House narrowly approves health care overhaul

WASHINGTON — Handing President Barack Obama a hard-fought victory, the House narrowly approved a sweeping overhaul of the nation's health care system on Saturday, advancing legislation that the Democrats said could be their defining social policy achievement.

After a daylong clash with Republicans over what has been a Democratic goal for decades, lawmakers voted 220-215 to approve a plan that would cost $1.1 trillion over 10 years and that Democrats said would provide relief to Americans struggling to buy or hold on to health insurance.

North Coast Democrats Lynn Woolsey of Petaluma and Mike Thompson of St. Helena both voted for the legislation.

“This is our moment to revolutionize health care in this country,” said Rep. George Miller, D-Calif., a chief architect of the bill.

Democrats were forced to make major concessions on insurance coverage for abortions to secure passage, a wrenching compromise for the numerous abortion-rights advocates in their ranks. They hope to change the amendment in Senate negotiations.

Democrats say the measure — paid for through new fees and taxes, and cuts in Medicare — would extend coverage to 36 million people without insurance and create a government health insurance program.

It would end insurance companies not covering pre-existing conditions or dropping people when they become ill.

The vote came after Obama traveled to Capitol Hill just before noon Saturday to ask lawmakers to “answer the call of history” and support the bill.

Only one Republican, Rep. Anh Cao of Louisiana, voted for the bill, and 39 Democrats opposed it. The House also defeated the Republicans' more modest plan, whose authors said it was a more common-sense and fiscally responsible.

A handful of remaining undecided lawmakers swung behind the proposal. And slightly more than 30 House Democrats were publicly lined up in opposition — not enough to deny the party a victory on one of the president's top domestic initiatives, unless their ranks swelled by 10.

Another turning point was the decision by Speaker Nancy Pelosi late Friday night to allow anti-abortion Democrats to try to tighten restrictions on coverage for the procedure under any insurance plan that receives federal money. That concession eased a threat by some Democrats to abandon the bill, but also left Democrats who support abortion rights facing a choice between backing a provision they bitterly opposed or scuttling the bill.

The new abortion controls were added to the measure on a vote of

240-194.