The U.S. House of Representatives passed a historic health-care bill late Sunday that will make coverage possible for more than 30 million uninsured Americans and end discrimination by insurance companies against people with existing medical conditions.
Legislators voted 219 to 212 in favour of the landmark legislation that has been debated on Capitol Hill for a year. The bill, previously passed by the Senate, didn't receive a single vote from Republicans. It will now go to President Barack Obama for his signing into law, possibly as early as Tuesday.
"It is with great humility and with great pride that we tonight will make history for our country and progress for the American people," House Speaker Nancy Pelosi said during her closing argument for health-care reform. "Just think, we will be joining those who established social security, Medicare and now, tonight, health care for all Americans."
Following the vote, Obama said, "This is what change looks like.
"We proved we are a people capable of doing big things and tackling our biggest challenges," he said. "We proved that this government — a government of the people and by the people —still works for the people."
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Overhauling of the health-care system is the most ambitious U.S. social program since Lyndon B. Johnson's Great Society reforms of the tumultuous 1960s and Franklin D. Roosevelt's New Deal that emerged from the trauma of the Great Depression in the 1930s.
The passage of the legislation was made possible by a last-minute deal struck earlier in the day between the White House and House Democrats who were holding out over abortion concerns.
The White House said in a statement that Obama would issue an executive order after passage of the health-care bill that would reaffirm current law banning federal spending on abortion, except in cases of rape, incest or a threat to the mother's life.
Moments after the statement, leading abortion foe Bart Stupak, a Democrat congressman from Michigan, and six other anti-abortion Democrats said they would back the health-care bill.
"We're well past 216," Stupak told reporters, referring to the number of votes required to pass the bill in the House of Representatives.
The legislation would extend coverage to an estimated 32 million uninsured Americans, bar insurers from denying coverage on the basis of existing medical conditions and cut federal deficits by an estimated $138 billion US over a decade.
Congressional analysts estimate the cost of the two bills combined would be $940 billion over 10 years.
Amid talk of success for Obama's efforts to expand health coverage to the uninsured, Republicans resolutely opposed the bill.
Republican House Leader John Boehner, on NBC's Meet the Press, said Sunday Republicans would work to repeal the sweeping reforms if they win a majority in Congress in November's mid-term election.
Republicans say the plan to overhaul the system amounts to a government takeover of health care that will lead to higher deficits and taxes.
Obama closes the deal
On Saturday, Obama made a rare trip to Capitol Hill to make an emotional and candid speech in an effort to close the deal, speaking to the entire Democratic caucus.
"We are proud of our individualism, we are proud of our liberty, but we also have a sense of neighbourliness and a sense of community and we are willing to look out for one another and help people who are vulnerable and help people who are down on their luck," he said.
Obama appealed to Democrats to recall individual stories of Americans who have not been able to get health insurance because of a pre-existing condition or because of loss of employment.
"Every single one of you at some point before you arrived in Congress and after you arrived in Congress have met constituents with heartbreaking stories," he said.
The bill would require most Americans to carry insurance, with subsidies for those who can't afford it. It would also create state-based exchanges where the uninsured can compare and shop for plans.
Seniors who spend more on prescription drugs would get a more generous benefit, including a $250 rebate this year. Young adults could remain on a parent's insurance plan until age 26, and no one with a pre-existing health condition could be denied insurance coverage.