After nearly 14 hours of debate, the U.S. House voted 220-215 to pass H.R. 3962 the Affordable Health Care for America Act.  The final vote took place around 11:30 p.m. Saturday night in the nation’s capital.

The bill required 218 votes to pass and achieved 220 with one Republican, Representative Joseph Cao (R-LA) voting “aye.”  Cao’s vote was unexpected, though does help push forward claims of “bipartisan negotiations” as desired by Democrats as Cao now joins Senator Olympia Snowe (D-ME) as the two Republicans now having voted “yes” on health care reform legislation. 

Cao refused to talk with reporters following the vote, but later released a statement indicating that he had garnered a deal with the White House concerning disaster relief in Louisiana should he vote yes on the measure.  Cao said, “Today, I obtained a commitment from President Obama that he and I will work together to address the critical health care issues of Louisiana including the Federal Medical Assistance Percentage crisis and community disaster loan forgiveness, as well as issues related to Charity and Methodist Hospitals.”

Although 39 Democrats voted no, in Iowa, all Democratic members, Congressmen Dave Loebsack, Leonard Boswell and Bruce Braley voted for the bill while Republicans Tom Latham and Steve King voted no.

Two amendments were considered, one offered by Congressman Bart Stupak (D-MI) which added language to the bill strengthening the section concerning abortion, limiting payment for abortions using federal health reform dollars to only those pregnancies caused by incest, rape or danger to the life of the mother.  This controversial amendment helped garner more votes for the overall package from conservative-leaning Democrats, while infuriating many members including the Democratic Women’s Caucus and other pro-choice Democrats in both chambers.  The amendment now adds an additional roadblock while moving toward final negotiations on the bill.

The other amendment was an “amendment in the nature of a substitute,” containing language that would strike the entire bill and replace its language with the Republican substitute bill.  The measure failed.

The final affirmative vote in the House is certainly a step forward in the health care debate but the process is long from over.  The battle now turns to the Senate where the Democrats are unsure as to whether or not they have the 60 votes needed to pass their bill, as Senator Joe Lieberman (I-CT) has expressed disappointment over the bill and has indicated he would join a Republican filibuster attempt should the bill be brought to the floor as is, leaving Democrats at least one vote shy of passage.

Remaining unresolved are the controversial issues of insurance mandates, tax increases and the public option.

Moving forward, the Senate will now attempt to pass its stand alone bill, following its action, both bills will need to be “reconciled” in Conference Committee with members appointed by Majority party leadership in both chambers.  However, Congressional leaders have also been working on methods aimed at skipping the conference committee process and working together to craft one bill between both chambers that would to go to the president.  The Senate is expected to move forward in the coming weeks, with hopes of sending a final bill to President Obama before the Congressional holiday break.

IHA is moving forward cautiously with health care reform, and continues to work with Iowa’s Congressional Delegation to ensure hospital concerns remain top priority in continuing discussions.