AFTER MUCH horse trading Barack Obama's heavily diluted healthcare bill was passed by the US House of Rep-resentatives by 219 to 212 votes. Thirty-four Democrats joined Republicans in voting against the bill.

The White House and the Democrat House of Representatives leadership, at the eleventh hour, managed to secure the support of a group of Democratic opponents of abortion rights. But, only after president Obama promised to issue an executive order to "ensure that federal funds are not used for abortion services."

Obama is hoping that the bill's passage will rejuvenate his flagging popularity. Some Democrat leaders have argued that in the wake of the vitriolic Republican campaign to scupper the bill - financed and fuelled by sections of big business, the right-wing media and the wealthy - he should shift his policies further to the right.

In reality it is Obama's big business policies and his failure to address the economic misery facing workers that has undermined his support.

The lack of a workers' political alternative to the Democrats has enabled a well-funded and highly vocal Republican movement to step into this political vacuum.

Provisions

The healthcare bill is expected to give coverage to 32 million uninsured people but will still leave 23 million uninsured in 2019. One-third of those remaining uninsured will be migrant workers.

The bill requires many employers to offer medical insurance coverage to workers. Each state will set up a 'marketplace' where people without coverage could shop for insurance which meets federal standards.

The bill, despite Republican propaganda calling it the "social-isation of medicine", will not bring about a British NHS-style health care system.

Effectively, Obama will be giving a federal subsidy to private medical insurance companies to extend medical insurance coverage.

Whether the bill will stop these companies imposing soaring insurance premiums on workers is unclear. However, it will stop workers' medical insurance being cancelled by these companies when they get sick.

The cost of the bill is expected to be offset by savings in Medicare and by new taxes and fees, including a tax on high-cost employer-sponsored health plans and a tax on the capital gains of the richest Americans.

Cost estimates by the budget office suggest the bill will reduce federal budget deficits by $143 billion in the next ten years. This helped to persuade some conservative Democrats to vote for the bill.

As well as the Republicans, the United States Chamber of Commerce and the National Federation of Independent Business tried to stop the bill, saying it would increase business costs.

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