The House of Representatives on Thursday gave final approval to the budget reconciliation bill containing a package of changes to the Democrats' sweeping health care overhaul. The bill, which Democratic leaders hailed as a landmark achievement, now goes to President Obama for his signature.
"The American people have waited for this moment for a century," the Senate majority leader, Harry Reid of Nevada, said at a news conference. "This, of course, was a health bill. But it is also a jobs bill, an economic recovery bill, was a deficit-reduction bill, was an antidiscrimination bill. It was truly a bill of rights. And now it is the law of the land."
In a fitting finale to the yearlong health care saga, the budget reconciliation measure that included the final changes was approved first by the Senate and then by the House on a tumultuous day at the Capitol, as lawmakers raced to complete their work ahead of a two-week recess.
The final House vote was
220 to 207, and the Senate vote was
56 to 43, with the Republicans unanimously opposed in both chambers.
The reconciliation bill makes numerous revisions to many of the central provisions in the measure adopted by the Senate on Dec. 24, including changes in the levels of subsidies that will help moderate-income Americans afford private insurance, as well as changes to the increase in the Medicare payroll tax that will take effect in 2013 and help pay for the legislation.
The bill also delays the start of a new tax on high-cost employer-sponsored insurance policies to 2018 and raises the thresholds at which policies are hit by the tax, reflecting a deal struck by the White House and organized labor leaders. It also includes changes to close the gap in Medicare prescription drug coverage known as the doughnut hole, and to clarify a provision requiring insurers to allow adult children to remain on their parents' insurance policies until their 26th birthday.
Many of the changes were intended to address the concerns of House Democrats, as well as to bridge differences between the original House and Senate bills and to incorporate additional provisions sought by Mr. Obama.
The bill also included a broad restructuring of federal student loan programs, a centerpiece of Mr. Obama's education agenda.
