House of Representatives Passes Health-Care Reform Bill in Historic Vote

Posted by Adele Stan, AlterNet at 8:32 PM on November 7, 2009.

In an historic vote in the U.S. House of Representatives, a health-care reform bill containing a public health-insurance plan passed the chamber by a vote of 220-215. One Republican, Joseph Cao of Louisiana, voted with the Democrats, while 39 Democrats, including Ohio Democrat Dennis Kucinich, voted against H.R. 3962, the Affordable Health Care for America Act.

Both of the Democrats who won special elections last week, Bill Owens of New York's 23rd district, and John Garamendi of California's 10th voted for the bill.

As the time allotted for voting drew to a close, Democrats, shouting in unison, counted down the final seconds like it was New Year's Eve. Speaker Nancy Pelosi smiled broadly as she pounded the gavel and announced the result.

At a meeting with reporters following the bill's passage, Pelosi called up Rep. Patrick Kennedy, D-R.I., son of the late Sen. Ted Kennedy, the upper chamber's long-time champion of health-care reform. "My dad was a senator," Kennedy said, "but tonight his spirit was in the House."

Rep. John Dingell, D-Mich., also played an historically symbolic role in the vote, gaveling the start of the proceedings.  Like his father before him, who was also a congressman, Dingell has introduced a health-care reform bill every year of his 54-year career in the House, and gaveled to order the 1964 proceedings for the passage of Medicare.

The bill passed in the House includes a public health-insurance plan that is one of a number of plans -- the rest offered by private and non-profit insurers -- that consumers will be able to purchase on an insurance exchange, which has been described as a sort of shopping mall of insurance policies. Lower-income citizens will be eligible for federally-financed subsidies of premiums. All Americans will be required to carry a minimum level of health insurance or face a tax penalty. Individuals earning more than $500,000 annually, and couples who earn more than $1 million per year, will face an additional tax to help finance the health-care plan.

Included in the legislation are protections against exclusion from coverage for pre-existing conditions and a prohibition on rescissions that have seen people suddenly dropped from coverage because they failed to disclose a minor condition such as acne. Women will be protected from elimination of coverage for gender-specific conditions. Young adults will be able to remain on the parents' policies until their 27th birthdays, and several discriminatory practices against LGBT people will be prohibited.

(For more on what's in the bill and likely battles to arise in a conference committee, see 5 Key Fights We Face Against the Insurance Industry by AlterNet's Joshua Holland.)

It was a week of wrangling, arm-twisting and conservaDem-whispering for House leaders as they sought to put together the 218 votes necessary to pass the bill. Originally scheduled for Friday, the vote was put off for a day as House Whip James Clyburn and Pelosi's whip team worked members of the Democratic caucus to bring more on board. President Barack Obama consequently delayed a planned Friday visit to Capitol Hill for a meeting with Democrats about the bill, instead making the trek today in a bid to sway any stragglers.

Much of the slow-down came at the hands of Rep. Bart Stupak, D-Mich., who insisted that the bill was not strong enough in preventing the use of federal funds for abortion procedures, since the bill would permit a woman who bought private health insurance -- with her own money -- through a federally-administered insurance exchange to purchase a policy that covered abortion. With the backing of the U.S. Conference of Catholic Bishops, Stupak and Joe Pitts, R-Penn., held up the bill, looking for a deal on language that would appease the church. (Both Stupak and Pitts belong to the secretive Capitol Hill religious group known as The Family.)

As of Friday night, Pelosi thought she had worked out a language compromise with the pro- and anti-choice forces, but before daybreak, the deal had fallen apart "because they can't count," Stupak said of Pelosi's negotiators during a press conference after the House vote.

Unable to deliver the compromise she thought she had forged, Pelosi allowed Stupak to bring his concerns to the floor in the form of an amendment, which passed with the votes of 64 Democrats. (More about the amendment from AlterNet here and RH Reality Check here.)

Part of Pelosi's calculus in allowing the Stupak amendment seems to be the unlikelihood that it will survive in the conference committee that will reconcile the House bill with whatever the Senate eventually passes and calls health-care reform. Certainly House Minority Leader John Boehner seemed to think so, as he made a point, during the general debate on the larger health-care bill of asking each of the committee chairmen who together crafted the Affordable Health Care Act whether they would commit to preserving the amendment when the bill is finalized in conference committee.

Boehner's point was rhetorical; no one in his right mind commits to the outcome of a conference negotiation, especially when you don't know what will be in the other body's bill.  But when he pressed House Ways and Means Committee Chairman Charles Rangel, D-N.Y.; Education and Labor Committee Chairman George Miller, D-Calif., and Energy and Commerce Committee Chairman Henry Waxman, D-Calif., whether they would personally commit to supporting inclusion of the Stupak amendment language in any bill to come out of a conference committee, none would.

Similarly, Speaker Pelosi, when asked during her presser after the bill's historic passage whether the Stupak language would survive in a conference committee replied that in the course of the development of the bill, she and key members of her caucus have sought "common ground" on the abortion issue, which was not to be found. "We will continue to seek common ground," she said, meaning that nothing was set in stone.

Rep. Rosa DeLauro, D-Conn., who decried the Stupak amendment on the House floor, stood at the speaker's side as she made her common-ground comments. Pelosi cited DeLauro as an important member of the whip team, which also included Maryland Congressman Chris Van Hollen.

Pelosi is keenly aware of the gender politics in the sausage-making of the health-care bill. The speaker made a point in her opening remarks at the press conference of saying that that bill made certain that "no longer would being a woman be a pre-existing condition." That language comes directly from a campaign by the National Women's Law Center, and refers to insurers' catagorization of pregnancy and domestic violence as "pre-existing conditions" for the purposes of denying coverage. H.R. 3962 prohibits such practices.

Asked by a reporter whether, given the close vote today on health care and a similarly close vote last month on climate-change legislation, the speaker had spent down her political capital for other important legislation coming down the pike, Pelosi replied, smiling, "What are you, Scrooge early? I reject your premise."

Tagged as: nancy pelosi, health care reform, affordable health care fo

Adele M. Stan is AlterNet's Washington editor.