Published on
The Nation

House Passes Health Reform, But Without Reproductive Rights

John Nichols

The U.S. House of Representatives answered "the call of history" put to
it by President Obama Saturday and voted 220-215 in favor of the most
sweeping expansion of health-care coverage since the enactment of Medicare and Medicaid Act of 1965.

House Democrats burst into sustained applause at 11:08 EST as the
majority-making 218th vote was cast in favor of the the Affordable
Health Care for America Act.

The measure ultimately received the votes of 219 Democrats.

Only one Republican, Louisiana's Joseph Cao,
supported it. (Cao, who represents an overwhelmingly-Democratic
district dominated by the city of New Orleans, frequently breaks with
the GOP leadership. He was one of the few Republicans who was seriously
lobbied by the White House and Democratic leaders in the House, and it

Thirty-nine Democrats joined 176 Republicans in rejecting reforms that polls suggest are broadly supported by Americans.

A handful of "no" votes came from Democrats who felt that the
legislation promoted by the Obama administration and House leaders was
an inadequate response to the health care crisis. Among the progressive
"no" voters was Ohio Democrat Dennis Kucinich, a leading proponent of a
single-payer "Medicare for All" system that would replace private
insurance companies with a public program.

Said Kucinich:

This health care bill continues the redistribution of
wealth to Wall Street at the expense of America's manufacturing and
service economies which suffer from costs other countries do not have
to bear, especially the cost of health care. America continues to stand
out among all industrialized nations for its privatized health care
system. As a result, we are less competitive in steel, automotive,
aerospace and shipping while other countries subsidize their exports in
these areas through socializing the cost of health care.

The reform plan shepherded through the House by Speaker Nancy Pelosi, is indeed flawed, as even the speaker acknowledges.

But it dramatically expands options for the tens of millions of Americans who are not currently covered by private insurers.

That was enough for Pelosi, who accepted what was for her a bitter
compromise on the issue of abortion in order to secure the votes needed
to pass the measure.

Late Saturday night, the speaker announced that her chamber had indeed "made history" with its endorsement of the reform plan.

Epic depictions of the House vote were commonplace Saturday, as
Democrats compared their measure with historic legislation of the past.

"This is an historic moment for our nation. House passage of H.R.
3962, the Affordable Health Care for America Act, marks the first step
toward ensuring health care for all Americans," said Wisconsin Democrat
Tammy Baldwin, who helped craft the legislation as a member of the
House Energy and Commerce Committee. "I truly believe that we'll look
back years from now and view the passage of this Act to be as
significant as the passage of the Social Security Act in 1935 and the
Medicare and Medicaid Act in 1965."

In truth, the House merely wrote a first draft of history.

The Senate still must act on a very different reform proposal.

The House and Senate bills then must be reconciled, after which they
will have to be approved once more by each chamber. Only after those
final votes will the Obama have a chance to sign a health reform bill.

It will not be a quick or easy process, as was evident Saturday.

Before the House vote, Democratic representatives heard a "now is
the time to finish the job" pep talk from Obama, which helped to
achieve relative unity within a caucus that wrangled to the last minute
over issues ranging from abortion to immigration to cost estimates for
the $1 trillion bill.

Late Friday and early Saturday, bitter battling over the hot-button issue of abortion fight came close to derailing the debate.

House Democratic leaders were pressured by several dozen anti-choice
Democrats to add language preventing federal funds from paying for
abortions. To get the votes she needed, Pelosi found herself in the
ugly position of bartering off assurances that low-income women would
have access to reproductive health services.

The tortured final negotiations put serious cracks in Thomas Jefferson's "wall of separation" between church and state,
as abortion foes such as Pennsylvania Democrat Jason Altmire openly
acknowledged that they would not vote for health-care reform
legislation unless they were told it was appropriate to do so by
Catholic bishops in their home districts.


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Pro-choice Democrats, led by Colorado Democrat Diana DeGette, pushed back.

That created a stalemate that Pelosi sought to break by allowing a
vote on an amendment to establish limits on the funding of abortions
within the new framework that would be established by the Affordable
Health Care for America Act. Pro-choice Democrats opposed the
amendment, with Illinois Democrat Jan Schakowsky, the co-chair of the
Congressional Women's Caucus, urging her colleagues to vote against the
move to restrict a woman's right to chose and force many women to pay
more their insurance.

Said Schakowsky:

This amendment goes far beyond current law which
already bans the use of federal funding for abortions. It goes far
beyond the language already in this bill that guarantees no federal
dollars are used for abortion. This amendment says that a woman CANNOT
purchase coverage that includes abortion services using her own
dollars; middle class women, using exclusively their own money will be
prohibited from purchasing a plan including abortion coverage in every
single public OR PRIVATE INSURANCE PLAN in the new health care
exchange. Her only option is to buy a separate insurance policy that
covers only abortion - a ridiculous and unworkable approach since no
woman anticipates needing an abortion. This amendment is a radical
departure from current law and will result in millions of women losing
coverage they already have.

This health reform bill is about improving access to care, not
further restricting a woman's right to choose. Our bill is about
lowering health care costs for millions of women and their families,
not further marginalizing women by forcing them to pay more for their
care. This amendment is a back door way of overturning Roe v. Wade; it
is a disservice and insult to millions of women throughout our country.
I urge my colleagues to vote against this amendment.

Despite Schakowsky's appropriately impassioned argument, the amendment was approved on a vote of 240 to 194.
Sixty-four Democrats voted with 176 Republicans to attach the amendment
that De Gette condemned as "the greatest restriction of a woman's right
to choose" passed by Congress "in our career."

"Party of 'No'" opposition to reform was such that even pro-choice
Republicans joined their anti-choice colleagues in a fully-unified GOP
vote for the amendment.

The abortion fight, like a battle over restrictions on the coverage
of immigrants that particularly upset members of the Hispanic Caucus,
made Saturday a difficult and at times uncertain day for Pelosi and her

But Obama was confident enough to expend political capital on a calm, yet effective, appeal for Democratic unity.

The president made a classic "no bill can ever contain everything
that everybody wants" appeal for what the vast majority of House
Democrats agreed was -- despite its less-than-robust public option and
the ugly compromise of abortion rights -- an imperfect-but-necessary
piece of legislation.

Said Obama:

The bill that the House has produced will provide
stability and security for Americans who have insurance; quality,
affordable options for those who don't; and lower costs for American
families and American businesses. And as I've insisted from the
beginning, it is a bill that is fully paid for and will actually reduce
our long-term federal deficit.

This bill is change that the American people urgently need. Don't
just take my word for it. Consider the national groups who've come out
in support of this bill on behalf of their members: The Consumers Union
supports it because it will create -- and I quote -- "a more secure,
affordable health care system for the American people."

The American Medical Association and the American Nurses Association
support it on behalf of doctors and nurses and medical professionals
who know firsthand what's broken in our current system, and who see
what happens when their patients can't get the care they need because
of insurance industry bureaucracies.

The National Farmers Union supports this bill because it will
control costs for farmers and ranchers, and address the unique
challenges rural Americans face when it comes to receiving quality

And the AARP supports it because it will achieve the goal for which
the AARP has been fighting for decades -- reducing the cost of health
care, expanding coverage for America's seniors, and strengthening
Medicare for the long haul.

Now, no bill can ever contain everything that everybody wants, or
please every constituency and every district. That's an impossible
task. But what is possible, what's in our grasp right now is the chance
to prevent a future where every day 14,000 Americans continue to lose
their health insurance, and every year 18,000 Americans die because
they don't have it; a future where crushing costs keep small businesses
from succeeding and big businesses from competing in the global
economy; a future where countless dreams are deferred or scaled back
because of a broken system we could have fixed when we had the chance.

What we can do right now is choose a better future and pass a bill
that brings us to the very cusp of building what so many generations of
Americans have sought to build -- a better health care system for this

Most House progressives accepted the "what-we-can-do-right-now" line as a reasonable one.

California Congressman Pete Stark,
a senior Democrat who has advocated for decades on behalf of replacing
the current for-profit scheme with a "Medicare for All" system, summed
up progressive sentiments when he explained why he was voting for a
measure that was far weaker than he would have preferred.

"At my age," said Stark, "I've learned to take what you can, when you can get it."

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