Page last updated at 22:55 GMT, Friday, 19 March 2010

Obama hails 'historic' healthcare reform vote


Obama hails 'historic' health bid

US President Barack Obama has described a congressional vote on healthcare reform due on Sunday as a "historic" moment in a century-long struggle.

Speaking at a rally in Virginia, he dismissed criticism of the bill from Republicans and some Democrats.

Appealing to lawmakers and citizens to back the legislation, he said: "The time for reform is right now."

Democrats are still working to secure enough House of Representatives votes to pass a Senate version of the bill.

The BBC's Mark Mardell in Virginia says that Mr Obama's speech was fiery but the Democratic Party seems deflated, with no real desire to motivate the people.

'Hard debate'

The reforms would deliver on Mr Obama's top domestic priority by providing insurance to some 30 million Americans who currently lack it.

Not only can we afford to do this. We can't afford not to do this
US President Barack Obama

Calling the battle to create the bill, "messy", "frustrating" and "ugly", Mr Obama said the final proposal was the culmination of a year of "hard debate".

"Every argument has been made," he told students at George Mason University.

"We have incorporated the best ideas from Democrats and Republicans into a final proposal."

The House of Representatives and the Senate adopted different versions of the bill in November and December.

The usual procedure would be for two versions of legislation to be combined into a single bill for President Obama to sign into law. But after Senate Democrats lost the 60-seat majority required to defeat a filibuster by Republicans, Democratic leaders decided to use a controversial procedure to ensure the bill's passage.

Under the plan, the House will vote on a package of reconciliation "fixes" amending the Senate bill.

'Bill of rights'

The Senate will then be able to make changes in a separate bill using a procedure known as reconciliation, which allows budget provisions to be approved with 51 votes - rather than the 60 needed to overcome blocking tactics.

Mark Mardell
I can't help thinking the Democrats haven't been trying or even thinking that hard about how to win this argument. The president seems sometimes like a one-man band
Mark Mardell
BBC North America editor

Mr Obama brushed aside Republican claims that the bill was too costly and said Americans had been told "a whole bunch of nonsense" about its contents.

The reform, he said, "brings our deficit down by more than one trillion dollars over the next two decades. Not only can we afford to do this. We can't afford not to do this."

According to Congressional Budget Office, the final version of the Democrats' healthcare plan will cut the federal deficit by $138bn over 10 years.

The non-partisan body said the proposed legislation would cost about $940bn over a decade.

Paul Adams
Paul Adams, BBC News, Washington
President Obama's speech to college students in suburban Washington was passionate, loud and frequently unscripted. But the outcome of this long, bitter debate is still not certain.

With Republicans united in opposition, at least 28 Democrats in the House of Representatives say they will also oppose the bill. Just another 10 opponents out of about 30 who are currently undeclared, and the bill will not pass.

The Republicans - who seem to sense that they may lose Sunday's historic vote - are already promising to punish vulnerable Democrats in November's mid-term elections.

The president also lashed out an insurance companies whose lobbyists, he said, were prowling the corridors of Washington, trying to prevent the bill passing.

"We are going to end the worst practices of insurance companies. This is a patients' bill of rights on steroids," he told a cheering crowd.

The reforms would increase insurance coverage through tax credits for the middle class and expansion of the Medicaid programme for the poor.

If approved, they would represent the biggest change in the US healthcare system since the creation in the 1960s of Medicare, the government-run scheme for Americans aged 65 or over.


Map showing highest snowfall and lowest temperature
Healthcare reform is a priority for Barack Obama. The US spends about $2.2tn a year on its system - which includes private, federal or employer schemes.
1 in 10 people missed work on Monday and Tuesday
US expenditure on healthcare is the equivalent of about 16.2% of GDP - nearly twice that of some other OECD countries.
Graphic showing amount of grit used so far
The US falls behind some OECD countries for life expectancy and has a higher rate of infant mortality. Almost 46m US citizens do not have health insurance.
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