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Obama signs health-care reform bill

By Scott Wilson
Washington Post Staff Writer
Wednesday, March 24, 2010; A01

His replies of "Thank you, thank you" were barely audible over the applause, whistles and shouts that filled the East Room on Tuesday, and when the noise finally faded, President Obama nodded to history in summing up the moment and the celebration unfolding before him.

"Today, after almost a century of trying; today, after over a year of debate; today, after all the votes have been tallied -- health insurance reform becomes law in the United States of America," he said. "Today."

Minutes later, sitting at a small desk surrounded by congressional leaders and some of the Americans whose problems he highlighted in speeches, Obama turned the most contentious bill in recent memory into law with his left-handed signature. He used 22 pens to do so, adding what his Democratic supporters say is another strand in a widening social safety net designed to protect those living in the world's wealthiest society.

Rich with symbolism and ceremony, the White House event provided clues about how the administration plans to sell the measure to a skeptical public: as a moral necessity of historic proportion. Obama told his audience of allies that "we are not a nation that scales back its aspirations." But his central challenge remains convincing an anxious nation that it can afford to help all, even at a time of rising debt, high unemployment and two distant wars.

In a 10-minute speech interrupted more than 20 times by ovations, Obama suggested that those Republicans and Democrats who opposed the measure sit now on the wrong side of history. But Republicans have promised to defeat his argument at the ballot box in November and take back those swing-district seats that Obama's once-towering popularity turned Democratic in 2008.

Such concerns went unmentioned at Tuesday's jubilant celebration. Among longtime Washington politicians in attendance, especially those who were part of failed health-care reform efforts in the past, the ceremony inspired a sense of awe.

That list included Vice President Biden, who introduced Obama, then leaned toward him amid a storm of applause and slipped into excited profanity. "This," Biden whispered, louder than he thought, "is a big [expletive] deal."

Pomp and ceremony

Signing ceremonies are just that -- ceremonies -- and presidents have used them over the years for various purposes.

White House advisers have made it clear since a closely divided House passed the bill Sunday night that Obama is more gratified by the success of the health-care overhaul than by winning the presidency. A president often criticized for being long on ambition and short on accomplishment has now achieved something that eluded his predecessors, five of whom he cited by name in his speech.

He said he was signing the bill for them; for his mother, "who argued with insurance companies even as she battled cancer in her final days"; and for several Americans whose illnesses and problems with the health-care system he has described in his more populist speeches.

In staging such a high-profile event, the Obama administration was helping to make health-care reform something for Democrats to run on in the midterm elections this fall, despite the fact that a majority of the electorate opposes it, according to opinion polls conducted before the vote. Rarely, if ever, have such events been as raucous as the ceremony-turned-political rally that rocked the ornate East Room for just over half an hour.

President Franklin D. Roosevelt chose the smaller Cabinet Room in August 1935 to sign legislation creating the Social Security system. He used 20 pens during a ceremony attended by 30 people, most of them members of Congress central to the bill's passage. Newspaper reporters were not invited.

In July 1965, President Lyndon B. Johnson flew to Independence, Mo., to sign the Medicare bill alongside a frail Harry S. Truman, who two decades earlier had become the first president to propose the idea. The low-key event was held in the Truman presidential library.

On Tuesday, by contrast, Obama invited every lawmaker who voted for the bill, requiring two events to address all those who wanted to take part after a forecast of rain moved the ceremony from the South Lawn. After the East Room event, Obama and Biden delivered similar remarks to a larger audience in the Interior Department auditorium.

"Everything has the potential these days of being a big event, and if you don't take advantage of it, there's a little bit of a sense of 'What's wrong with you?' " said Stephen Hess, a senior fellow at the Brookings Institution. "It's there to be taken advantage of, which, of course, is the way a White House staff looks at anything."

Bad feelings forgotten

Obama has seen his popularity slide over his year-long push for health-care reform, which Republican critics say has come at the expense of an effective job-creation agenda. His own party split over the scope and cost of the legislation, and the messy process revived a traditional distrust between the House and the Senate, which must still approve a set of House amendments.

But Obama brought them all into one room, where they snapped photographs of one another in front of the podium and touched the desk where the president signed the thick bill. Political enemies became friends again.

Liberal Sen. Al Franken (D-Minn.) mingled among colleagues, at one point leaning over to shake hands with Rep. Bart Stupak (D-Mich.), the antiabortion lawmaker who nearly scuttled the bill. After a few seconds of conversation, Stupak tilted his head back and let out a loud laugh, the months of friction forgotten for a moment.

The 15-foot-tall wooden doors behind the podium slid open around 11:30 a.m., offering a glimpse down a long, column-lined corridor of a portrait of President Bill Clinton on a distant wall. Obama and Biden, each in a navy-blue suit, white shirt and navy-blue tie, entered to applause and chants of "Fired up, ready to go!" from lawmakers, some of whom had questioned the president's commitment, tactics and policy goals over the past year.

In his speech, Obama thanked the lawmakers for their "historic leadership and uncommon courage" during a year of fierce opposition, acknowledging that they had "taken their lumps during this difficult debate."

"Yes, we did," shouted Rep. Gary L. Ackerman (D-N.Y.), drawing laughter from his colleagues with his play on Obama's campaign slogan.

"Our children and our grandchildren, they're going to grow up knowing that a man named Barack Obama put the final girder in the framework for a social network in this country to provide the single most important element of what people need -- and that is access to good health," Biden said in a brief introduction that included the word "history" or "historic" a dozen times.

In the audience was the sister of Natoma Canfield, an Ohio woman and cancer patient who chose her house over health insurance and is now in the hospital wondering how she will pay the bills. Also there was Vicki Kennedy, the widow of Edward M. Kennedy (D-Mass.), a man who for decades worked in the Senate for universal health care.

And so was 11-year-old Marcelas Owens, whose mother died, Obama said, because she was not insured and so could not afford treatment. In a dress shirt, vest and tie, Owens, at the same height as the seated president, leaned over the desk from Obama's right to watch him sign the bill.

A minute or so later, Obama lifted the last of the pens from the desk.

"We are done," he said.

Research editor Alice Crites contributed to this report.

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