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

Wielding the gavel used by Rep. John Dingell, D-Mich., to mark the passage of Medicare some 45 years ago, House Speaker Nancy Pelosi made history Sunday night as she ushered in a new era in health care. The late-night vote marked the final passage of the health-care reform legislation originally crafted by the Senate, now on its way to President Obama's desk. The bill passed with only three votes to spare, 219-212, with 34 Democrats voting against the bill.

After the Senate version of the health-care reform bill passed, the House voted, 217-209, a package of "fixes" to the Senate bill, which strip out several special deals made with specific senators in order to win their votes -- for example, a Medicaid windfall for the state of Nebraska -- and add changes to various thresholds for subsidies and taxes. That package will require a vote in the Senate in order to pass into law, but, as a budget reconciliation measure, that vote will require only a simple majority. Still, Republicans are promising mischief in the upper chamber once the reconciliation bill is taken up by that body, so the fate of those fixes remains a bit dicey.

Who's On First(s)?

It took the first African-American president and the first woman Speaker of the House to do what generations of politicians had failed to do: create a federally regulated health-care reform program that extends health insurance coverage to the majority of Americans. Given the vitriol and epithets hurled at Democratic lawmakers by anti-health-reform protesters this weekend, it appeared that the faces of those who led the health-care reform effort had more to do with the ground-level opposition represented by the Tea Party protesters than the actual substance of the bill, which was obscured by false accusations of a "government take-over of the health system" -- and worse.

"This is what change looks like," Obama told reporters after the House vote. "This isn't radical reform," he said, "but it is major reform."

While the bill doesn't come close to fulfilling the promise of the sort of universal, single-payer coverage favored by progressives, it will, according to the Congressional Budget Office, create access to health insurance to 32 million currently uninsured Americans. But the victory came at the expense of a further erosion of women's reproductive rights, even as it proscribed discrimination against women in premium costs and gender-specific pre-existing conditions.

As Tea Party protesters, whose collective narrative relies on the symbols and story of the American Revolution, chanted on the Capitol grounds, Pelosi pointedly invoked the words of the Declaration of Independence in her floor speech just prior to the vote. In passing the bill, Pelosi said, "we will honor the vows of our founders, who in the Declaration of Independence said that we are 'endowed by our Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness.'  This legislation will lead to healthier lives, more liberty to pursue hopes and dreams and happiness for the American people.  This is an American proposal that honors the traditions of our country."

The Bill's Not Dead; It's Red

On both the House floor and on the grounds of the Capitol, the opposition's red-baiting was in full flower. During the debate preceding the bill, Rep. Ginny Brown-Waite, R-Fla., said that if the bill passed, "...you must now do things in [the Democrats'] socialist way, or face the wrath of the IRS." The part of her remark about the Internal Revenue Service apparently referred to the bill's mandate that all Americans purchase health coverage or be subject to a tax penalty.