Health Care Reform Passes the House, But It Gets Stupak'd Along The Way

Late Saturday night:

Hours after President Obama exhorted Democratic lawmakers to "answer the call of history," the House hit an unprecedented milestone on the path to health-care reform, approving a trillion-dollar package late Saturday that seeks to overhaul private insurance practices and guarantee comprehensive and affordable coverage to almost every American.

After months of acrimonious partisanship, Democrats closed ranks on a 220-215 vote that included 39 defections, mostly from the party's conservative ranks. But the bill attracted a surprise Republican convert: Rep. Anh "Joseph" Cao of Louisiana, who represents the Democratic-leaning district of New Orleans and had been the target of a last-minute White House lobbying campaign. GOP House leaders had predicted their members would unanimously oppose the bill.

Democrats have sought for decades to provide universal health care, but not since the 1965 passage of Medicare and Medicaid has a chamber of Congress approved such a vast expansion of coverage. Action now shifts to the Senate, which could spend the rest of the year debating its version of the health-care overhaul. Majority Leader Harry M. Reid (D-Nev.) hopes to bring a measure to the floor before Thanksgiving, but legislation may not reach Obama's desk before the new year.

At the Capitol, Obama urged the few Democrats who were still wavering on Saturday afternoon to put aside their political fears and embrace the bill's ambitious objectives. "Opportunities like this come around maybe once in a generation," he said afterward. "This is our moment to live up to the trust that the American people have placed in us. Even when it's hard. Especially when it's hard. This is our moment to deliver."

The House legislation would for the first time require every individual to obtain insurance, and would require all but the smallest employers to provide coverage to their workers. It would vastly expand Medicaid and create a new marketplace where people could obtain federal subsidies to buy insurance from private companies or from a new government-run insurance plan.

Now here's the bad news:

But this came at a huge price. In the name of what anyone would agree is an incremental health reform (and entrenched powers in this country leave little opportunity for reform in anything but an incremental fashion, sadly), women’s reproductive rights were set back further than at any time in the last generation, with the passage of the Stupak amendment, a brazen introduction of the anti-choice movement into private insurance markets. Under this standard, any insurance company offering plans on the exchange, be they public or private, would effectively have to deny coverage of elective abortion services. The exchanges are set to grow to emcompass practically all companies, large or small, and maybe all individuals, so you’re basically talking about, over time, banning insurance coverage of abortion. This puts a massive restriction on access to anyone who doesn’t have the funds. Jon Walker explains further.

64 members of the Democratic caucus voted in favor of the Stupak Amendment. 62 were men (of course, Marcy Kaptur and Kathy Dahlkemper were foregrounded in the debate, but no women joined them). Of the 64, 41 ended up going ahead and voting for the bill. But 23 members voted for Stupak, to restrict choice, and then against the health care reform bill. These 23 are simply moles inside the caucus, opposing key planks of the Democratic platform. What’s more, they will have giant targets on their back, both from Democratic activists seeking primaries and Republicans who know that their base will turn out in much stronger numbers for their candidates than these so-called Democrats who appear to stand for nothing. Those names:

Altmire (PA), Barrow (GA), Boccieri (OH), Boren (OK), Bright (AL), Chandler (KY), Childers (MS), Davis (AL), Davis (TN), Gordon (TN), Griffith (AL), Holden (PA), Marshall (GA), Matheson (UT), McIntyre (NC), Melancon (LA), Peterson (MN), Ross (AR), Shuler (NC), Skelton (MO), Tanner (TN), Taylor (MS), Teague (NM)

I don’t know any Democrat who would actually miss any of them.

Amen to that. I was telling someone this weekend that one positive of the potential Democratic midterm losses is that it most likely be these people losing their jobs. Would anyone else care? I know I wouldn't.

Where we move forward from here will be interesting. There will be the typical douchebaggery from the senate, since the super important and totally not gay Senator Lindsay Graham declared the house bill "dead on arrival". That was an appropriate phrase for Graham to use, since another 45,000 people will be "dead on arrival" next year thanks to assholes like himself.

If Reid's bill passes the Senate (which it probably will), then you have an intense conference committee thunderdome where all the specifics get worked out mysteriously behind closed doors. Obama apparently promised Waxman that he'd attempt to remove the Stupak's anti-abortion nonsense then, but we'll see.

To sum it up, I'd feel much better about the passage of this bill if it wasn't guaranteed to get shittier throughout the next stages of the process. I suppose that's the way the process works so I shouldn't expect differently, but it just makes it all the more crushing that Pelosi didn't have enough votes for the medicare +5 public option.

So if you thought the last couple weeks of debate were stupid, things are about to get a whole lot worse. We're headed to the Senate, where the Douche Caucus rules the day and people seem to rise in stature the more irrelevant they become. I demand to know what President Snowe thinks about this!