Barack Obama is sworn into office as president in January. He vows to overhaul the nation's healthcare system. In a February speech to Congress, he says healthcare costs are driving families and small businesses into bankruptcy and impeding U.S. companies in the global marketplace. Democrats push for reform, while Republicans are nearly unanimous in opposition to any Democratic plan. As the year closes, the Senate conducts furious negotiations and debates in a struggle to complete legislation by Christmas.
Congressional battle over reform roils Obama's first year
Obama's choice for HHS secretary, former Democratic Senate leader Tom Daschle, withdraws his nomination in the wake of revelations over taxes and interest from a consulting job and use of a car service. Former Kansas Gov. Kathleen Sebelius is chosen to replace him and is confirmed by the Senate. Nancy-Ann DeParle, a former Clinton administration health official, becomes director of a newly created White House Office on Health Reform.
In May, Obama lauds promises by segments of the healthcare industry to cut $2 trillion in spending over a decade.
Action accelerates in June as the American Medical Association, which historically has opposed reform, indicates it will back reform legislation and perhaps a public plan option.
In July, House Democratic leaders unveil their reform proposal, called America's Affordable Health Choices Act. The measure—estimated to cost $871 billion—is soon approved by Democrats on three House committees. Also in July, in a party-line vote, the Senate health committee approves a healthcare reform plan. The bill must be melded with a then-unapproved finance committee measure to secure funding.
Congress adjourns for an August recess and anti-reform protesters flock to lawmakers' “town hall” constituent meetings. The gatherings sometimes turn chaotic and feature denunciations of Obama as a socialist and a fascist. Some Republicans contend the House reform legislation would create “death panels” to withdraw medical care for senior citizens.
Obama addresses a joint session of Congress in September to argue in favor of reform. He tells lawmakers: “I am not the first president to take up this cause, but I am determined to be the last.” He denounces what he terms a “partisan spectacle” and “scare tactics.”
In October, the Congressional Budget Office estimates the Senate Finance Committee's $829 billion reform bill would not only meet spending targets but would actually reduce the federal deficit by more than $81 billion over a decade. About a week later, the committee votes 14-9 to approve the legislation, with one Republican, Olympia Snowe of Maine, joining Democrats to endorse the measure.
Later in October, House Democrats unveil a compromise $894 billion reform package that would provide insurance to offer coverage to up to 36 million additional people by expanding Medicaid and by offering subsidies to moderate-income Americans to buy insurance either from private carriers or a new government-run plan.
The House narrowly approves its reform measure in early November. Lawmakers vote 220-215 to OK the legislation with only one Republican joining Democrats. A last-minute amendment to strengthen anti-abortion provisions secures some Democratic votes but creates a backlash from abortion-rights backers.
Senate Majority Leader Harry Reid of Nevada unveils a 10-year, $848 billion health overhaul package that melds components of two previously approved Senate bills. In 2014, it would create a public health insurance option that requires states to participate unless they pass a law to opt out.
The Senate in late November votes 60-39 along party lines to begin debate on the healthcare reform package. Democrats manage to corral a trio of the party's holdouts to reject a GOP move to halt the process.
Senior Senate Democrats reach a deal to drop the government-run insurance plan from their reform package. Instead, people 55 and older would be permitted to buy into Medicare. That deal is torpedoed when Sen. Joseph Lieberman (I-Conn.) threatens to filibuster any legislation with a Medicare expansion.
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