Even when the “fixes” that have to be approved by the Senate are made, the health-care bill will still be something of a mess. But it’s a glorious mess, because it enshrines the principle that all Americans have the right to health care — an extraordinary achievement that will make this a better nation.

It may take years to get the details right. The newly minted reforms are going to need to be reformed or at least fine-tuned, and those will not be easy battles. But the social movements that allowed Obama to become president and Pelosi to become speaker proved that the arc of history bends toward fairness and inclusion.

Needed change must not be thwarted, even if some people find it hard to accept. Obama got it right in his remarks following the vote: “We did not fear our future. We shaped it.”

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Seventy-five years ago, on August 8, 1935, the United States Congress passed the first sweeping legislation creating a welfare safety net for the American people, the Social Security Act 1935. Its champion was President Franklin D. Roosevelt….

Support in Congress was both overwhelming and bi-partisan.

Thirty years later, in July 1965, Congress passed the second major piece of the national safety net, the Medicaid and Medicare act.

It, too, passed by an overwhelming majority with bi-partisan support. That bill was championed by another Democratic President, Lyndon B. Johnson….

Now comes the third major piece in the safety net when tomorrow (local time), President Barack Obama signs the Health Care and Education Affordability Reconciliation Act of 2010, introducing almost universal health care.

The bill passed yesterday in the House by a slender and contentious majority, 219 vote to 212.

Not a single Republican voted ‘yes’.

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This is a very good discussion of some of the real substance of the legislation.

The process was wrenching, and tainted to the 11th hour by narrow political obstructionism, but the year-long struggle over health care reform came to an end on Sunday night with a triumph for countless Americans who have been victimized or neglected by their dysfunctional health care system. Barack Obama put his presidency on the line for an accomplishment of historic proportions.

The bill, which was approved by the Senate in December and by the House on Sunday, represents a national commitment to reform the worst elements of the current system. It will provide coverage to tens of millions of uninsured Americans, prevent the worst insurance company abuses, and begin to wrestle with relentlessly rising costs ”” while slightly reducing future deficits.

Read it carefully and read it all.

If you don’t care how this affects businesses, you should. Some 15 million people in this country don’t have jobs ”” and another 12 million work part-time but want full-time positions.

If America’s major employers are hit with huge, government-mandated cost increases during an economic downturn, do you really think they’ll hire more when the economy starts growing on its own again? Of course not.

Despite this, the White House predicts its plan will “cut costs” for businesses. House Speaker Nancy Pelosi even makes the bizarre prediction that passage of health reform will lead to 400,000 new jobs “immediately,” and millions more down the road.

Such claims don’t hold water because health reform includes $569.2 billion in new taxes, at last count 160 new bureaucracies and regulations, and 16,500 new IRS agents to collect all those taxes….

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In approving the most sweeping piece of social legislation since the mid-1960s, Democrats proved that they can govern, even under challenging circumstances and in the face of significant internal divisions.

To understand how large a victory this is, consider what defeat would have meant. In light of the president’s decision to gamble all of his standing to get this bill passed, its failure would have crippled his presidency. The Democratic Congress would have become a laughing stock, incapable of winning on an issue that has been central to its identity since the days of Harry Truman.

This is why Republicans decided to put everything they had into an effort to defeat the measure. They said its passage would hurt the Democrats in November’s elections. They knew that its failure would have haunted Democrats for decades.

Without this concrete achievement, as House Speaker Nancy Pelosi kept warning her troops, Democrats would have been stuck with their votes for reform bills and nothing to show for them. The real and imagined flaws of their proposed system would have been hung around their necks, yet they would have had no way of demonstrating its advantages.

With success comes the chance to defend what is, in many of its particulars, the sort of plan a majority of Americans said they wanted. Yes, it is imperfect and it won’t come cheap. But it fills a gaping hole in the American social insurance system.

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Rep. Henry Waxman, D-Calif., was right Sunday night when he hailed looming approval of an unprecedented expansion of the federal government’s health care role as “an historic moment.” Yet the House also made history by taking that giant step without a single Republican vote. Regardless of your opinion on how to cure what’s ailing our nation’s medical system, that lack of bipartisanship sends a disturbing signal about how deeply our nation is divided — and assures that this debate is far from over.

Our opinion remains that while major health care changes are needed, Obama-Care is a counterproductive regulatory behemoth that will impose devastating new financial burdens on both the private and public sectors.

That’s particularly alarming in these hard times of record federal deficits and high unemployment. Persisting poll trends show that a solid majority of Americans share that opinion.

But even those who think the president’s reform plan is sound should be troubled by the legislative machinations required to advance it….

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House Majority Whip Jim Clyburn experienced the most significant legislative triumph of his congressional career Sunday evening as a historic health care bill extending insurance to 32 million Americans was passed.

Clyburn, a South Carolina Democrat, ended a week that he said was the most exhausting of his 17-plus years in Congress by finally corralling the minimum 216 votes needed for the House to pass the landmark legislation.

“We have debated this issue for several generations,” Clyburn said on the House floor at 9:30 p.m. “The time has come to act. This is the Civil Rights Act of the 21st Century.”

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House Democrats approved a far-reaching overhaul of the nation’s health system on Sunday, voting over unanimous Republican opposition to provide medical coverage to tens of millions of uninsured Americans after an epic political battle that could define the differences between the parties for years.

With the 219-to-212 vote, the House gave final approval to legislation passed by the Senate on Christmas Eve. Thirty-four Democrats joined Republicans in voting against the bill. The vote sent the measure to President Obama, whose yearlong push for the legislation has been the centerpiece of his agenda and a test of his political power.

After approving the bill, the House adopted a package of changes to it by a vote of 220 to 211. That package ”” agreed to in negotiations among House and Senate Democrats and the White House ”” now goes to the Senate for action as soon as this week. It would be the final step in a bitter legislative fight that has highlighted the nation’s deep partisan and ideological divisions.

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Should the House pass the Senate bill and the package of reconciliation fix-its tonight, Senators will take over the reconciliation fix-its as soon as Tuesday.

That will set in motion a week or longer parliamentary floor battle with points of order, references to the budget act, the Byrd Rule and more.

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Congress was poised tonight to approve the boldest piece of American social legislation in half a century after President Obama issued a last-minute executive order to reassure anti-abortion Democrats who had been threatening to vote against his health reforms.

After 14 months of debate, the group of eight Democrats announced their support for a $940 billion health bill with just four hours to go until an historic vote that could transform Mr Obama’s presidency ”“ but could also cost his party dearly at elections later this year.

The Bill, if passed, will bring near-universal health coverage to the US for the first time in the country’s history by requiring individuals to buy insurance and subsidising coverage for those who cannot afford it.

Facing solid Republican opposition and multiple defections from their own ranks, Democrats needed 216 votes in the House to pass the Bill, which would outlaw abuses by the health insurance industry and extend coverage to 32 million Americans who now lack it.

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On 25 March 1995, the Solemnity of the Annunciation, Pope John Paul II promulgated the encyclical letter Evangelium Vitae, on the value and inviolability of human life. Today, four days before the fifteenth anniversary of that glorious defense of the Gospel of Life, the Congress of the United States, led to this moment by the President of the United States, is poised to enshrine in American law a savage assault on human life and the freedom of conscience of those pledged to help heal the sick. Make no mistake: This is a dark hour in the history of our Republic, and the tyranny of abortion is about to be enshrined under the guise of health care reform as a public entitlement which will be paid for by public funds collected from every tax payer and from which, in due course, no doctor, nurse, hospital, or clinic will be permitted to withdraw on a conscientious objection. This is a dark hour in the history of our Republic, and we have been led to this hour by self-described Catholics.

It must be said that the general effort to change the ways in which we Americans pay for our health care is a prudential matter about which reasonable people are free to disagree in good conscience. Passionate arguments have been advanced in this debate by partisans of every viewpoint, and in most of these arguments no absolute moral truths have been at stake. But there is one absolute moral truth at stake now, and it is this: Abortion is a crime against God and man which no human law can legitimize. And as John Paul the Great taught us in Evangelium Vitae, not only is there no obligation to obey such laws; there is, instead, a grave and clear obligation to oppose such laws by conscientious objection and civil disobedience.

In these last days of this national debate, some voices have been raised by those who identity themselves as Catholic to say that the bill which will be voted on today does not provide funds for abortion, but that is simply false. Our Bishop Robert wrote to every priest of the diocese on Friday to say that “It is evident the current health care legislation before the House of Representatives violates the teachings of Jesus Christ and His Church in several areas. As pastors of souls we have an obligation to form our people to understand the end can never justify the means. The lives of the innocent unborn cannot be sacrificed so that health insurance can be extended to some who do not have it.” Then in a companion letter addressed to all the faithful of the Diocese of Charleston, Bishop Guglielmone asks all of us to oppose this legislation “because it will allow for federal funding of abortion and will not provide conscience protection for health care professionals and health care institutions.” The bishop then adds that “Unfortunately, some organizations and individuals have decided that it is better to pass something to help a few. We can never allow evil to be done for own personal gain or for the benefit of some. Abortion should not be a part of health care reform, nor financed with tax dollars.”

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President Obama, rallying last-minute support for landmark health-care legislation nearing a crucial vote in the House, announced Sunday that he will issue an executive order after passage attesting that the bill is consistent with longstanding restrictions on the use of federal funds for abortions.

The arrangement won the support of a key bloc of anti-abortion House Democrats, whose leader, Rep. Bart Stupak D-Mich.), said at a news conference, “I’m pleased to announce we have an agreement.”

Appearing with Stupak were half a dozen other holdout Democrats. With them on board, “we’re well past” the 216 votes needed in the House to approve the health-care legislation, Stupak said.

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In a final, urgent plea to prevent the passage of the current form of the Senate health care bill, the United States Conference of Catholic Bishops (USCCB) on Saturday evening sent a letter to Congressmen asking them to vote “no.”

“For decades,” the letter says, “the United States Catholic bishops have supported universal health care. The Catholic Church teaches that health care is a basic human right, essential for human life and dignity.”

“Our community of faith,” the bishops continue, “provides health care to millions, purchases health care for tens of thousands and addresses the failings of our health care system in our parishes, emergency rooms and shelters. This is why we as bishops continue to insist that health care reform which truly protects the life, dignity, consciences and health of all is a moral imperative and an urgent national priority.”

Nevertheless, they add, “we are convinced that the Senate legislation now presented to the House of Representatives on a ”˜take it or leave it’ basis sadly fails this test and ought to be opposed.”

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On Thursday, the Congressional Budget Office reported that, if enacted, the latest health care reform legislation would, over the next 10 years, cost about $950 billion, but because it would raise some revenues and lower some costs, it would also lower federal deficits by $138 billion. In other words, a bill that would set up two new entitlement spending programs ”” health insurance subsidies and long-term health care benefits ”” would actually improve the nation’s bottom line.

Could this really be true? How can the budget office give a green light to a bill that commits the federal government to spending nearly $1 trillion more over the next 10 years?

The answer, unfortunately, is that the budget office is required to take written legislation at face value and not second-guess the plausibility of what it is handed. So fantasy in, fantasy out.

In reality, if you strip out all the gimmicks and budgetary games and rework the calculus, a wholly different picture emerges: The health care reform legislation would raise, not lower, federal deficits, by $562 billion.

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As the House Rules Committee labored to set the formal terms of the debate, the dispute over the abortion provisions was shaping up as a bitter stand-off between the abortion opponents, led by Representative Bart Stupak of Michigan, and lawmakers who favor abortion rights, led by Representative Diana DeGette of Colorado. At the center was Nancy Pelosi, the first woman to serve as House speaker, who is a champion of abortion rights.

The issue has divided Roman Catholic groups in the United States, with the United States Conference of Catholic Bishops opposing the bill and other organizations, including the Catholic Health Association and a coalition of nuns from leading religious orders, favoring it.

In a similar showdown in November, Mr. Stupak succeeded in winning approval of tight limits on insurance coverage of abortions in the House health care bill. But the current package now includes language from the Senate-passed bill, negotiated by Senators Bob Casey of Pennsylvania and Ben Nelson, who have built up solid credentials in their political careers as opponents of abortion.

Mr. Stupak and many of the lawmakers insisting on the tighter restrictions are Catholic, as is Ms. Pelosi, and all have cited their faith in justifying their position on the legislation.

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Caterpillar Inc. said the health-care overhaul legislation being considered by the U.S. House of Representatives would increase the company’s health-care costs by more than $100 million in the first year alone.

In a letter Thursday to House Speaker Nancy Pelosi (D-Calif.) and House Republican Leader John Boehner of Ohio, Caterpillar urged lawmakers to vote against the plan “because of the substantial cost burdens it would place on our shareholders, employees and retirees.”

Caterpillar, the world’s largest construction machinery manufacturer by sales, said it’s particularly opposed to provisions in the bill that would expand Medicare taxes and mandate insurance coverage. The legislation would require nearly all companies to provide health insurance for their employees or face large fines.

The Peoria-based company said these provisions would increase its insurance costs by at least 20 percent, or more than $100 million, just in the first year of the health-care overhaul program.

“We can ill-afford cost increases that place us at a disadvantage versus our global competitors,” said the letter signed by Gregory Folley, vice president and chief human resources officer of Caterpillar. “We are disappointed that efforts at reform have not addressed the cost concerns we’ve raised throughout the year.”

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Here is the chart.

True, Obama’s approval ratings had dropped faster during his first year in office than any recent rookie president. They had hovered around the 50% level the last couple of months.

But in recent days Gallup found Americans suddenly souring even more until more disapprove than approve.

The only possible reason to explain this drop is the public does not like the president’s NCAA tournament picks. Or maybe the fact that the administration’s $787 billion economic stimulus plan has stimulated unemployment up to 9.7%.

Unless this dramatic poll drop perhaps has a little something to do with Obama’s determined drive to….

…push through/down/up/over/into the $940 billion healthcare legislation that seems to have dominated virtually every moment of his public thought and talk for months.

A congressional showdown appears set now for Sunday using a series of controversial parliamentary maneuvers because the leadership of the overwhelming Democratic majorities in both houses either don’t have the votes to pass the measure as usual and/or they don’t want to force colleagues to take a recorded stand on the measure with crucial midterm elections coming in November.

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I will take comments on this submitted by email only to at KSHarmon[at]mindspring[dot]com.

Roman Catholic opposition to the health care overhaul package is crumbling, with some church officials and lawmakers concluding that their long-sought goal of health care overhaul trumps the desire to adopt the severest restrictions on abortion funding.

A coalition of 59,000 nuns released a letter yesterday calling on Congress to approve the overhaul, defying the US Conference of Catholic Bishops, which opposes the measure. The Catholic Health Association, which represents 1,200 Catholic hospitals, has endorsed the package, as have Catholics United and Catholic groups promoting social justice.

That split mirrors a division among some antiabortion US representatives. In preparing to cast perhaps one of the most important votes on a domestic issue in their careers, they are wrestling with questions that strike at the core of their beliefs and that threaten to embolden voters in November.

Ardently antiabortion Representative Dale Kildee, a Michigan Democrat who once studied in a Catholic seminary, said yesterday he will vote for the package despite language that some believe is not strict enough in ensuring that no federal funds are used for abortions.

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Many House Democrats strongly disliked the Senate’s proposed excise tax on high-cost, employer-sponsored insurance policies. In the Senate-passed bill, that provision would have raised $150 billion over 10 years. Mr. Obama and White House officials reached a deal with organized labor groups to delay the implementation and limit the impact of that tax. As a result, the excise tax will raise only $32 billion over 10 years, according to the budget office.

Of course, that meant coming up with another $118 billion elsewhere to plug the hole. Not a problem: the final legislation imposes a 3.8 percent tax on “unearned income” such as dividends and interest, or on regular income above $200,000 a year for individuals and $250,000 for couples.

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Lingering fear of defections from the Democratic left — among those who believe the bill does not go far enough to expand access to healthcare — was allayed Wednesday when Rep. Dennis J. Kucinich (D-Ohio) became the first liberal opponent of the House bill approved last year to announce that he would support the more restrictive Senate legislation.

“If I can vote for this bill, there are not many others that shouldn’t be able to,” said Kucinich, a leader of the movement to provide universal healthcare by offering the Medicare program to all Americans.

Among social conservatives, the legislation won an important new endorsement from dozens of leaders of Catholic nuns, including a group that says it represents more than 90% of the 59,000 nuns in the United States. That contrasted with the staunch opposition of the U.S. Conference of Catholic Bishops, which issued a statement Monday arguing that the bill would not adequately guard against using federal funds for abortion. The nuns disagreed, and so did a retired bishop.

And a senior antiabortion Democrat, Rep. Dale E. Kildee of Michigan, issued a statement Wednesday announcing that he would support the bill.

The political pressure intensified in the Capitol, as the House’s telephone switchboard was jammed with incoming phone calls — apparently about the healthcare bill. Democratic leaders pleaded with uncommitted House members — even if they were inclined to vote “no” — to stand ready to support the bill if their vote would be decisive.

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Because of congressional rules and partisan politics, Democratic leaders are pushing the House to adopt the Senate version. The Catholic Health Association, which represents 2,000 health care sponsors, systems, hospitals, and long-term facilities, calls the Senate bill a “major first step” toward covering all Americans. CHA officials say the abortion language can be “corrected” after it passes.

George acknowledged the CHA’s difference of opinion. “The bishops, however, judge that the flaws are so fundamental that they vitiate the good that the bill intends to promote,” he said.

“Assurances that the moral objections to the legislation can be met only after the bill is passed seem a little like asking us, in Midwestern parlance, to buy a pig in a poke,” he said.

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The forced march to pass ObamaCare continues, and all that matters now is raw politics. But opponents should go down swinging, and that means exposing such policy debacles as President Obama’s 11th-hour decision to apply the 2.9% Medicare payroll tax to “unearned income.”

That’s what savings and investment income are called in Washington, and this destructive tax wasn’t in either the House or Senate bills, though it may now become law with almost no scrutiny.

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House Democratic leadership: They’re trying to see if they have the 216 votes needed to get the bill passed. No Republicans have said they will vote for the bill. According to an ongoing CNN analysis, 26 of 253 House Democrats, including nine who supported the House plan in November, have said they would oppose the Senate plan, and nine say they would vote no but might reconsider if their concerns are addressed.

Of the remaining Democrats, 34 are undecided and 31 have declined to respond or state a position after numerous inquiries from CNN

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The U.S. Conference of Catholic Bishops said Monday it opposes the Democratic health care plan heading for a vote in the U.S. House of Representatives because of its language on abortion.

The group noted that it liked the House health care bill because it would continue the strict ban on federal financing of abortion. But it said the Senate version would open the door to federal financing, and it is the Senate version heading to the House for a vote.

Senate Democrats have insisted their bill would not allow federal financing of abortion, but George and the Catholic group disagreed.

“The Catholic bishops regretfully hold that it must be opposed unless and until these serious moral problems are addressed,” said Cardinal Francis George of Chicago, the president of the conference.

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The U.S. Conference of Catholic Bishops said Monday it opposes the Democratic health care plan heading for a vote in the U.S. House of Representatives because of its language on abortion.

The group noted that it liked the House health care bill because it would continue the strict ban on federal financing of abortion. But it said the Senate version would open the door to federal financing, and it is the Senate version heading to the House for a vote.

Senate Democrats have insisted their bill would not allow federal financing of abortion, but George and the Catholic group disagreed.

“The Catholic bishops regretfully hold that it must be opposed unless and until these serious moral problems are addressed,” said Cardinal Francis George of Chicago, the president of the conference.

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