A health care overhaul has passed the House in Washington without much help from Missouri’s Congressional delegation.
Democratic leaders in the House were able to convince enough reluctant Democrats to vote in favor of the measure to squeeze out a 220-215 vote and send the massive bill to the Senate. The vote came Saturday evening after President Obama delivered a pep talk to Democrats, urging them to “answer the call of history” and approve the trillion-dollar package.
Missouri Republicans Roy Blunt, Jo Ann Emerson, Sam Graves, Todd Akin and Blaine Luetkemeyer all voted against the measure. Democrat Ike Skelton also voted against it. Democrats Emanuel Cleaver, Lacy Clay and Russ Carnahan voted in favor. Only one Republican in the House voted in favor of the measure.
“It’s families and patients who will suffer most under this government takeover of health care. This bill costs more than $1 trillion, increases premium costs, puts a bureaucrat between you and your doctor, and pays for most of it with Medicare cuts and job-killing tax hikes,” southwest Missouri Congressman Blunt said in a written statement.
Demoicrat Russ Carnahan of St. Louis saw it differently.
“After years of effort, months of debate and listening to the ideas and concerns of people throughout Missouri, momentum is on the side of the American people and health insurance reform,” said Carnahan in a written statement issued after Saturday’s vote. “Today we are one step closer to enacting health insurance reform that controls costs, provides choice and competition, and emphasizes wellness, prevention and shared responsibility.”
The House version of health care legislation would require every individual to obtain health insurance. It would require nearly all businesses to provide health coverage for workers or face a health care tax. Medicaid would expand. It contains a public option in which people could get federal subsidies to buy insurance in the private sector or join a new government-run insurance plan. Democrats say the plan will cover workers who currently don’t receive any health care benefits.
House leadership scheduled a rare Saturday of work in which debate began early and stretched out to 12 hours. Republicans harshly criticized the 1,990-page bill as a government takeover of health care and a budget buster which would cost jobs. The bill is expected to cost $1.05 trillion over the next decade. The House, on a 176-258 vote, rejected a Republican alternative.
The key to the Democratic victory was a compromise on abortion. Party leaders agreed to hold a vote on an amendment, offered by anti-abortion Democrats, which would explicitly bar the public plan from cover the procedure. The amendment passed on a 240-194 vote, removing an obstacle that threatened to derail the bill.
The House bill is complex. It would require private insurance companies to accept people with pre-existing conditions. Private insurers would have to justify proposed premium increases to regulators and would be required to keep adult children younger than 27 on their parents’ family policies. The bill seeks to close the so-called donut hole in Medicare prescription drug coverage by 2019. High-risk insurance pools would be available for the uninsured. Unemployed workers would be allowed to keep COBRA benefits until the public plan and insurance exchanges begin in 2013.
Under the plan, a new insurance system would be created in four years. Businesses with payrolls exceeding half a million dollars would be required to offer workers insurance coverage or pay a fine of as much as 8% of payroll. Individuals would either buy insurance or pay a fine of as much as 2.5% of their income. States would have to extend Medicaid coverage to as many as 15 million additional people.
Paying for the package is complicated. Medicare would be cut by more than $400 billion over the next ten years. A 5.4% surcharge would be added to the income tax of individuals making half a million dollars a year, $1 million for families.