WATCH THE DEBATE LIVE
BY CARL HULSE and ROBERT PEAR
The New York Times
President Obama exhorted Democrats on Saturday to approve a sweeping overhaul of health care and to “answer the call of history” as the House began debating legislation that would transform the nation’s health insurance system.
Democrats quickly took a significant step toward passage of the plan by surmounting a key procedural hurdle in approving the rules for debate.
Despite a sharp party divide over how strictly to limit spending for abortions, leading Democrats were increasingly confident they had locked up the necessary support for the measure. A handful of undecided lawmakers announced they were ready to back it.
“We are on the cusp of making a historical decision on behalf of the American people,” said Representative James E. Clyburn of South Carolina, the No. 3 Democrat in the House.
Mr. Obama made a rare weekend appearance on Capitol Hill as part of an all-out effort to rally Democrats to support the biggest health care legislation since the creation of Medicare for the elderly in 1965.
Democrats say their $1.1 trillion, 10-year measure would extend coverage to 36 million people now without insurance and end insurance company practices like not covering pre-existing conditions or dropping people when they become ill.
During the private meeting with Democrats in the Cannon Caucus Room, the president acknowledged the political difficulty of supporting major legislation in the face of unanimous Republican opposition and tough criticism from conservatives.
But, those present said, he urged them on, saying, “When I sign this in the Rose Garden, each and every one of you will be able to look back and say, ‘This was my finest moment in politics.’ ”
That sentiment drew a cheer, senior aides in the room said.
The House debate opened after months of internal party wrangling, angry town-hall-style meetings and committee deliberations and Republicans were united in their criticism of the measure, describing it as a government take-over of health care that would damage the economy at a weak moment.
“This bill is a wrecking ball to the entire economy,” said Representative Jack Kingston, Republican of Georgia. “ We need targeted specific reforms to help people who have fallen through the health care cracks.”
But Democrats said Republicans were intent on protecting the status quo in health care and that the new Democratic approach would vastly improve the ability of Americans to gain affordable health insurance.
“Now is the chance to fix our health care system and improve the lives of millions of Americans,” said Representative Louise M. Slaughter, Democrat of New York and chairwoman of the Rules Committee, as she opened the daylong proceedings.
In remarks later Saturday from the Rose Garden, Mr. Obama continued to ask lawmakers to press ahead with the legislation. “I urge members of Congress to rise to this moment,” he said. “Answer the call of history, and vote yes for health insurance reform for America.”
He told Democrats on Capitol Hill that their vote would define them in the future just as Social Security and Medicare has in the past.
The expected wall of Republican opposition gave Democrats little room to maneuver and they were working to corral as many party members as they could. But the preliminary approval to clear the way for the debate came on a vote of 242-192, suggesting Democrats had a historic win within reach.
The difficult issue of how much to restrict new federal spending on abortion continued to complicate the outcome by creating a split between Democrats supporters and opponents of abortion rights and loomed as one last obstacle.
Unable to reach agreement on compromise language on abortion coverage, House leaders decided early Saturday to allow a vote on tight restrictions that would prohibit federal money from being used to pay for abortions, either through a new federal health insurance plan or under private plans that enroll people relying on federal subsidies.
“From Day 1, my goal has been to ensure federal tax dollars are not used to pay for abortions,” said Representative Brad Ellsworth, Democrat of Indiana and one of the authors of the abortion provision.
But the abortion restrictions were bitterly opposed by Democrats who support abortion rights and may face a choice of either accepting the restrictions or scuttling the entire health measure that Democrats have spent months negotiating and assembling. Several Democrats said they expected those lawmakers to go along grudgingly with the anti-abortion proposal in the hope of changing it during later negotiations with the Senate.
“There’s no way at the end of the day we’re going to support these kinds of further restrictions on abortion,” Representative Jan Schakowsky, Democrat of Illinois, said on C-Span. Ms. Schakowsky said that she and others would try to defeat the abortion proposal. But if they are unsuccessful, she said, “we want to move the process along.”
The looming House vote was a significant step in the long-sought Democratic goal of enacting broad changes in the way health care is delivered in the nation. But the Senate has yet to bring its own emerging measure to the floor for debate, and should both the House and the Senate advance a measure, they will still need to negotiate and approve a final bill in the weeks ahead.
The struggle House Democrats had in lining up the minimum number of votes for the measure was a clear indication of how difficult it will be to get final legislation to the president’s desk.
The House legislation, running almost 2,000 pages long, would cost $1.1 trillion over 10 years and would require most Americans to obtain health insurance or face penalties. Insurers could not reject people because of pre-existing medical conditions and could not charge higher premiums because of a person’s health status or sex. The bill would trim Medicare payments to hospitals and many other health care providers and would impose a new tax surcharge on high-income people.
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