Health Care: Congress completes overhaul

WASHINGTON - Capping an epic struggle, congressional Democrats put the final touches Thursday to historic legislation enshrining health care as the right of every citizen. Republicans vowed to campaign for repeal in the fall election season, drawing a quick retort from President Barack Obama: "I welcome that fight."

The president spoke in Iowa as the Senate voted

56-43 for legislation making changes, including better benefits for seniors and low-income and middle-class families, to the bill he signed into law with a flourish at the White House on Tuesday.

The House added its approval a few hours later, 220-207, clearing the way for Obama's signature on the second of two bills that marked the culmination of what the president called "a year of debate and a century of trying" to ensure coverage for nearly all in a nation where millions lack it. Obama is expected to sign the legislation early next week.

Taken together, the two bills also aim to crack down on insurance industry abuses and to reduce federal deficits by an estimated $143 billion over a decade. Most Americans would be required to buy insurance for the first time, and face penalties if they refused.

The second of the two bills also presented Obama with another victory, stripping banks and other private lenders of their ability to originate student loans in favor of a system of direct government lending.

After a monthslong battle in Congress, the political struggle was morphing into a new phase, where public debate was tinged with violence - and politicians accused one another of seeking to exploit it for their own advantage.

Apart from their impact on nearly every American and an estimated one-sixth of the American economy, the week's events marked Obama's biggest political triumphs since he took office more than a year ago. A pending arms control agreement with Russia, announced on Wednesday, added to his resume, and White House officials said they hoped the momentum would translate into further political successes in the run-up to the midterm elections.

In Iowa, Obama trumpeted a "set of reforms" that will take effect before the elections.

He said small businesses would be eligible for tax credits to help them cover the cost of insurance for employees, including a $250 rebate from the government for seniors with high prescription drug costs.

"This year, insurance companies will no longer be able to drop people's coverage when they get sick, or place lifetime limits or restrictive annual limits on the amount of care they can receive," he said.

"This is the reform that some folks in Washington are still hollering about. And now that it's passed, they're already promising to repeal it. ... Well, I say go for it," he said.

Under a revised strategy, the House agreed to approve a Senate-passed bill despite numerous objections, on the condition that both houses would follow quickly with a fix-it measure. The one finally brought to a vote on Thursday added more than $20 billion to subsidies for lower- and middle-income individuals and families who will be required to purchase insurance and about $8 billion over a decade for states that already provide more generous than average Medicaid benefits.