Obama signs landmark health bill into law

SAUL LOEB / AFP - Getty Images
President Barack Obama, surrounded by supporters and camera-wielding lawmakers, signs the health care insurance reform legislation during a ceremony in the East Room of the White House on Tuesday.

updated 1:57 p.m. ET March 23, 2010
WASHINGTON - President Barack Obama on Tuesday signed into law a landmark health care reform bill, presiding over the biggest shift in U.S. domestic policy since the 1960s and capping a divisive, yearlong debate that could define the November congressional elections.

The law will bring near-universal coverage to a wealthy country in which tens of millions of people are uninsured. The plan's provisions will be phased in over four years, and it is expected to expand coverage to about 94 percent of eligible non-elderly Americans would have coverage, compared with 83 percent today.

"We have now just enshrined the core principle that everybody should have some basic security when it comes to their health," Obama said at a signing ceremony at the White House, where he was joined by House and Senate Democrats who backed the bill as well as ordinary Americans whose health care struggles have touched the president.

"We are not a nation that scales back its aspirations. We are not a nation that falls prey to doubt or mistrust," Obama said. "That's not who we are. That's not how we got here."

The president praised those House members who had "taken their lumps" during the overhaul debate. Shouted one lawmaker in the audience to laughter, "Yes we did!"





Obama paid tribute to what he called the "historic leadership and uncommon courage" of the members of Congress who pushed ahead with the measure amid the often heated debate. He also hailed the new law, saying it helps lift a "decades-long drag" on the economy.



With Victoria Kennedy, widow of the late Sen. Edward Kennedy in the audience, Obama took note of the long battle to bring the health overhaul measure to his desk. "He was confident we would do the right thing," the president said of the longtime Democratic lawmaker.

The plan is expected to extend coverage to 32 million uninsured Americans, reduce federal budget deficits and ban such insurance company practices as denying coverage to people with existing medical problems.

Obama has pushed health care as his top priority since taking office in January 2009. Failure would have weakened him and endangered other issues on the president's ambitious domestic agenda, including immigration reform and climate change legislation.

Republicans were united in opposition to Obama's redesign of the health care system, criticizing it as a costly government takeover affecting one-sixth of the U.S. economy. They have vowed to use the issue to try to regain control of
Congress in this year's elections.

"By signing this bill, President Obama is abandoning our founding principle that government governs best when it governs closest to the people," said House Republican leader John Boehner. "Never before has such a monumental change to our government been carried out without the support of both parties.

Shortly after Obama signed the bill, mostly Republican attorneys general from 13 states said they are suing the federal government to stop the health care overhaul, arguing that the provision that requires Americans to carry health insurance is unconstitutional. Experts say the effort will likely fail because the U.S. Constitution states that federal law supersedes state laws, but the legal challenge may keep the issue fresh in the mind of voters come November.

Democratic lawmakers say they have delivered on Obama's campaign pledge for change, revamping a system in which the spiraling costs have put health care and insurance out of the reach of many Americans.

Now the president must sell the law's merits to a wary American public.

The next act begins Thursday, when Obama visits Iowa City, Iowa, where he announced his health care plan as a presidential candidate in May 2007. There Obama plans to talk about how the new law will help lower health care costs for small businesses and families, selling the overhaul to Americans who are deeply divided over the plan.

The House passed the 10-year, $938 billion bill Sunday night after a rancorous debate. Not one Republican voted for the bill. Some Democrats also voted against it.

The measure represents the biggest expansion of the U.S. federal government's social safety net since President Lyndon B. Johnson enacted the Medicare and Medicaid government-funded health care coverage programs for the elderly and poor.

A companion measure sought by House Democrats to make a series of changes to the main bill was approved 220-211. It goes to the Senate, where debate could begin as early as Tuesday. Majority Leader Harry Reid says he has the votes to pass it — though only under special budget rules requiring just 50 votes rather than the 60 usually needed to bypass the opposition's delaying tactics.

Republicans plan to offer scores of amendments to slow or change the companion measure, which Democrats hope to approve as written and send directly to Obama for his signature.

Both the House and Senate had passed separate versions and were close to resolving their differences when the Democrats lost a crucial Senate seat in a January special election that put the effort in peril. The Democrats regrouped and came up with an compromise that required the House to approve the Senate-passed measure despite opposition to many of its provisions, then have both chambers pass a measure incorporating numerous changes.