Live from Capitol Hill: Healthcare reform set to pass

224 "yes" votes as House adopts rule for healthcare debate. Abortion executive order means bill will pass easily

Published March 21, 2010 7:22PM (EDT)


The moment Democrats have been waiting for is almost here: The House plans to vote on the healthcare reform bill Sunday evening. Lawmakers began debate on a rule governing the rest of the day's procedures in mid-afternoon. Later, they'll vote on the Senate's healthcare bill, and then a budget reconciliation measure designed to fix that version. Look here for updates throughout the day, and read earlier coverage here.

9:01 p.m. Eastern: For months, undecided lawmakers have been the target of coordinated phone call, mail and e-mail campaigns, pressing them to vote one way or the other on the healthcare bill. But Rep. Brian Baird, D-Wash., says the phone calls nearly all stopped Sunday when he announced he'd vote "yes."

"The calls dropped off right when we worked out where I was going to be," Baird told Salon outside the House chamber. Most of the calls he was getting were from out of state, anyway. But it wasn't just calls, either. "The banging on the door stopped, too," Baird said. "It was like 'Night of the Living Dead' in there."

8:21 p.m. Eastern: The House just had one of its moments where members pretend they're far more civil to each other than they actually are. Rep. Bill Pascrell, D-N.J., called Republicans "shameless" and accused them of "fear-mongering" and being "utterly dishonest" -- prompting an immediate outcry from the GOP, demanding that he "take down" the words.

That's House-speak for "take it back." Members aren't allowed to insult each other personally on the floor. The acting speaker was considering a Republican request for Pascrell's remarks to be reviewed, when Pascrell decided discretion was the better part of valor and apologized.

Of course, on cable news, both sides are saying far worse about each other. And Republican lawmakers routinely take to the House podium to denounce a "government takeover" and predict all manner of sinister outcomes if the bill passes. But the rules are the rules, and some things are still considered out of bounds.

8:16 p.m. Eastern: The sun has set on the tea party protesters outside the Capitol, but they're still at it. "Nah nah nah nah, nah nah nah nah, hey hey hey, goodbye," they're singing. If they stay until the final vote, they will have been outside chanting and shouting for a solid 12 hours.

There's a much smaller group out there than in the middle of the afternoon, though.

6:39 p.m. Eastern: The National Organization for Women is "incensed" that the White House agreed to issue the executive order on abortion to win a few more votes for the healthcare bill. "The message we have received today is that it is acceptable to negotiate health care on the backs of women, and we couldn't disagree more," NOW president Terry O'Neill said in a statement

The outrage over the way Rep. Bart Stupak, D-Mich., and some allies held the healthcare bill hostage to demand more restrictions on abortion rights isn't likely to go away quickly. And in the end, the fact that the bill will pass by a (relatively) comfortable margin will only make questions about whether agreeing to issue the executive order more pointed.

Read O'Neill's full statement here:

The National Organization for Women is incensed that President Barack Obama agreed today to issue an executive order designed to appease a handful of anti-choice Democrats who have held up health care reform in an effort to restrict women's access to abortion. Through this order, the president has announced he will lend the weight of his office and the entire executive branch to the anti-abortion measures included in the Senate bill, which the House is now prepared to pass.

President Obama campaigned as a pro-choice president, but his actions today suggest that his commitment to reproductive health care is shaky at best. Contrary to language in the draft of the executive order and repeated assertions in the news, the Hyde Amendment is not settled law -- it is an illegitimate tack-on to an annual must-pass appropriations bill. NOW has a longstanding objection to Hyde and, in fact, was looking forward to working with this president and Congress to bring an end to these restrictions. We see now that we have our work cut out for us far beyond what we ever anticipated. The message we have received today is that it is acceptable to negotiate health care on the backs of women, and we couldn't disagree more.

6:31 p.m. Eastern: If it's not too late to enter your office pool on the final tally for healthcare reform in the House, put your money on 224 "yes" votes and 206 "no" votes. That's the margin by which the House just adopted the rule for debate of the bill, with 28 Democrats joining all 178 Republicans to vote no.

Up next, two hours of debate on the Senate's version of the healthcare bill. Tune in on C-SPAN if you really like to hear constant repetitions of phrases like "government takeover" and "Cornhusker kickback." A vote on the Senate bill will follow that, and then, eventually, a vote on the reconciliation bill.

6:04 p.m. Eastern: The House has just started voting on the rule for debate of the healthcare reform bill, the first of three votes required to move the whole package along Sunday. Democrats won a procedural vote about the rule with 228 votes just now, which is probably a few more than they'll have on final passage, but it's yet another indication that the bill will all but certainly pass later Sunday. 

5:53 p.m. Eastern: A statement from NARAL Pro-Choice America president Nancy Keenan just arrived by e-mail. She's angry the executive order on abortion wound up being needed to smooth the way for passage, but still supports the legislation. Her complete statement:

"On a day when Americans are expected to see passage of legislation that will make healthcare more affordable for more than 30 million citizens, it is deeply disappointing that Bart Stupak and other anti-choice politicians would demand the restatement of the Hyde amendment, a discriminatory law that blocks low-income women from receiving full reproductive healthcare. Today's action is a stark reminder of why we must repeal this unfair and insulting policy. Achieving this goal means increasing the number of lawmakers in Congress who share our pro-choice values. Otherwise, we will continue to see women's reproductive rights used as a bargaining chip."

5:48 p.m. Eastern: The House has finally started voting! Unfortunately, they're voting on a motion to suspend the rules and agree to passing this very important resolution:

H.Res. 900 - Supporting the goals and ideals of a Cold War Veterans Recognition Day to honor the sacrifices and contributions made by members of the Armed Forces during the Cold War and encouraging the people of the United States to participate in local and national activities honoring the sacrifices and contributions of those individuals

A vote on the rule for the healthcare debate, the first of three votes that will occur Sunday night (or early Monday morning, if things drag on past midnight), is still set for... sometime in the future.

5:33 p.m. Eastern: Anti-abortion groups hate the executive order the White House plans to issue, and they're furious that Rep. Bart Stupak, D-Mich., agreed to vote for the bill. "This deal to pass the largest expansion of abortion since Roe v. Wade is a tragedy for America," Charmaine Yoest, president of Americans United for Life Action, said in a statement Sunday afternoon. "We believe that Mr. Stupak’s choice to succumb to the intense pressure of the last week has resulted in his endorsement of a charade that does not even begin to address the anti-life provisions in this legislation. The American people do not support taxpayer funding of abortion and Speaker Pelosi and the President have undermined representative democracy by working to pass this legislation with this unprecedented contortion of the legislative process."

Pro-choice groups have been a little slower to react. A spokesman for NARAL Pro-Choice America hasn't replied to a question from Salon about the order. There's nothing in the executive order that actually changes current law. Pro-choice organizations spent quite a bit of time blasting Stupak for threatening to kill the healthcare bill in the last few days, but lawmakers who support abortion rights had said Saturday they would be okay with an executive order that was narrowly crafted.

5:07 p.m. Eastern: The White House just announced that President Obama will make a statement to the press in the East Room as soon as the House votes.

4:43 p.m. Eastern: Now that House leaders know for sure they'll have the votes to pass the healthcare bill, Democrats are looking ahead to how to use the bill to help their members survive in November.

Republicans will vote against everything the House does Sunday -- the rule governing debate, the Senate healthcare proposal and the reconciliation package that fixes the Senate proposal. Which is what has some Democratic strategists excited. When the GOP votes against the reconciliation package, Republicans will, technically, be voting to keep the "Cornhusker kickback" and other unpopular deals in the bill.

It's sort of a bank-shot political argument, since the GOP will also have voted against passing the Senate bill with those special deals to begin with. But still, expect Democrats to try to confuse voters over who voted for what, exactly, in order to keep the GOP from looking as pure on the issue as Republicans would like.

4:09 p.m. Eastern: The bloc of anti-abortion Democrats holding out against healthcare reform have just announced that they've reached a deal with the White House and with House leadership, and they'll vote for the bill. "We've all stood on principle," Rep. Bart Stupak, D-Mich., the leader of the bloc said. "The real winner here is the American people."

There won't be any additional language on abortion added to the bill, but President Obama will issue an executive order to ensure that tax money can't be used to pay for abortions once the legislation becomes law. Pro-choice groups have complained about the restrictions, which will force women who buy insurance through the exchanges the bill sets up to buy separate policies to cover abortions, but have still supported the bill nonetheless.

Here's a statement from White House communications director Dan Pfeiffer, which the administration blasted out by e-mail just as Stupak arrived at his press conference:

Today, the President announced that he will be issuing an executive order after the passage of the health insurance reform law that will reaffirm its consistency with longstanding restrictions on the use of federal funds for abortion.

While the legislation as written maintains current law, the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation’s restrictions against the public funding of abortions cannot be circumvented.

The President has said from the start that this health insurance reform should not be the forum to upset longstanding precedent. The health care legislation and this executive order are consistent with this principle.

The President is grateful for the tireless efforts of leaders on both sides of this issue to craft a consensus approach that allows the bill to move forward.

A group of pro-choice lawmakers had told House leadership they might not vote for the bill if Stupak got additional language included, and besides, the abortion language couldn't make it in through budget reconciliation process that Congress will use to pass some changes to the bill.

The announcement virtually guarantees that Democrats will have the votes they need to pass the bill.

Here is the language of the executive order that the White House will be issuing:


- - - - - - -


By the authority vested in me as President by the Constitution and the laws of the United States of America, including the “Patient Protection and Affordable Care Act” (approved March __, 2010), I hereby order as follows:

Section 1. Policy.

Following the recent passage of the Patient Protection and Affordable Care Act (“the Act”), it is necessary to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), consistent with a longstanding Federal statutory restriction that is commonly known as the Hyde Amendment. The purpose of this Executive Order is to establish a comprehensive, government-wide set of policies and procedures to achieve this goal and to make certain that all relevant actors—Federal officials, state officials (including insurance regulators) and health care providers—are aware of their responsibilities, new and old.

The Act maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to the newly-created health insurance exchanges. Under the Act, longstanding Federal laws to protect conscience (such as the Church Amendment, 42 U.S.C. §300a-7, and the Weldon Amendment, Pub. L. No. 111-8, §508(d)(1) (2009)) remain intact and new protections prohibit discrimination against health care facilities and health care providers because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions.

Numerous executive agencies have a role in ensuring that these restrictions are enforced, including the Department of Health and Human Services (HHS), the Office of Management and Budget (OMB), and the Office of Personnel Management (OPM).

Section 2. Strict Compliance with Prohibitions on Abortion Funding in Health Insurance Exchange.

The Act specifically prohibits the use of tax credits and cost-sharing reduction payments to pay for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered) in the health insurance exchanges that will be operational in 2014. The Act also imposes strict payment and accounting requirements to ensure that Federal funds are not used for abortion services in exchange plans (except in cases of rape or incest, or when the life of the woman would be endangered) and requires state health insurance commissioners to ensure that exchange plan funds are segregated by insurance companies in accordance with generally accepted accounting principles, OMB funds management circulars, and accounting guidance provided by the Government Accountability Office.

I hereby direct the Director of OMB and the Secretary of HHS to develop, within 180 days of the date of this Executive Order, a model set of segregation guidelines for state health insurance commissioners to use when determining whether exchange plans are complying with the Act’s segregation requirements, established in Section 1303 of the Act, for enrollees receiving Federal financial assistance. The guidelines shall also offer technical information that states should follow to conduct independent regular audits of insurance companies that participate in the health insurance exchanges. In developing these model guidelines, the Director of OMB and the Secretary of HHS shall consult with executive agencies and offices that have relevant expertise in accounting principles, including, but not limited to, the Department of the Treasury, and with the Government Accountability Office. Upon completion of those model guidelines, the Secretary of HHS should promptly initiate a rulemaking to issue regulations, which will have the force of law, to interpret the Act’s segregation requirements, and shall provide guidance to state health insurance commissioners on how to comply with the model guidelines.

Section 3. Community Health Center Program.

The Act establishes a new Community Health Center (CHC) Fund within HHS, which provides additional Federal funds for the community health center program. Existing law prohibits these centers from using federal funds to provide abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), as a result of both the Hyde Amendment and longstanding regulations containing the Hyde language. Under the Act, the Hyde language shall apply to the authorization and appropriations of funds for Community Health Centers under section 10503 and all other relevant provisions. I hereby direct the Secretary of HHS to ensure that program administrators and recipients of Federal funds are aware of and comply with the limitations on abortion services imposed on CHCs by existing law. Such actions should include, but are not limited to, updating Grant Policy Statements that accompany CHC grants and issuing new interpretive rules.

Section 4. General Provisions.

(a) Nothing in this Executive Order shall be construed to impair or otherwise affect: (i) authority granted by law or presidential directive to an agency, or the head thereof; or (ii) functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b) This Executive Order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c) This Executive Order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity against the United States, its departments, agencies, entities, officers, employees or agents, or any other person.


 3:55 p.m. Eastern: For supporting healthcare reform, Rep. Barney Frank, D-Mass., was yelled at Saturday and Sunday by protesters calling him "faggot" on his way into the Capitol. Once he was inside, he decided to take a second look at the tea party scene. Frank just wandered out on the second floor balcony overlooking the protest. When he came back in, he said it was unfortunate that Republicans were encouraging some of the angry rhetoric.

"I regret that a reasonable conversation about important policy is to some extent getting hijacked by thuggery," Frank said. "The worst thing that happened today, it seemed to me, was when a man in the gallery stands up and disrupts, and Republican members of the House stand up and cheer him on. And the people who work for us are trying to do their job, and expel people, and they're sort of grappling in this narrow space, and you have Republican members of Congress encouraging people to physically resist arrest. It was appalling."

The incident Frank was talking about happened earlier Sunday; a man watching the House debate stood up and shouted something about killing the healthcare bill before he was escorted out. Some GOP lawmakers applauded him. Republicans have been playing to the tea party crowd all day, and they'll probably keep it up all night as the House stays in session.

By Mike Madden

Mike Madden is Salon's Washington correspondent. A complete listing of his articles is here. Follow him on Twitter here.

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