A package of final changes to Barack Obama’s landmark healthcare reforms has been approved by the US congress, with the US president daring opposition Republicans to try repealing the law. (photo from aljazeera.net)
The finishing touches on the overhaul was put on by the House of Representatives on Thursday. By 220 votes to 207, a companion package was passed that would make insurance more affordable, raise taxes on the wealthy and close a gap for prescription drug coverage for seniors.
After a contentious debate on Sunday, the House had approved the overhaul and the companion package of changes, but had yet to approve the changes again after the senate approved them by 56-43 votes but sent them back to the House after Republicans complained that two minor provisions on a student loan revamp did not meet reconciliation rules.
These votes came after a yearlong political struggle that dominated Obama’s domestic agenda and hurt his approval ratings.
“This has been a legislative fight that will be in the record books,” said Harry Reid, the Democratic senate majority leader.
‘We’re not going back’
And as ruling Democrats and opposition Republicans fight for control of congress in November electins, it looks like the political battle is not over.
While launching a public relations blitz in order to sell the new programme, president Obama mocked his Republican critics and said their promise to make repeal of the law the centrepiece of the congressional campaign would backfire.
“If they want to have that fight, I welcome that fight,” Obama said in Iowa, in his first major speech since signing the law on Tuesday.
“I don’t believe the American people are going to put the insurance industry back in the driver’s seat. We’ve been there already and we’re not going back,” he said.
The overhaul of the $2.5 trillion healthcare system is the most dramatic change in US health policy in four decades.
It will extend coverage to an estimated 32 million uninsured Americans and bar insurance practices such as refusing coverage to those with pre-existing medical conditions.
An expansion of federal subsidies to make insurance more affordable and more state aid for the Medicaid programme for the poor where among the final changes approved by congress on Thursday.
The changes also eliminate a controversial senate deal exempting Nebraska from paying for Medicaid expansion costs, close a gap in prescription drug coverage for seniors and delay a tax on high-cost insurance plans.
The final package would also extend taxes for Medicare, the federal health insurance programme for the elderly, to unearned income.
A reform of the student loan programme is also included.
Threats and attacks
The measure was fought by Republicans as a costly government takeover of healthcare which would restrict patient choice and drive up insurance premiums.
“This has been a sombre week for the American people,” said John Boehner the Republican House minority leader.
He added that Obama had “with the stroke of a pen … signed away another share of Americans’ freedom”.
But Obama said he would be happy to engage Republicans in a debate over repeal of the law.
“I say go for it,” Obama said. “If these congressmen in Washington want to come here to Iowa and tell small business owners that they plan to take away their tax credits and essentially raise their taxes, be my guest.”
On Thursday, tensions over the massive healthcare overhaul went on, as Democrats and Republicans disclosed new details of threats against them in the aftermath of the bil’s passage and traded blame over the threast and attacks.
Congressional leaders said that at least four Democratic offices in the states of New York, Arizona and Kansas were attacked and that at least 10 members of congress have reported threats, including obscene phone messages and a fax bearing the image of a noose.