In a sign of the fight ahead, Republicans on Saturday quickly blasted the Democrats' proposals as a "dangerous and costly experiment" that will run up the federal deficit and overwhelm state budgets.
The 31-28 vote in the House Energy and Commerce Committee late Friday was weeks later than either the White House or Democratic leaders had hoped. Nonetheless, it was a triumph for them.
The vote came after weeks of negotiations finally satisfied concerns raised by fiscally conservative Democrats
- only to produce a compromise that riled liberals.
The liberal opposition was quieted with a last-minute series of changes agreed to early Friday that included limiting how much insurers can raise premiums, and giving the federal government authority to negotiate directly with drug companies for lower prices under Medicare.
"We passed a bill out that shows that we can bring together conservative, moderate and progressive Democrats," Energy and Commerce Chairman Henry Waxman, D-Calif., said after the vote. "We're going to need that coalition on the House floor, and I feel confident that we'll pass a health care reform bill in the House when we come back in September."
Five Democrats and all committee Republicans opposed the bill.
The measure is designed to extend health insurance to millions who now lack it, at the same time it strives to slow the growth in medical costs nationwide
- Obama's twin goals.
While the pace of action was slower than party leaders had hoped, it was speedier by far than the timetable in the Senate.
There, Democrats said a deadline of Sept. 15 had been imposed on marathon talks aimed at producing a bipartisan compromise in the Senate Finance Committee.
In the GOP's weekly radio and Internet address, Sen. John Thune of South Dakota contended that the Democrats' current proposals do not improve health care because it would force millions of Americans in employer-based coverage into a government-run system.
He also said the proposals would burden states because they expand Medicaid coverage without a clear source of funding. In South Dakota, for example, the new requirements could require $45 million a year in new state spending that will "have to come from somewhere, and that means either higher taxes or cuts to other priorities."
"That's what we're facing not just in South Dakota, but nationwide," he said.
Thune said Republicans would seek reforms that allow small businesses to band together to buy affordable health insurance for their employees; protect doctors and hospitals from frivolous lawsuits; encourage wellness and prevention programs proved to cut costs; and give people who buy their own insurance the same tax breaks as those who get insurance through their employers.
Without a bipartisan bill, Finance Chairman Max Baucus, D-Mont., would presumably have to produce a measure tailored to Democratic specifications, a step he has said repeatedly he would rather avoid. It wasn't clear how much the deadline for the committee to start voting was Baucus' idea, and how much it reflected growing impatience at the White House and on the part of Senate Majority Leader Harry Reid of Nevada.