US begins healthcare debate

President Barack Obama urged Democrats in the US House of Representatives to pass a broad healthcare reform bill on Saturday …

President Barack Obama urged Democrats in the US House of Representatives to pass a broad healthcare reform bill on Saturday as they prepared for a close vote on the biggest changes in health policy in four decades.

House Democratic leaders said they were confident they would have the 218 votes needed for approval after striking a middle-of-the-night deal with foes of abortion rights.

The healthcare overhaul cleared its first hurdle when Democrats easily approved, on a 242-192 vote, a procedural rule setting the terms of the debate. It was the first test of support for the measure.

In a closed-door pep rally with Democrats on Capitol Hill, Mr Obama emphasized the need for healthcare reform and said a vote against the bill would not protect them from Republican attacks, lawmakers said.

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"Now is the time to finish the job," Obama said later at the White House. "I urge members of Congress to rise to this moment, answer to the call of history and vote yes for health insurance reform for America."

The healthcare overhaul, Mr Obama's top priority, is designed to rein in costs, expand coverage to millions of uninsured and bar insurance practices such as denying coverage to people with pre-existing conditions.

The abortion deal, struck after hours of closed-door negotiations last night, allowed dozens of Democratic moderates concerned about the bill's abortion provisions to have a floor vote on whether to impose stronger restrictions on using federal funds to pay for abortions.

The vote on the amendment adds a new element of uncertainty after days of fevered negotiations and intense lobbying. If it is adopted, party leaders hope it will win over many abortion rights opponents without driving off supporters.

The reform bill would lead to the biggest policy changes in the $2.5 trillion US healthcare system since the creation of the Medicare health program for the elderly in 1965.

House Republicans are united in opposition to the measure, unhappy with its $1 trillion price tag, new taxes on the wealthy and what they say is government interference in the private insurance market.

"We can't afford this bill," said Republican Representative Roy Blunt. "It's a 2,000-page road map to a government takeover of healthcare."

The vote is critical for Mr Obama and his fellow Democrats who control Congress. A House victory would be a big step forward for the overhaul and would shift the political spotlight to the Senate, which is preparing its own version.

But failure in the House would be a huge blow to Mr Obama, who has staked much of his political capital on the healthcare battle and has said he wants to sign a bill by year's end.

Reuters