Saturday night the House finally passed the health care bill by a vote of 220 to 215. There were 39 Democrats who ended up voting against the bill, and only one Republican who voted for it.
That Republican was Rep. Joseph Cao (pronounced Gow) of Louisiana who represents an extremely liberal district. His district is about as liberal as Missouri's 1st district. It's so liberal that the only reason a Republican won was that William Jefferson, the Democratic incumbent, was insanely corrupt. Sometimes politicians can pretend they made an innocent mistake, but this is a little hard when federal agents find almost $100,000 in cash in your freezer. The district was so liberal that despite all of this, Jefferson was heavily favored, and Cao only won because the election was held in December, leading to embarrassingly low turnout. While Republicans were able to force Cao to vote against the stimulus bill, voting against health care would have been political suicide for him.
Unfortunately, in order to win the support of Cao and a few moderate Democrats, Democratic leaders allowed the Stupak amendment to be voted on and passed. This amendment prevents the public option from covering abortion. It even prevents people who receive affordability credits from purchasing any private plan that covers abortion. It still allows people to buy additional "abortion plans", but how many people are actually going to get an additional plan that just covers abortion? How many people really expect to have an abortion sometime in the future and make plans accordingly? What will end up happening is that poor women who get their insurance through the health care exchange will be unable to get an abortion, even when one is desperately needed.
This language was inserted into the bill primarily to receive the blessing of the Conference of Catholic Bishops. Democratic leaders had been working for days trying to find something the church would accept because there was a group of Democrats who wouldn't vote for the bill unless it had the church's endorsement. I'm a little uncomfortable with important legislation needing the Catholic church's seal of approval in order to pass. And considering how much of the funding for the anti-gay marriage ads in Maine came from the Catholic church, it seems like the church has become very effective at getting their moral beliefs written into our laws.
Besides this, the bill appears to be pretty good. It contains a public option, and, according to the Congressional Budget Office, would cover 36 million additional people and would reduce the budget deficit by more than $100 billion dollars over 10 years. However, it still has a tough road ahead. It first has to pass the Senate, where it will need 60 Senators to prevent a filibuster and bring it to the floor. There are some means, such as reconciliation, that have previously been used to get bills passed with a bare majority, but Democrats seem unlikely to go this route. Then a group of members from the House and Senate will get together in a conference committee to hash out the differences between the House and Senate bills. The resulting bill then has to be voted on in both houses. This could be problematic because many Democrats have pledged to vote against a bill that does not have a public option, and the Senate bill may not have one. Also, some House members voted for the bill with hopes that the anti-abortion language would later be taken out and may vote against the bill if it’s in the final version. But if it's taken out, a group of moderates may vote against the bill. If the bill makes it through all of that, it finally reaches the President’s desk.
While we're still a long way from health care reform being signed into law, the vote last night was an important first step.