Cuenta de la reforma de la salud de la señal de los pasos de la casa

por Brendon Nafziger, DOTmed News Associate Editor | March 22, 2010
The House floor
A divisive $875 billion health reform legislation that promises to expand health insurance to cover 32 million uninsured Americans passed the House by 219 to 212 late Sunday night.

In a rare Sunday vote that split along party lines, the House adopted the Senate health bill as well as a reconciliation package meant to bridge differences between the House and Senate legislation. All 178 Republicans, and 34 Democrats who jumped the aisle, opposed the bill.

"Tonight, after nearly 100 years of talk and frustration, after decades of trying, and a year of sustained effort and debate, the United States Congress finally declared that America's workers and America's families and America's small businesses deserve the security of knowing that here, in this country, neither illness nor accident should endanger the dreams they've worked a lifetime to achieve," President Obama said in a speech Sunday night.

On Tuesday, Obama is expected to sign the bill on the White House lawn, after which the reconciliation package, which passed 220 to 211 in a separate vote, will go to the Senate for debate.

Hurdles remain

However, hurdles remain for both pieces of the reform legislation. The reconciliation package, which can't be approved by the Senate until President Obama signs the bill, will face a tough fight, as Republicans Senators are keying-up to delay or thwart its passage.

Under Senate rules, there must be at least 20 hours of debate on the reconciliation package, but Republicans could offer unlimited amendments in an effort to derail the discussion. While under parliamentary rules Democrats could override the Republicans, it would require votes from three-fourths of the body, meaning they would need to lure some Republicans in support of the legislation.

And larger battles lie ahead for the reform bill itself. Attorneys general from Virginia, South Carolina and Florida have pledged to file lawsuits, alleging the bill is unconstitutional because it requires citizens to purchase health insurance.

Details of the bill

The legislation and the reconciliation package passed on Sunday aim to expand health care coverage over the next decade to some 32 million Americans who are currently uninsured. The bills do this largely by expanding Medicaid rolls, covering anyone who makes up to 133 percent of the poverty line, and also requiring almost everyone to carry insurance under threat of an annual fine. The size of the fine is set to rise every year, starting in 2014 at $95, or one percent of income, whichever is greater, and in 2016 capping at $695, or 2.5 percent of income.