Summoned to success by President Barack Obama, the Democratic-controlled Congress approved historic legislation Sunday night extending health care to tens of millions of uninsured Americans and cracking down on insurance company abuses, a climactic chapter in the century-long quest for near universal coverage.
"This is what change looks like," Obama said a few moments later in televised remarks that stirred memories of his 2008 campaign promise of "change we can believe in."
Widely viewed as dead two months ago, the Senate-passed bill cleared the House on a 219-212 vote. Republicans were unanimous in opposition, joined by 34 dissident Democrats.
A second, smaller measure - making changes in the first - cleared the House shortly before midnight and was sent to the Senate, where Democratic leaders said they had the votes necessary to pass it quickly. The vote was 220-211.
Following the vote, President Obama, with Vice President Biden at his side, said it proves government "still works for the people."
Passage, he said, showed that lawmakers "didn't give in to mistrust or to cynicism or to fear."
"Instead," he said, "we proved that we are still a people capable of doing big things."
Obama went through the bill's provisions, stating that "this isn't radical reform, but it is major reform."
The bill "will not fix everything that ails our health care system, but it moves us decisively in the right direction," he said. "This is what change looks like." ()
Obama will travel outside Washington on Thursday as he now turns to seeing a companion bill through the Senate and selling the health care overhaul's benefits on behalf of House lawmakers who cast risky votes. It is most likely that he will sign the bill on Tuesday, but the plans are not yet final, said a senior administration official, who spoke on condition of anonymity to discuss as-yet unannounced strategy.
Obama's young presidency received a badly needed boost as a deeply divided Congress passed the rare piece of legislation that will touch the lives of nearly every American. The battle for the future of the medical system - a sixth of the economy - galvanized Republicans and conservative activists, particularly the anti-government tea party movement.
Far beyond the political ramifications - a concern the president repeatedly insisted he paid no mind - were the sweeping changes the bill held in store for Americans, insured or not, as well as the insurance industry and health care providers that face either smaller than anticipated payments from Medicare or higher taxes.
The nonpartisan Congressional Budget Office said the legislation awaiting the president's approval would extend coverage to 32 million Americans who lack it, ban insurers from denying coverage on the basis of pre-existing medical conditions and cut deficits by an estimated $138 billion over a decade. If realized, the expansion of coverage would include 95 percent of all eligible individuals under age 65.
For the first time, most Americans would be required to purchase insurance, and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.
For the president, the events capped an 18-day stretch in which he traveled to four states and lobbied more than 60 wavering lawmakers in person or by phone to secure passage of his signature domestic issue. According to some who met with him, he warned that the bill's demise could cripple his still-young presidency, and his aides hoped to use the victory on health care as a springboard to success on bills to tackle stubbornly high unemployment that threatens Democratic prospects in the fall.
Obama watched the vote in the White House's Roosevelt Room with Vice President Joe Biden and dozens of aides, exchanged high fives with Rahm Emanuel, his chief of staff, and then telephoned Speaker Nancy Pelosi with congratulations.
"We proved that we are still a people capable of doing big things," he said later in the White House East Room. "We proved that this government - a government of the people and by the people - still works for the people.
Sen. John McCain said Monday morning that Democrats have not heard the last of the health care debate, and said he was repulsed by "all this euphoria going on." outside the Capitol shouted "just vote no" in a futile attempt to stop the inevitable taking place inside a House packed with lawmakers and ringed with spectators in the galleries above.
Appearing on ABC's "Good Morning America," McCain, who was Obama's GOP rival in the 2008 presidential campaign, said that "outside the Beltway, the American people are very angry. They don't like it, and we're going to repeal this."
McCain, who is in a tough Republican primary fight in his home state, said the GOP "will challenge it every place we can," and said there will be reprisals at the polls, in Congress and in the courts.
Meanwhile, Secretary of Health and Human Services Kathleen Sebelius said on CBS' "The Early Show" that Americans will be.
"Once people understand what's in the bill and the fact that a lot of what they've been hearing has never been contemplated, has never been in the bill, that they'll be very enthusiastic about what congress did last night," Sebelius said.