Health care reform legislation a year in the making heads to President Obama’s desk after Democrats cemented a narrow victory Sunday night on the heels of an intense week of arm-twisting and deal-making.

A bloc of pro-life Democrats turned out to be the linchpin to passage of the Senate’s massive health insurance overhaul, as Obama sealed a 219-212 victory with a pledge to issue an executive order “clarifying” abortion language in the Senate bill.  [All of the 178 Republicans and 34 Democrats voted against the bill.]

The House also voted 220-211 to support a “reconciliation” bill aimed to “fix” provisions in the Senate bill that many House Democrats opposed but viewed as better than nothing.

The Senate was scheduled to begin debate on those “fixes” on Tuesday, the earliest day that Obama would sign the original legislation.

The president delivered a statement after the vote, calling the “reform” the “right thing to do” for families, seniors, businesses, workers and the future and “another stone firmly laid in the foundation of the American dream.”

“The United States Congress finally declared that America’s workers and America’s families and small businesses deserve the security of knowing that here in this country neither illness nor accident should endanger the dreams they worked a lifetime to achieve,” Obama said in the East Room of the White House as Vice President Joe Biden stood beside him.

“We proved that this government, a government of the people and by the people, still works for the people,” he said. “I know this wasn’t an easy vote for a lot of people but it was the right vote.

“This isn’t radical reform, but it is major reform. This is what change looks like,” Obama added.

Thirty-four Democrats voted against the Senate bill, whose passage turned out to be incumbent upon the president satisfying pro-life Democrats like Rep. Bart Stupak, D-Mich., who insisted on stronger restrictions on abortion than the Senate’s bill.

The Senate bill allows insurance companies who participate in a planned government-run exchange to provide abortions but attempts to create separate accounts for those using federal subsidies who might seek abortion services.

Stupak had claimed he had at least seven votes with him against the Senate bill. They turned out to be more than enough to make or break the bill. On Sunday afternoon, he said the president’s promise of an executive order was enough to win over the group, even though pro-choice groups slammed Obama as a sell-out to their cause and pro-life groups said the order would change nothing in the Senate bill.  [Obama said that the executive order he will sign will reaffirm that the bill would maintain a “consistency with longstanding restrictions on the use of federal funds for abortion.”]

Republicans too called the executive order a toothless regulation that does not have the force of law and can easily be overturned with a strike of the pen.

After the vote for passage, GOP [Republican] lawmakers sought to send the Senate bill back to the House committee with language asking for additional protections against tax-funded abortions like those successfully proposed by Stupak in the House legislation that passed in November.

The president’s executive order does “absolutely nothing to mitigate or change” in any way the Senate’s provisions on abortion accounts, said Rep. Chris Smith, R-N.J. ……….

House leaders on both sides of the aisle gave impassioned pleas before the final vote Sunday night, with [Democratic] House Speaker Nancy Pelosi praising Obama’s leadership and [Republican] House Minority Leader John Boehner warning congressional members against defying the will of the American people. ……….

Saying the actions taken by the House to get the bill passed discredits the Congress, Boehner…demanded lawmakers answer simple questions.  “Can you go home and tell your senior citizens that these cuts in Medicare will not limit their access to doctors or further weaken the program instead of strengthening it? No, you can not,” Boehner said to shouts of support from his GOP caucus. “And look at how this bill was written. Can you say it was done openly, with transparency and accountability without backroom deals struck behind closed doors, hidden from the people? Hell, no you can’t.”

Boehner warned lawmakers that they will have to face the music if they vote for the legislation.

“In a democracy you can only defy the will of the people for so long and get away with it,” he said.

Despite his dire warnings, Boehner was followed by Pelosi, who earned an equally passionate response from her Democratic colleagues. ……..

Pelosi pledged the new legislation would create hundreds of thousands of jobs and save $1.2 trillion in its second 10 years, numbers predicated on unlikely scenarios, including Congress’ withholding its authority to make discretionary spending changes to the bill and future Medicare savings.  ……..

After the vote, Democratic leaders spoke to the press. Rep. James Clyburn, D-S.C., the majority whip, called Pelosi the most “tenacious” person he’d ever met. He added that the bill is “a giant step toward the establishment of a more perfect union.”

“I consider this to be the civil rights act of the 21st century because I do believe this is the one fundamental right that this country has been wrestling with now for almost 100 years,” Clyburn said. ……..

Once the fixes bill goes back to the Senate, lawmakers were expected to approve a series of “fixes” aimed at getting rid of special deals for some districts and states, including the “cornhusker kickback” for Nebraska and others made to win Senate support.

Obama will have to sign the Senate bill into law before any fixes bill goes to the Senate under rules designed to enable Democrats to pass the bill with 51 votes, thus avoiding a Republican filibuster. Democrats control 59 of the Senate’s 100 seats, one vote shy of the number needed to overcome bill-killing filibusters from a united GOP.

But senators have given no guarantees they will pass the fixes, which are strictly the wishes of House Democrats.

Any reconciliation package that does get sent to the Senate is facing a block — or at least a delay — from Senate Republicans who will try to use “hundreds” of amendments to stop the fixes.

“We’re not going to try to drag this out forever with amendments, but I do think it’s important to try to amend some portions of the bill and at least use the amendment process to demonstrate to the American people some of the things that are still wrong with this bill,” said Sen. Jon Kyl, R-Ariz.

Much may hinge on the judgments of an unelected figure, Senate Parliamentarian Allan Frumin, who will enforce the so-called “Byrd rule,” named after the Democratic senator from West Virginia. The rule holds that any provisions in a reconciliation bill that do not firstly and chiefly affect the budget must be stricken from the measures.

“There are some provisions that have — clearly, (the Congressional Budget Office) has scored as having zero or no budgetary consequence,” said Bill Hoagland, a one-time aide to former Senate Majority Leader Bill Frist, R-Tenn. “They’re not important, they’re not significant in the grand scheme of things. But just to have one would be enough to create the point of order and, if sustained by the chair, would create this situation where it would have to go back to the House again.”

Of course, the parliamentarian’s rulings are not the final word in the Senate. That authority belongs to the president of the Senate, currently Vice President Joe Biden.

Leading Democrats hinted on Sunday that they may invoke Biden’s authority to shut down the GOP.

“We’re going to deal with honest amendments on substance that meet the test of the Senate rules,” Sen. Richard Durbin, D-Ill., said on CBS’ “Face the Nation.” “But there is going to come a point when the American people and the people in the Senate are going to say this really isn’t about substance, it’s all about politics. Now let’s make a final decision, up or down vote.”

Republicans may also argue that select provisions of the bill impact Social Security, and if that argument carries the day, it would, under Senate rules, effectively kill the bill.

Fox News’ James Rosen contributed to this report.

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1. What was the final vote in the House on the health care reform bill?

2. a) How many of the Democrats are there in the House of Representatives?
b) How many Democrats voted against President Obama’s health care bill?
c) Why do you think this many voted against the bill?

3. Pro-life Democrat Bart Stupak said he had at least 7 others who would vote against the bill based on the fact that taxpayer money would be used to pay for abortions. Why did they change their votes and support the bill?

4. a) What is an executive order?
b) How do Republicans view the executive order on abortion, compared to their pro-life Democratic colleagues?

5. What benefits did Democratic House leader Nancy Pelosi pledge the new legislation will provide?

6. a) Define bipartisan.
b) Polls have shown that a majority of Americans oppose making this health care reform bill a law. In addition to the pro-life Democrats who opposed the bill (but then voted for it) almost 15% of Democratic Congressmen voted against the bill. The president has said he will not campaign for any Democrat who opposed his bill, yet 34 still voted against it despite strong opposition from their party.
Why do you think that the media is not reporting widely on the number of Democrats who voted against the bill?
NOTE: The media emphasize “bipartisan” support for bills proposed by Democrats (e.g. one Republican senator is supporting the Democrats’ immigration reform bill and it has been widely publicized as having “bipartisan” support – why not point out that Congress was bipartisan in their opposition of the bill?) Should the fact that Congress voted for the bill despite the fact that the majority of Americans oppose the bill be newsworthy?

7a) Skim through the headlines from Yahoo News, The New York Times, Washington Post. What is the overall tone of news reports on the passage of President Obama’s health care reform bill?
b) Ask a parent whether he/she supports the passage of the health care reform bill and to explain why.


Do you know how your representative voted?  Go to for the breakdown.

Read the Agence France Presse report at YahooNews Most U.S. Media Support Health Care Legislation”

Read an observation on President Obama’s executive order on abortion funding at

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