Below The Beltway

Last night as much of the nation either slept or watched college football, the House of Representatives passed H.R. 3962, the latest version of health care reform:

WASHINGTON — Handing President Obama a hard-fought victory, the House narrowly approved a sweeping overhaul of the nation’s health care system on Saturday night, advancing legislation that Democrats said could stand as their defining social policy achievement.

After a daylong clash with Republicans over what has been a Democratic goal for decades, lawmakers voted 220 to 215 to approve a plan that would cost $1.1 trillion over 10 years. Democrats said the legislation would provide overdue relief to Americans struggling to buy or hold on to health insurance.

“This is our moment to revolutionize health care in this country,” said Representative George Miller, Democrat of California and one of the chief architects of the bill.

(…)

Republicans condemned the vote and said they would oppose the measure as it proceeds on its legislative route. “This government takeover has got a long way to go before it gets to the president’s desk, and I’ll continue to fight it tooth and nail at every turn,” said Representative Kevin Brady, Republican of Texas. “Health care is too important to get it wrong.”

On the House floor, Democrats exchanged high-fives and cheered wildly — and Republicans sat quietly — when the tally display showed the 218th and decisive vote, after the leadership spent countless hours in recent days wringing commitments out of House members.

“We did what we promised the American people we would do,” said Representative Steny H. Hoyer, Democrat of Maryland and the majority leader, who also warned, “Much work remains.”

The final vote was 220-215, and while it been reported that yesterday that the entire Republican caucus would vote against the final bill, in the end, there was one Republican defection to the “yes” column as Louisiana Congressman Joseph Cao, who represents an historically Democratic district that is likely to go Democratic again in 2010, crossed party lines to vote “yes.”

As it turned out one of the biggest hurdles that the bill had to pass dealt with that thirty-seven year old bugaboo, abortion:

WASHINGTON — It was late Friday night and lawmakers were stalling for time. In a committee room, they yammered away, delaying a procedural vote on the historic health care legislation. Down one floor, in her office, House Speaker Nancy Pelosi desperately tried to deal with an issue that has bedeviled Democrats for more than a generation — abortion.

After hours of heated talks, the people she was trying to convince — some of her closest allies — burst angrily out of her office.

Her attempts at winning them over had failed, and Ms. Pelosi, the first woman speaker and an ardent defender of abortion rights, had no choice but to do the unthinkable. To save the health care bill she had to give in to abortion opponents in her party and allow them to propose tight restrictions barring any insurance plan that is purchased with government subsidies from covering abortions.

The restrictions were necessary to win support for the overall bill from abortion opponents who threatened to scuttle the health care overhaul.

That change, the Stupak Amendment, passed the House 240-194 and resulted in swift condemnation from the left for the 64 Democrats who had voted in favor the Amendment, and Planned Parenthood is already saying that they will make an issue of the abortion funding restrictions when the  bill is debated in the Senate.

And so, at least for the first stage of the legislative process, the deed is done. One wonders if the Congressman who voted for this bill were aware of its highlights:

• Sec. 202 (p. 91-92) of the bill requires you to enroll in a “qualified plan.” If you get your insurance at work, your employer will have a “grace period” to switch you to a “qualified plan,” meaning a plan designed by the Secretary of Health and Human Services. If you buy your own insurance, there’s no grace period. You’ll have to enroll in a qualified plan as soon as any term in your contract changes, such as the co-pay, deductible or benefit.

• Sec. 224 (p. 118) provides that 18 months after the bill becomes law, the Secretary of Health and Human Services will decide what a “qualified plan” covers and how much you’ll be legally required to pay for it. That’s like a banker telling you to sign the loan agreement now, then filling in the interest rate and repayment terms 18 months later.

On Nov. 2, the Congressional Budget Office estimated what the plans will likely cost. An individual earning $44,000 before taxes who purchases his own insurance will have to pay a $5,300 premium and an estimated $2,000 in out-of-pocket expenses, for a total of $7,300 a year, which is 17% of his pre-tax income. A family earning $102,100 a year before taxes will have to pay a $15,000 premium plus an estimated $5,300 out-of-pocket, for a $20,300 total, or 20% of its pre-tax income. Individuals and families earning less than these amounts will be eligible for subsidies paid directly to their insurer.

• Sec. 303 (pp. 167-168) makes it clear that, although the “qualified plan” is not yet designed, it will be of the “one size fits all” variety. The bill claims to offer choice—basic, enhanced and premium levels—but the benefits are the same. Only the co-pays and deductibles differ. You will have to enroll in the same plan, whether the government is paying for it or you and your employer are footing the bill.

• Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan. If not, you will be fined thousands of dollars. Illegal immigrants are exempt from this requirement.

• Sec. 412 (p. 272) says that employers must provide a “qualified plan” for their employees and pay 72.5% of the cost, and a smaller share of family coverage, or incur an 8% payroll tax. Small businesses, with payrolls from $500,000 to $750,000, are fined less.

Given that Nancy Pelosi blatantly broke her promise to make the final bill available for review 72 hours before voting, I’m guessing that the answer is no.

There really isn’t much to say about this that Quincy didn’t say last night:

The media says this is a bill about health care. So do the Democrats. They lie. This is a bill about control. The bill’s proponents want to control you. Whether or not you actually get health care is irrelevant.

Or, as Stephen Green put it, this is not the America I knew.

The battle’s not over yet, though, as Leslie Carbone notes, it’s time to start calling your Senators.