The House has approved health care reform legislation after a tense series of negotiations that left the vote in doubt until a group of pro-life Democrats agreed to support the bill after receiving assurances that President Obama would issue an executive order prohibiting federal funding of abortions.

Rep. Bart Stupak, D-Mich., agreed to vote for the measure, bringing along a group of about eight supporters. The House passed the Senate’s version of the health reform bill by a margin of 219-212 on Sunday night, with every Republican and 34 Democrats voting against the bill.

Immediately afterward, the House voted to reject a motion by Republicans to recommit the bill, which would have sent the bill back to committee for not including the abortion compromise. The House also voted to approve a related reconciliation bill by 220 to 211 that made changes in the Senate version of the bill. The reconciliation bill now goes back to the Senate for another vote Tuesday and the likelihood of parliamentary challenges from Republicans.

House Minority Leader John Boehner, R-Ohio, delivered a lacerating speech near the close of the debate, telling those who would vote for the bill, “Shame on each and every one of you who substitutes your will and your desires above those of your fellow countrymen,” he said.

The health care reform bill and reconciliation passed by the Senate would end the ability of insurance companies to use pre-existing conditions as a reason to deny health coverage. It would set up state-based insurance exchanges through which about 32 million uninsured people would be able to buy health insurance with the help of tax credits from the federal government. Tax credits would also be available to small businesses to help them buy health insurance coverage. The bill would also close the so-called donut hole for prescription drug coverage for senior citizens, and parents would be able to keep their children on their health insurance policies until the age of 26.

The bill was combined with a student loan reform bill that would shift federal funding to support direct loans to college students rather than providing $60 billion in subsidies to private lenders. The bill would add $36 billion to the Pell grant program

“Today’s vote answers the prayers of every American who has hoped deeply for something to be done about a health care system that works for health insurance companies, but not for ordinary people,” said Obama after the vote. “Tonight’s victory isn’t a victory for any one party. It’s a victory for the American people, and it’s a victory for common sense.”

“It’s with great pride and great humility that we undertook this great act of patriotism that occurred on the House floor tonight,” said House Speaker Nancy Pelosi, D-Calif. “It honored the vows of our founders for us to be a land of opportunity, all the way back to before we were a country, when the Declaration of Independence talked about life, liberty and the pursuit of happiness. To provide quality affordable health care for all Americans, enabling people to have the liberty to pursue their own happiness, to change jobs without losing their health care, they can become self-employed, start a small business, and follow their passion.”

To pay for the bill, a 40 percent tax would be levied on high-value health insurance policies of over $10,200 for individuals and $27,500 for families starting in 2018. The Medicare Hospital Insurance Tax would be increased for individuals who earn more than $200,000 and families who earn more than $250,000. There is also a 3.8 percent tax on unearned income, including dividends and interest, for individuals making over $200,000 per year, or couples making over $250,000 a year.

The proposal would also impose fees on various sectors of the health industry. These include a fee on branded prescription drug pharmaceutical companies in proportion to their federal sales, an excise tax on medical devices, an annual fee on health insurance companies, and an excise tax on indoor tanning services.

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