On November 7, 2009, the U.S. House of Representatives passed landmark health care reform legislation [3] after months of negotiations and despite some really outrageous lies [4] by opponents [5] of any efforts to redress corporate malfeasance. Only a single Republican, Congressman Joseph Cao [6] of New Orleans, "the Good Joe," was willing to defy his party's command and vote for the bill, along with 219 Democrats, giving the bill two votes more than it needed to pass. Upon the historic vote, the Good Joe said [7]: "I read the versions of the House health reform bill. I listened to the countless stories of Orleans and Jefferson Parish citizens whose health care costs are exploding – if they are able to obtain health care at all. Louisianans need real options for primary care, for mental health care, and for expanded health care for seniors and children."

Quick Summary of the Health Reform Bill's Changes

Under the bill as passed, according to the Washington Post [8]: insurance companies could no longer deny coverage based on preexisting conditions or abandon people if they become sick. It would require coverage for young adults (until age 27) through their parents' plans and eliminate the gap in prescription drug coverage for older Americans. And, people who lose their jobs would be able to continue their insurance coverage. Additionally, middle-income Americans who could not afford coverage could obtain subsidized health care benefits under a government plan (a "public option") or through a corporate plan via a new insurance marketplace in which the government would help negotiate for reduced cost comprehensive policies, by 2013. Under an amendment passed last night, no public funding for abortions [9] under any of these options would be permitted. Click here [10] for more information about the time-table for implementing these changes and here [11] for a summary of the bill by its sponsors. The Center for Media and Democracy [12] is in the process of analyzing the bill as passed. Among other things, we have previously commented [13] on the controversy surrounding the Big Pharma elements of the prescription drug provisions related to the bill.

Will a Minority of Senators Filibuster Health Reform

The next stop in this debate is the Senate. According to the Post [8]: the key sticking points are whether to allow states to "opt-out" of allowing a public option for middle class residents, whether to require employers to provide insurance coverage, whether to tax union-negotiated health benefits or to tax the super-rich who make more than 97% of all Americans.

Under procedural rules in the Senate, the minority party can deny a majority vote on a measure if they have 41 votes to "filibuster," a Dutch term meaning "free booters," sailors who are pirates who rob people on the high seas. There are 40 Republicans in the Senate. Registered Independent Senator Joseph Lieberman [14], "the Bad Joe," who the Center for Media and Democracy [12]'s Wendell Potter [15] has called a "shill" [16] for the insurance companies, has threatened to join the Rs in filibustering or blocking any opportunity for the majority to have an up or down vote on health reform legislation, even though he caucused with the Ds this year to secure his job as Chairman of the Senate Homeland Security Committee. (Senator Harry Reid [17] recently stated [18], however, that he believes the Bad Joe will allow the Ds an up or down vote on health care reform despite the threatened filibuster.) Senator Olympia Snowe [19] crossed the aisle in the Senate Finance Committee to vote with the Ds on one of the competing bills, but she has not made a formal commitment on the filibuster issue. So, negotiations continue.

Health Reform Debate Heated

President Obama gave some strong advice to House Democrats Friday: "If you think the Republicans are not going to go after you if you vote no," the president said, according to several people present as reported by the Washington Post, "think again." Meanwhile, during the debate over the bill, critics began the day by trying to prevent the Ds from even talking about the legislation, let alone getting to a vote. As Think Progress [20] reported: "This morning, the House began consideration of the rule for debate of the House health care bill. As the Democratic Women's Caucus took to the microphone on the House floor to offer their arguments for how the bill would benefit women, House Republicans — led by Rep. Tom Price [21] (R-GA) — repeatedly talked over, screamed, and shouted objections. 'I object, I object, I object, I object, I object,' Price interjected as Rep. Lois Capps [22] (D-CA) tried to hold the floor." House minority leader John Boehner [23] issued a statement [24] criticizing the bill and saying, "I came here to fight big-government monstrosities like this bill that dim the light of freedom and diminish opportunity for future generations."

Rose Garden Remarks on Health Reform

As the president worked to secure votes yesterday, he urged congressional representatives from both parties to "answer the call of history" and reform the deeply flawed U.S. health care system. Here is an excerpt of that speech [25]:

Now, no bill can ever contain everything that everybody wants, or please every constituency and every district. That's an impossible task. But what is possible, what's in our grasp right now is the chance to prevent a future where every day 14,000 Americans continue to lose their health insurance, and every year 18,000 Americans die because they don't have it; a future where crushing costs keep small businesses from succeeding and big businesses from competing in the global economy; a future where countless dreams are deferred or scaled back because of a broken system we could have fixed when we had the chance.

What we can do right now is choose a better future and pass a bill that brings us to the very cusp of building what so many generations of Americans have sought to build -- a better health care system for this country.

Millions of Americans are watching right now. Their families and their businesses are counting on us. After all, this is why they sent us here, to finally confront the challenges that Washington had been putting off for decades -- to make their lives better, to leave this country stronger than we found it.

I just came from the Hill where I talked to the members of Congress there, and I reminded them that opportunities like this come around maybe once in a generation. Most public servants pass through their entire careers without a chance to make as important a difference in the lives of their constituents and the life of this country. This is their moment, this is our moment, to live up to the trust that the American people have placed in us -- even when it's hard; especially when it's hard. This is our moment to deliver.

I urge members of Congress to rise to this moment. Answer the call of history, and vote yes for health insurance reform for America.

Lisa Graves [26] is the Executive Director of the Center for Media and Democracy [27] based in Madison, Wisconsin.