Guiding the bill through to passage, House Speaker Nancy Pelosi compared this victory to the landmark passage of Social Security (old age pensions) in 1935 and Medicare (medical care for the aged) thirty years later. Obama himself had slightly delayed his next overseas trip – to Asia – to help lobby for its passage over the weekend.

Congressman John Dingell, the 83-year-old Michigan representative, said this bill “provides coverage for 96 percent of Americans. It offers everyone, regardless of health or income, the peace of mind that comes from knowing they will have access to affordable health care when they need it.” Dingell has introduced a national health insurance in every Congress since 1955 and has obviously been waiting a long, long time for this particular moment.

By the time the bill reached the floor for a vote, the actual legislation had blossomed into a nearly 2000-page behemoth of legislation. In its final form, it would require all Americans to carry health insurance and provide federal subsidies to those who cannot afford it, ensure large companies provide insurance to their employees, end exclusions for pre-existing medical conditions and end the health insurance industry’s exemption from antitrust restrictions. The net result is the establishment of a federally regulated marketplace where consumers could shop for coverage among a wide array of health care choices and plans.

The cost for Speaker Pelosi of getting a majority – however slim – was to agree to tight restrictions preventing any insurance plan obtained via a USG subsidy from covering abortions. Abortion remains one of the most highly emotive issues in American politics as it pits religious feeling and women’s rights against each other.

Attention now turns to the Senate where several competing bills will have to be merged together and then the Democratic Party will want to hold a super-majority (60 of the 100 seats) to ensure that cloture, an end to unlimited debate can be enforced.  The Senate has a tradition of unlimited debate unless 60 senators agree to stop it.  The Democratic leadership’s challenge is to keep all 58 Democratic senators plus two independents who vote with them united on the bill. Or, in the event of Democratic defections, to get few Republican moderates to join in on ending debate.  The latter is much more difficult of course. As a result, expect plenty of ‘sturm und drang’ before a bill agreed to by both houses of the Congress finally reaches President Obama’s desk for signature, turning the proposal into law.

By Brooks Spector

Read more: AP, New York Times, Washington Post, New York Times

Photo: Majority Leader Steny Hoyer (D-MD) speaks next to U.S. Speaker of the House Nancy Pelosi (R) during a news conference about the House vote on health care reform on Capitol Hill in Washington November 7, 2009. The U.S. House of Representatives approved a sweeping healthcare reform bill on Saturday, backing the biggest health policy changes in four decades and handing President Barack Obama a crucial victory. REUTERS/Yuri Gripas