Congress approves 'fixes' to health-care law

By Shailagh Murray
Washington Post Staff Writer
Friday, March 26, 2010

Congress agreed Thursday to amend the nation's new health-care law, concluding its long and contentious quest to pass major reforms, and prepared to head home for a two-week recess and to hear from skeptical voters about the legislation.

Lawmakers are leaving Washington on a rancorous note. Members of both parties seethed over the political response to threats of violence against a number of House Democrats, and senators belittled one another during amendment votes that lasted nearly 21 straight hours.

The last legislative hurdle to clear before recess was a reconciliation bill that contained a number of "fixes" to the health-care law, as well as an overhaul of the student loan program and expansion of Pell Grants. The measure was designed to proceed through Congress along a fast track, but it bogged down nevertheless.

Senate Republicans forced 41 votes to strip or alter provisions -- although Democrats won every one -- and identified 20 words that violated procedural rules, requiring the bill to return to the House to be approved a second time.

Both parties think they are emerging from the health-care debate in the stronger political position, going into midterm elections. Democrats are convinced that Americans will warm to the legislation once they have a chance to digest it and that the party will be rewarded for addressing a serious problem.

Republicans are just as certain that voters will dislike the measure even more as they absorb its scope and cost. They countered that Democrats had defied the public's wishes by passing legislation that expands the government's role in health care, cuts Medicare and raises taxes on millions of Americans.

In the end, the reconciliation bill passed the Senate 56 to 43, and the House approved it again, this time on a 220 to 207 vote. It goes to President Obama for his signature.

"We have worked and waited for this moment for a century," Senate Majority Leader Harry M. Reid (D-Nev.) said after his chamber's vote. "This, of course, was a health bill. But it was also a jobs bill. It was also an economic recovery bill. It was a deficit-reduction bill. It was an anti-discrimination bill. It was, truly, a bill of rights. And now it is the law of the land."

"The only thing bipartisan about today's vote is the opposition to this bill," retorted Sen. Lamar Alexander (Tenn.), a member of the Senate Republican leadership. "It is an historic mistake."

With health care off the agenda, Republicans are turning to other legislative targets. On Thursday, the Senate considered a temporary extension of unemployment benefits and was quickly ensnared in another procedural standoff between the parties. [Story, A7]

Even the threats against House Democrats who voted for the health-care law turned into a political flash point. On Wednesday, law enforcement officials briefed lawmakers about incidents involving at least 10 Democrats. By Thursday, party leaders traded barbs over who was to blame for turning the issue into a national news story.

Rep. Eric Cantor (Va.), the second-ranking House Republican, accused prominent Democrats, including party Chairman Timothy M. Kaine and Rep. Chris Van Hollen (D-Md.), chairman of the Democratic Congressional Campaign Committee, of "fanning the flames" by questioning whether Republicans had been aggressive enough in renouncing the violence.

"I've received threats since I assumed elected office, not only because of my position but also because I'm Jewish. I've never blamed anyone in this body for that, period," Cantor said.

"Just recently I have been directly threatened," he added, referring to a bullet shot through the window of his campaign office in Richmond on Tuesday. The Richmond Police Department confirmed Thursday that it is investigating the early-morning incident.

Doug Thornell, a spokesman for Van Hollen, responded: "This is straight out of the Republicans' political playbook of deflecting responsibility."

The "fixes" bill adopted Thursday would alter major provisions of the health law. Uninsured people would receive more-generous subsidies to buy coverage; federal funding of Medicaid would increase; and seniors would see the "doughnut hole" coverage gap disappear in their Medicare prescription drug policies.

The amendments also speed up enactment of new insurance restrictions that will particularly benefit people with chronic medical conditions. And in six months, uninsured adults younger than 26 may be added to their parents' health plans.

Because the measure was written under special budget reconciliation rules, it was protected from a Republican filibuster. But it was vulnerable to GOP parliamentary challenges. Aides scrutinized every line of the 150-page addendum and finally identified two minor provisions, related to the student-loan section, that were deemed out of order. That forced the legislation back to the House for one last late-night vote.

Amid the maneuvering, both parties remained remarkably unified. Six Senate Democrats whose states are home to private student-loan providers warned early this month that shifting the loans to federal control would probably cause job losses. But only two of those six, Ben Nelson (Neb.) and Blanche Lincoln (Ark.), voted against the amendments.

Although Democrats think that public support will grow for the health-care law, certain provisions could prove hard to explain.

In Pennsylvania, Sen. Arlen Specter (D) faces a tough reelection battle this year and is already under attack for voting yes on the bill. Nevertheless, he voted with his party in opposing an amendment that would have saved the Medicare Advantage program from dramatic cuts. More than 800,000 Pennsylvanians are enrolled in the program, and the National Republican Senatorial Committee responded to the vote by announcing, "Senator Specter has betrayed Pennsylvania seniors."

Staff writer Ben Pershing contributed to this report.

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