of Michigan, continuing a federal ban on the use of federal funds for elective abortions, and barring use of federal affordability credits to buy a health insurance policy that covers abortion. It passed 240 to 194.
“Passage of the Stupak Amendment does not impose a new federal abortion policy; it simply continues what has been the law of the land since 1977,” The congressman said in a statement after the vote.
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Soundly whipped, Republicans condemned the vote for final passage. “This government takeover has got a long way to go before it gets to the president’s desk, and I’ll continue to fight it tooth and nail at every turn,” said Texas Rep. Kevin Brady, Republican of Texas, to The New York Times. “Health care is too important to get it wrong.”
“This bill is a wrecking ball to the entire economy,” Georgia Rep. Jack Kingston told The Times.
And Chuck DeVore, California State Assemblyman and a candidate for the Senate, fired a warning shot on his Web site: "Tonight's passage of H.R. 3962, imposing the liberal Democratic vision of government-controlled healthcare on our country, is a saddening moment that starkly illustrates why we need to elect proven conservatives to the Congress and Senate in 2010. This fight is not over: the United States Senate must pass its own version, and that must be reconciled with the House bill. With the paper-thin margin Nancy Pelosi mustered this evening, Obamacare is no sure thing."
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In recent weeks and months, the punditburo was up in arms about what many of their number saw was a lack of personal conviction on Obama’s part. They always seemed to characterize it militarily, or in pugilisitic terms: when will Obama get tough, they seemed to say, when will Obama go to the mat, when’s he gonna lead the charge?
Such characterizations were more than a casual look in the rear-view mirror; they reflected the Beltway journalistic infatuation with the arm-twisting, hands-on, in-your-face style wielded by President Lyndon Johnson, who cajoled with menace in pursuit of several domestic action items, including agriculture, civil rights legislation and … Medicare.
Anyone looking for that kind of fight from President Obama was disappointed. If we’ve learned nothing over the past eleven months, we’ve found that Obama is both a master delegator and a thoroughly involved project manager of deft rhetorical timing and a pitch-perfect sense of the moment. There’s more than one way to move the bully levers of the presidency.
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Obama, who’s been said to have been privately working congressmen thought to be wavering in support of the bill, came to Capitol Hill and personally spoke with some of those still on the fence. But Obama left much of the heavy lifting to House Speaker Nancy Pelosi, House Majority Leader Steny Hoyer and House Whip Jim Clyburn.
And some in the blogosphere understand the real distinction between campaigning and governing: only one of those you can do on your own terms. Matt Yglesias of Think Progress gets it:
“[I]n a unicameral United States of America, we would now have passed both a comprehensive health care reform bill and also the most important piece of environmental legislation in the history of the world. Now that’s not the world we live in. Instead we live in a world where neither of those things have passed and where their prospects aren’t clear. But think back on this point the next time you hear someone say Obama is struggling with his agenda because he’s not centrist enough, or else that Obama is struggling with his agenda because he’s not left-wing enough. The reality is that he’s struggling with his agenda because of the way our political institutions are structured."
Now the scene shifts to the Senate, where Democratic Majority Leader Harry Reid said he expected a bill would be sent to the floor soon. Unless it all comes a cropper there — and anything is possible given the withering opposition mounted in recent weeks — the door is open for near universal health care in America. It’s not a slam dunk but the baller in chief has a lane to the basket.
HR 3962: Still from Fox News. Clyburn, Pelosi and Obama: Unknown source, possible pool image. Stupak: Public domain. LBJ: Arnold Newman (public domain).