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"This Is What Change Looks Like": Congress Passes Health-Care Reform

Once Rep. Bart Stupak announced he would vote for the Senate version of the health-care reform bill that came before the House, Democrats had their votes.

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Several Republican members emerged from the chamber to address, through a bullhorn, the Tea Party protesters who had gathered on the grounds of the Capitol Building. Rep. Todd Akin, R-Mo., shouted that the health-care bill represented "the poison of socialism."

"What the socialists are gonna find out is that freedom dies hard in America," he said to cheering activists. "They're gonna find out that freedom in America is watered by a spring that comes from our faith, and our rights come from God Himself. They're going to find that it's not so easy to put the golden chains of velvet socialism on [our wrists] and consign us to the goals of welfare state...We will not submit to any kind of socialistic deal.."

As he made his way through the crowd after his remarks, I heard him speaking to a protester of the need "to take our country back."

"We have to win back our hopes, our churches, our culture for God."

"Take it back from what?" I asked.

"Take it back from the people who have the worshipping of the big state that can give everybody everything -- the idea that socialism itself is, we trust government with all power. Government is a terrible force. That's why we have to have limited government," he said. "That's what this country was founded on."

"But is Medicare a socialist program?" I asked.

"It sure is socialist," he said.

High Drama: The Stupak Saga

It was a day of high drama, as Democratic leaders scrambled to find the 216 votes that were needed to pass the bill, which originated in the Senate. There was plenty in the bill for Democrats of both progressive or conservative stripes not to like. Progressives had to look past the bill's omission of a public health insurance plan, which was included in the bill that the House passed last November. But with the loss to the Republicans of the seat previously held by the late Sen. Ted Kennedy, D-Mass., the Democrats lost their 60-vote majority in the Senate, which is required to overcome the procedural obstacle called the filibuster -- a maneuver that allows a minority to block votes at will. So the only way to move forward was for the House to accept the bill the Senate had already voted in before the loss of Kennedy's seat to Republican Scott Brown.

Progressive Rep. Peter DeFazio, D-Ore., threatened to withhold his vote unless his state's low Medicaid reimbursement rates were adjusted upward; he won his point on Saturday, reaching an agreement with House leaders to include a fix for his and 16 other states that suffer low reimbursement rates from the federal government. But the vote came down to the wire on Sunday thanks to the threats of Rep. Bart Stupak, D-Mich., to not only withhold his own vote, but to lead other anti-choice Democrats to vote "no" on the legislation unless the already stringent anti-abortion measures of the Senate bill be replaced with the more draconian amendment he had succeeded in attaching to the version originally passed by the House last year. The Stupak amendment would functionally forbid anyone who receives a federal subsidy to purchase health insurance through the exchanges the bill sets up from buying a policy that covers abortion. (Sarah Posner offers an analysis of the back story at TAPPED.)

All day, it remained unclear whether Stupak would make good on his threat, and whether he actually controlled the votes of some 10 or so lawmakers he claimed to have in his bloc, though he refused to name them. Then, at 4:00, he called a press conference, announcing that he would indeed vote for the bill, based on a deal he worked out with the White House. According to the terms, President Obama will issue an executive order that will satisfy Stupak's demand that federal dollars will not flow to insurance policies that cover abortion. The order directs the Secretary of Health and Human Services and the director of the Office of Management and Budget to develop plans for the "segregation" of funds intended for abortions, and tightens restrictions on abortion services by federally funded community health centers.