WASHINGTON—Summoned to success by President Barack Obama, the Democratic-controlled Congress approved historic legislation Sunday night extending health care to tens of millions of uninsured Americans and cracking down on insurance company abuses, a climactic chapter in the century-long quest for near universal coverage.
Widely viewed as dead two months ago, the Senate-passed bill cleared the House on a 219-212 vote. Republicans were unanimous in opposition, joined by 34 dissident Democrats.
Obama watched the vote in the White House's Roosevelt Room with Vice President Joe Biden and dozens of aides. When the long sought 216th vote came in -- the magic number needed for passage -- the room burst into applause and an exultant president exchanged a high-five with his chief of staff, Rahm Emanuel.
"We proved that we are still a people capable of doing big things," the president said a short while later in televised remarks. "We proved that this government -- a government of the people and by the people -- still works for the people.
A second, smaller measure -- making changes in the first -- cleared the House shortly before midnight and was sent to the Senate, where Democratic leaders said they had the votes necessary to pass it quickly. The vote was 220-211.
Far beyond the political ramifications -- a concern the president repeatedly insisted he paid no mind -- were the sweeping changes the bill held in store for nearly every American, insured or not, as well as the insurance industry and health care providers such as hospitals, nursing homes and medical device manufacturers.
The nonpartisan Congressional Budget Office said the legislation awaiting the president's approval would extend coverage to 32 million Americans who lack it, ban insurers from denying coverage on the basis of pre-existing medical conditions and cut deficits by an estimated $138 billion over a decade. If realized, the expansion of coverage would include 95 percent of all eligible individuals under age 65.
For the first time, most Americans would be required to purchase insurance, and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.
For the president, the events capped an 18-day stretch in which he traveled to four states and lobbied more than 60 wavering lawmakers in person or by phone to secure passage of his signature domestic issue. According to some who met with him, he warned that the bill's demise could cripple his still-young presidency, and his aides hoped to use the victory on health care as a springboard to success on bills to tackle stubbornly high unemployment that threatens Democratic prospects in the fall.