Pelosi: New Health Care Bill Is 'Historic Moment'

After months of struggle, House Democrats unveiled sweeping legislation Thursday to extend health care coverage to millions who lack it and create a new option of government-run insurance. A vote is likely next week on the plan patterned closely on President Obama's own.

Speaking on the steps of the U.S. Capitol, Speaker Nancy Pelosi said Congress was "on the cusp of delivering on the promise of making affordable, quality health insurance available to every American - and laying the foundation for a brighter future for generations to come."

Officials said the measure, once fully phased in over several years, would extend coverage to 96 percent of Americans. Its principal mechanism is creation of a new government-regulated insurance "exchange" where private companies could sell policies in competition with the government. Federal subsidies would be available to millions of lower-income individuals and families to help them afford the policies.

The ceremony marked a pivotal moment in Democrats' yearlong attempt to answer Obama's call for legislation to remake the nation's health care system by extending insurance, ending industry practices such as denying coverage on the basis of pre-existing medical conditions, and slowing the growth of medical spending nationwide.

Democrats issued a statement saying their measure "lowers costs for every patient" and would not add to federal deficits. They put the cost of coverage at under $900 billion over 10 years, a total that evidently didn't include additional spending.

Pelosi was flanked by rank-and-file Democrats as she made her remarks.

Across the Capitol, Senate Democrats, too, are hoping to pass legislation by year's end. Legislation outlined by Majority Leader Harry Reid earlier this week would include an option for a government-run plan, although states could drop out if they wished, a provision not in the House measure.

With Republicans expected to oppose the measure unanimously, Pelosi and her lieutenants worked for weeks to resolve differences within the Democratic rank and file.

The toughest of them covered the terms under which the government insurance option would function. Liberals generally wanted the government to dictate the rates to be paid to doctors, hospitals and other health care providers, with the fee levels linked to Medicare.

Moderates, fearing the impact on their local hospitals, held out for negotiated rates between the government and private insurers - and won.

Not all liberals were ready to sign on. Rep. Lynn Woolsey, D-Calif., a co-chair of the Congressional
Progressive Caucus, was noncommittal about whether progressives would accept the negotiated rates. "This is not walkaway time and it is not acceptance time," she said.

Democrats control 256 seats in the House, are overwhelmingly favored to win one special election next week and are competitive for another. As a result, they can afford 30 defections or more on the legislation and still prevail.