WASHINGTON — The House of Representatives on Saturday approved the most sweeping healthcare legislation since the creation of Medicare 44 years ago, giving a boost to President Obama's campaign to guarantee health coverage to almost all Americans.
The gargantuan Democratic measure passed 220 to 215, with a single Republican vote, capping a contentious daylong debate that underscored the ideological divide separating the two parties over healthcare.
The narrow Democratic victory underscored the difficult road ahead as the issue moves on to the Senate. But it also meant that the party had reached a historic landmark: It has been trying since the Depression to win a vote to extend the government's social safety net to include healthcare.
The House plan would cover an additional 36 million people by 2019, leaving 4% of the nation without coverage, compared with the estimated 17% who do not have insurance now, according to the nonpartisan Congressional Budget Office.
For The Record
Los Angeles Times Sunday, November 15, 2009 Home Edition Main News Part A Page 4 National Desk 1 inches; 44 words Type of Material: Correction
Healthcare bill and abortion: In a Nov. 8 article about an abortion funding provision in the House healthcare overhaul bill, a statement in support of the bill by Catholics United was misattributed to the U.S. Conference of Catholic Bishops. (Both groups endorsed the bill.)
"For generations, the American people have called for affordable, quality healthcare for their families. Today, the call will be answered," said House Speaker Nancy Pelosi (D-San Francisco), who rallied her members behind the legislation after weeks of cajoling and deal-making.
The Democratic side of the House cheered loudly when the vote count reached 218, a majority. Like a crowd waiting for the final gun at a football game, they counted down the final seconds of the voting period in unison, and roared their approval when Pelosi went to the speaker's chair, grabbed the gavel and declared, "The bill is passed."
President Obama hailed the vote in a statement from Camp David, saying: "Thanks to the hard work of the House, we are just two steps away from achieving health insurance reform in America. Now the United States Senate must follow suit and pass its version of the legislation. I am absolutely confident it will, and I look forward to signing comprehensive health insurance reform into law by the end of the year."
Republicans, who have fought Obama's healthcare campaign for most of the year, charged Democrats with pushing the nation toward government-run healthcare and threatening to bankrupt the treasury at a time when the deficit is skyrocketing.
"People have a grave concern about what Washington is doing to them, not for them," Rep. Eric Cantor of Virginia, the No. 2 House Republican, said Saturday, citing last week's GOP electoral victories in Virginia and New Jersey.
Louisiana Rep. Anh "Joseph" Cao was the only Republican to cross the aisle and vote for the bill. Thirty-nine Democrats voted against it.
The legislation -- which includes more than $1 trillion in new healthcare spending over the next decade while also reducing the deficit by an estimated $106 billion -- will ultimately have to be reconciled with the Senate bill.
Senate Majority Leader Harry Reid (D-Nev.) is working to unite his members in time to hold a vote on the Senate bill before Christmas.
With the unemployment rate continuing to rise and the public increasingly jittery about Obama's healthcare campaign, Democrats are racing to push through an overhaul before what many see as a historic opportunity slips away.
Pelosi had hoped to get a bill through the House sooner than November. But she and her lieutenants had to spend months hammering out a series of difficult compromises to satisfy the liberal and conservative wings of the party.
New requirements on businesses and insurance companies have alienated major industry groups, many of which actively fought the House bill, charging that it would actually make healthcare less affordable.
"The healthcare reform bill just passed by the House of Representatives fails the crucial test of reducing the soaring cost of health coverage for businesses or individuals," U.S. Chamber of Commerce Executive Vice President Bruce Josten said after the vote.
But even as opposition to the bill stiffened, Democratic leaders managed to defuse major disagreements over the shape of a new government insurance plan and the scope of new income taxes on wealthy Americans.
They picked up major endorsements from AARP and the American Medical Assn., which joined a collection of leading consumer and patient groups and labor unions that have backed the healthcare campaign all year.
And facing the possible collapse of the legislation late Friday night, Democratic leaders brokered a deal to settle a debate within party ranks over abortion.
Under pressure from a group of socially conservative Democrats and the U.S. Conference of Catholic Bishops, Pelosi and other lawmakers who favor abortion rights were forced to accept a last-minute compromise that placed tight restrictions on federal funding for abortion services.
The amendment was added to the bill Saturday by a coalition of 240 Republicans and conservative Democrats; 194 Democrats voted against the amendment.