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Obama signs sweeping healthcare overhaul into law

With a sense of generational history in the making, President Obama on Tuesday signed into law a sweeping healthcare overhaul that offers insurance to an estimated 32 million uninsured Americans and provides new guarantees of more secure coverage for all.

Obama, who sought passage of this legislation for more than a year, portrayed it as an achievement on a historic par with the passage of Social Security after the Great Depression and Medicare in the 1960s.

“Today, after almost a century of trying, today, after over a year of debate, today, after all the votes have been tallied, healthcare insurance reform becomes law in the United States of America,” Obama said at a boisterous bill-signing ceremony attended by Democratic congressional leaders in the East Room of the White House.

“We mark a new season in America,” said Obama, suggesting that “all the overheated rhetoric of reform will suddenly confront the reality of reform. . . .

“The bill I’m signing will set in motion reforms that generations of Americans have fought for,” the president said. “It will take four years to implement fully many of these reforms, because we need to implement them responsibility. But a host of desperately needed reforms will take place right away.”

The immediate benefits include tax credits this year for small businesses offering health insurance to employees, as well as a guarantee that children with preexisting medical conditions can gain insurance coverage and a ban against insurers dropping coverage for the ill.

“It’s easy to succumb to the sense of cynicism of what’s possible in this country,” Obama said. “But today we are reaffirming that essential truth. . . . We are not a nation that scales back its expectations. . . . We are not a nation that does what’s easy. . . . We are a nation that faces its challenges and accepts its responsibilities. . . . Here in this country, we shape our own destiny. That is what we do. That is who we are.”

Among Republicans who opposed the new law, however -- not one Republican member of the House or Senate supported the bill that the president signed today -- the new law offers a political opportunity: challenging the Democratic leadership of Congress in the fall midterm elections over a measure that polls have portrayed as unpopular.

The Republican National Committee is taking aim at House Speaker Nancy Pelosi (D-Calif.), who steered the Senate-passed healthcare bill through a 219-212 vote of the House on Sunday night. “Fire Nancy Pelosi,” the RNC demanded with a new website-based fundraising drive picturing Pelosi in flames and raising money for 40 targeted House seat campaigns - nearly $1 million reported so far.

" Democrats are celebrating,” the narrator of a RNC website-based ad launched today says of the healthcare bill. “It’s time to fire Nancy Pelosi. Now that’s a cause worth celebrating.”

Obama called Pelosi “one of the best speakers the House of Representatives has ever had,” and the crowd cheered, “Nancy.”

The Democrats “have taken their lumps” during the debate on Capitol Hill, the president said Tuesday. “Yes, we did,”’ one called out from the bill-signing audience at the White House, with an allusion to Obama’s presidential campaign slogan, “Yes, we can.”

Vice President Joe Biden introduced Obama to a cheering audience filling the East Room that chanted the president’s campaign-trail rallying cry: “Fired up, ready to go.”

“This is a historic day,” Biden said. “History is made when you all assembled here today, members of Congress, take charge to change the lives of tens of millions of Americans. . . . That’s exactly what you’ve done. . . . History is made when a leader’s passion is matched with principle,” said Biden, telling Obama: “You are that leader.”

Their children and grandchildren will grow up, Biden said, “knowing that a man named Barack Obama put the final girder in a social framework in this country . . . for what the people need, and that is access to good health.”

The president signed the healthcare legislation -- the Patient Protection and Affordable Care Act -- in the East Room of the White House with members of Congress who supported the bill. He was joined at the signing table by Vicki Kennedy, widow of the late Sen. Edward M. Kennedy, who had been a champion of healthcare reform.

“It’s fitting that Teddy’s widow Vicki is here, and his niece Caroline, his [son] Patrick, whose vote helped make this reform a reality,” Obama said. “I remember seeing Ted walk through that door at a summit in this room a year ago. . . . It was hard for him to make it, but he was confident we would do the right thing.”

Senate Majority Leader Harry Reid (D-Nev.), who will attempt to shepherd another “reconciliation” bill through the Senate, which aligns the House and Senate on some differences in the legislation, joined Obama at the signing. So did the assistant majority leader, Sen. Dick Durbin (D-Ill.) and Pelosi, who secured the winning vote Sunday night as well as a 220-211 vote on the reconciliation bill.

The president planned to follow the bill-signing ceremony at the White House with a speech at the Interior Department before an audience of about 600 people -- doctors, nurses, people with health problems, members of Congress and administration officials.

Obama also will take his campaign for public support for the measure on the road again. On Thursday, he plans to tout the benefits of the bill in Iowa City, Iowa, where he first proposed a healthcare overhaul during his campaign for the presidency, in 2007. Obama’s victory in Iowa’s Democratic precinct caucuses in January 2008 also boosted his campaign.

The new law eventually will require most Americans to purchase health insurance and impose penalties on those who don’t. It also provides tax breaks for small business that provide coverage for employees.

The combined healthcare measures, at an estimated cost of $940 billion over 10 years, are to be financed in part by a repeal of Bush-era tax cuts on households earning more than $250,000 a year, in addition to an extension of Medicare payroll tax to investment income for the wealthiest taxpayers.

More immediately -- later this year -- the measure will prevent insurers from denying coverage to children with preexisting medical conditions. That protection is extended to adults in 2014. The law also enables children to stay on their parents’ policies until they are 26. And it prohibits lifetime caps on benefits that can be paid and bars insurers from dropping coverage for policyholders who become ill.

The law this year also will provide coverage for senior citizens who now face a gap in coverage under Medicare.

The measure will allow more lower-income Americans to take part in the federally subsidized Medicaid program, and also offer subsidies to consumers who purchase insurance through new commercial exchanges.

mdsilva@tribune.com


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