msnbc.com staff and news service reportsupdated 37 minutes agoWASHINGTON - Summoned to success by President Barack Obama, the Democratic-controlled Congress approved historic legislation Sunday night extending health care to tens of millions of uninsured Americans and cracking down on insurance company abuses, a climactic chapter in the century-long quest for near universal coverage.
Widely viewed as dead two months ago, the Senate-passed bill cleared the House on a 219-212 vote. Republicans were unanimous in opposition, joined by 34 dissident Democrats.
In remarks after the completion of the House's votes, Obama praised fellow Democrats for passing the legislation after well over a year of negotiations and setbacks.
"We proved that we are still a people capable of doing big things," the president said in televised remarks. "We proved that this government — a government of the people and by the people — still works for the people."
Obama watched the vote in the White House's Roosevelt Room with Vice President Joe Biden and about 40 staff aides. When the long sought 216th vote came in — the magic number needed for passage — the room burst into applause and hugs. An exultant president exchanged a high-five with his chief of staff, Rahm Emanuel.
A second, smaller measure — making changes in the first — also passed later in the evening. It will go to the Senate, where Democratic leaders said they had the votes to pass it.
The nonpartisan Congressional Budget Office said the legislation awaiting the president's approval would extend coverage to 32 million Americans who lack it, ban insurers from denying coverage on the basis of pre-existing medical conditions and cut deficits by an estimated $138 billion over a decade. If realized, the expansion of coverage would include 95 percent of all eligible individuals under age 65.
For the first time, most Americans would be required to purchase insurance, and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.
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Far beyond the political ramifications — a concern the president repeatedly insisted he paid no mind — were the sweeping changes the bill held in store for millions of individuals, the insurance companies that would come under tougher control and the health care providers, many of whom would face higher taxes.
Crowds of protesters outside the Capitol shouted "just vote no" in a futile attempt to stop the inevitable taking place inside a House packed with lawmakers and ringed with spectators in the galleries above.
Across hours of debate, House Democrats predicted the larger of the two bills, costing $940 billion over a decade, would rank with other great social legislation of recent decades.
"We will be joining those who established Social Security, Medicare and now, tonight, health care for all Americans, said Speaker Nancy Pelosi, partner to Obama and Senate Majority Leader Harry Reid, D-Nev., in the grueling campaign to pass the legislation.
"This is the civil rights act of the 21st century," added Rep. Jim Clyburn of South Carolina, the top-ranking black member of the House.
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Republicans readily agreed the bill would affect everyone in America, but warned repeatedly of the burden imposed by more than $900 billion in tax increases and Medicare cuts combined.
"We have failed to listen to America," said Rep. John Boehner of Ohio, leader of a party that has vowed to carry the fight into the fall's midterm elections for control of Congress.
Video
Lawmakers' heated exchange on health care
March 21: Republican David Dreier and Democrat Louise Slaughter pointed exchange doing a discussion on health care.msnbc tv
Abortion deal cleared way for passage
The final obstacle to the bill's passage was cleared at mid-afternoon when Obama and Democratic leaders reached a compromise with anti-abortion lawmakers whose rebellion had left the outcome in doubt. The White House announced he would issue an executive order pledging that no federal funds would be used for elective abortion, satisfying Rep. Bart Stupak of Michigan and a handful of like-minded lawmakers.A spokesman for the U.S. Conference of Catholic Bishops expressed skepticism that the presidential order would satisfy the church's objections.
Republican abortion foes also said Obama's proposed order was insufficient, and when Stupak sought to counter them, a shout of "baby killer" could be heard coming from the Republican side of the chamber.
The measure would also usher in a significant expansion of Medicaid, the federal-state health care program for the poor. Coverage would be required for incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014.
The insurance industry, which spent millions on advertising trying to block the bill, would come under new federal regulation. They would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions and from canceling policies when a policyholder becomes ill.
The fiber-to-the-home project calls for miles of fiber optic lines to be installed in Plummer, Worley, Tensed and DeSmet. “This is awesome news for everyone living on the reservation,” said Coeur d’Alene Tribe Chairman Chief James Allan. “The broadband project will have a profound impact on all residents of the Coeur d’Alene reservation.” The project will provide services to anchor institutions and critical community facilities and roughly 3,800 un-served and underserved households on the reservation – both tribal and non-tribal member alike, said Valerie Fast Horse, the tribe’s information and technology director. “We have a rare opportunity to build one of the first fiber-to-the-home networks of this scale in the region. True economic development must involve revitalizing the human spirit of our communities. It is our hope that by lighting up the reservation with a fiber optic network we will spark our most creative minds and encourage the knowledge-based economy we’ve been striving to develop.” The tribe expects to start work on installing fiber optic lines in the coming months. The telecommunication funding is part of the American Recovery and Reinvestment Act. The tribe will receive half of the money through a grant and the other half will be loaned to the tribe. Agriculture Secretary Tom Vilsack recently announced the selection of 22 broadband infrastructure projects to give rural residents in 18 states or territories. The Coeur d’Alene Tribe’s selection is one of the first Native American tribes to receive broadband funding and was the only application in Idaho to be funded. “These broadband projects will provide rural America access to the tools it needs to attract new businesses, educational opportunities and jobs,” Vilsack said. “The Obama administration understands that bringing broadband to rural America is an economic gateway for people, business owners and key institutions – such as libraries, hospitals, public safety buildings and community centers. Broadband is important for rural communities to remain strong in the 21st century.” The tribe received congressional and state support for the project, including support from U.S. Rep. Walt Minnick, U.S. Sen. Mike Crapo, R-Idaho, and Gov. Butch Otter. “We truly appreciate them for seeing the need in our rural community,” Allan said. In all, the federal government will invest more than $254.6 million on 22 projects. An additional $13.1 million in private investment will be provided in matching funds. Congress provided USDA $2.5 billion in Recovery Act funding to assist applicants to bring broadband services to those without service and underserved communities. To date, $895.6 million has been provided to support 55 broadband projects in 29 states or territories. The tribe currently offers wireless broadband services to more than 600 customers through Red Spectrum. The service is available to all residents living in the service area.
Under the Native American Graves Protection and Repatriation Act, culturally unidentifiable Native American remains have been repatriated for burial or other disposition only after consultation with a Review Committee that advises the Secretary of the Interior on disposition approval. The new regulation will eliminate the review process, and the remains would be turned over to the requesting tribe or native organization after the request was announced in the Federal Register.
The act, which was passed in 1990, requires all museums and federal agencies to identify Native American cultural items in their collections, such as human remains, funerary objects, and sacred objects, to lineal descendents and culturally affiliated Indian tribes. As of Sept. 2009, museums and federal agencies have listed the remains of nearly 40,000 individuals and almost one million funerary objects on their inventories.
The most famous case of unaffiliated remains was the discovery in 1996 of the skeleton of a prehistoric man on a bank of the Columbia River in Kennewick Washington on land owned by the U.S. Army Corps of Engineers. Five Indian tribes claimed ownership of the remains, which became known as Kennewick Man, and sought to dispose of the remains according to traditional burial practices without subjecting them to scientific examination.
In 2004 the U.S. Court of Appeals for the Ninth Circuit rejected the claims of the tribes because they could not establish cultural affiliation or kinship to the remains. Later testing revealed that Kennewick Man was approximately 9,000 years old and that his DNA could not be definitively tied to any modern Native American tribes.