Sunday night's votes capped an unpredictable and raucous weekend at the capitol, with Democratic leaders negotiating around the clock for the final votes as hundreds of protesters paraded outside, their shouts of "Kill the Bill! Kill the Bill!" audible within the Capitol.
A last-minute deal with a critical group of anti-abortion lawmakers Sunday afternoon sealed Democrats' victory. The leader of the anti-abortion bloc, Rep. Bart Stupak, D-Mich., didn't get to add stricter anti-abortion language to the underlying bill, but was satisfied by an executive order signed by Obama affirming current law and provisions in the legislation that ban federal funding for abortions except in cases of rape, incest or danger to the life of the mother.
Republican abortion foes said Obama's proposed order was insufficient, and when Stupak sought to counter them, a shout of "baby killer" was heard coming from the Republican side of the chamber.
Far beyond the political ramifications — a concern the president repeatedly insisted he paid no mind — were the sweeping changes the bill held in store for Americans, insured or not, as well as the insurance industry and health care providers.
The nonpartisan Congressional Budget Office said the legislation awaiting the president's approval would cut deficits by an estimated $143 billion over a decade. For the first time, most Americans would be required to purchase insurance, and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.
The second measure, which House Democrats demanded before agreeing to approve the first, included enough money to close a gap in the Medicare prescription drug coverage over the next decade, starting with an election-season rebate of $250 later this year for seniors facing high costs.
It also included sweeping changes in the student loan program, an administration priority that has been stalled in the Senate for months.
For the president, the events capped an 18-day stretch in which he traveled to four states and lobbied more than 60 wavering lawmakers in person or by phone to secure passage of his signature domestic issue. He also postponed an overseas trip to remain in Washington and push for the bill.
Obama watched the vote in the White House's Roosevelt Room with Vice President Joe Biden and dozens of aides, exchanged high fives with Rahm Emanuel, his chief of staff, and then telephoned Pelosi with congratulations.
Associated Press Writers Jennifer Loven, David Espo, Jim Kuhnhenn, Ben Feller and Natasha Metzler contributed to this report.
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