House Approves Healthcare Reform Measure by Slim Margin

Janice Simmons, for HealthLeaders Media , November 9, 2009

Shortly before the clock ticked down to midnight, the House passed the healthcare reform bill (HR 3962) on Saturday by a narrow margin (220-215). Thirty-nine Democrats voted against the bill, while one Republican, Joseph Cao of Louisiana, voted for it. The bill's estimated cost is $1.1 trillion over the next 10 years.

House Speaker Nancy Pelosi (D-CA), after the vote, attributed the bill's passage in part to the "team" approach by House Democrats. She praised the three House committee chairmen—Henry Waxman (D-CA) of Energy and Commerce, George Miller (D-CA) of Education and Labor, and Charles Rangel (D-NY) of Ways and Means—who all had shepherded earlier the healthcare reform bill through their House panels.

She also thanked President Obama, who made a reform-related trip to Capitol Hill earlier in the day—telling those in attendance that now is the time "to finish the job."

"No bill can ever contain everything that everybody wants—or please every constituency and every district," the president said. "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 healthcare insurance." The proposed bill has been projected to cover approximately 96% of Americans.

Conservative members from both sides of the aisle did join together over one issue prior to the vote on the Democratic healthcare bill: imposing tougher updated restrictions on abortion coverage. With a roll call vote (240 194), they cleared the way for conservative Democrats to back the overall reform bill. Also, a push by Republican members Saturday night for their alternative bill to reform was defeated 176 258.

In a statement after the vote, the American Medical Association's President James Rohack, MD, said that passage of the House health reform bill was "a big step forward as we work for comprehensive health reform this year."

Rohack added that the "bill will significantly expand health insurance coverage to Americans, empower patient and physician decision making, institute meaningful insurance market reforms, make substantial investments in quality, institute prevention and wellness initiatives, provide incentives to states that adopt certificate of merit and/or early offer liability reforms, and reduce administrative burdens."

Karen Ignagni, president and CEO of America's Health Insurance Plans, said in a statement, that "health plans strongly support comprehensive health care reform." However, she added that "the current House legislation fails to bend the health care cost curve and breaks the promise that those who like their current coverage can keep it" and that the public option included in the bill "will cause millions to lose their existing coverage."

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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