Scroll down for a photo slideshow on health care reform's journey to passage
More than a year's worth of intense political haggling, legislative maneuvering and emotional debate reached its stirring conclusion Tuesday morning as President Barack Obama officially signed health care reform legislation into law.
Speaking in the East Room of the White House, with roughly 200 lawmakers seated before him as well as Vicky Kennedy, the widow of the late Senator Ted Kennedy (D-Mass.), the president called the moment a "new season in America."
"Today, after almost a century of trying, today, after over a year of debate, today, after all the votes have been tallied, health insurance reform becomes law in the United States of America. In a few moments when I sign this bill, all of the overheated rhetoric of reform will finally confront the reality of reform."
"We are not a nation that scales back its aspirations," Obama said. "We don't fall prey to fear. We are not a nation that does what's easy. That is not who we are, that's not how we got here. We are a nation that faces its challenges and accepts its responsibilities."
Obama dedicated the signing to individuals whose stories of struggle have come to personify the need for reform. Included in that list was his mother, "who argued with insurance companies even as she battled cancer in her final days," the president said. Then he talked about his mentor in this fight, former Senator Kennedy.
"I remember seeing Ted walk through that door in the summit in this room a year ago, one of his last public appearances," Obama said. "It was hard for him to make it but he was confident we would do the right thing"
It was, undoubtedly, a moment of jubilation and relief for the president -- largely because few people in the administration anticipated how arduous the debate would be over the course of the year. Speaking just days before the House cast the deciding vote on Sunday, a senior White House official gave a hint at what kind of toll health care has taken on the administration.
"No president in this generation has spent as long a time on a singe legislative issue," the official said, explaining that he couldn't name a single comparable policy debate in recent administrations.
For many in Obama's inner circle, health care reform began to eerily resemble a legislative version of the Democratic primary, with emotional ebbs and flows, dramatic breakthroughs, vitriolic rhetoric, crushing defeats and, ultimately, historic conclusions.
It started, like the primary, with a tall task. Administrations going back to Teddy Roosevelt have, in one form or another, tried to get health care reform into law, with no success on a major scale. Obama's staff took a look at the landscape and decided early on to learn from the failures of the most recent effort -- Bill Clinton's attempt to reform health care in the early '90s. Rather than take on special interests, they would accommodate them. Rather than write the legislation inside the White House, they would pay deference to Capitol Hill. Rather than browbeating opponents, the president would bargain with them.
The resulting deals were toxic for many -- the pharmaceutical and hospital lobbies lent their support, but at the cost of watering down the legislation. The process was moving forward, even if the progressive community was aghast that the president (as early as last winter) talked about bargaining away the public option if it got him Republican votes.
During the August recess, Tea Party protests became forums for angry opponents of reform. During those dog days of summer, a sense developed that the floor had fallen out from under the party. Rep. James Clyburn (D-S.C.) a civil rights hero who was tasked with whipping support for legislation in the House, offered his most direct assessment to date that the environment had become riddled with racist undertones. Hill aides, for the first time, started questioning whether the Obama White House had done the grunt work needed to get health care reform passed. But the legislation progressed.
The January election of Scott Brown in Massachusetts provided more fodder for health care fatalists. Without 60 seats in the Senate, the conventional wisdom held, there was no avenue to get legislation finalized. Sen. Al Franken (D-Minn.) offered a withering critique of the White House's hands-off approach directly to Obama's senior aide, David Axelrod. And the griping between House and Senate leadership, as well as the White House's political arm, grew intense -- each side blaming the other for the impending failure.
But when the emotions ebbed and cooler heads prevailed, the party coalesced around a broad idea -- that reform was needed and good for the Democrats -- and a particular path forward, reconciliation for the fixes to the Senate's bill. Whipping up the votes this past week, there was still uncertainty that the numbers were there. But a steady stream of "no" to "yes" votes among one-time skeptical Democrats, had aides reminiscing about the Democratic primary once again.
Did it feel like the late run of superdelegates in Obama's favor?
"Let's hope," Robert Gibbs told the Huffington Post.
On Sunday, the president finally got the votes he needed. Three year's prior he had told the audience at a progressive forum that he would judge his "first term as president based on the fact on whether we have delivered the kind of health care that every American deserves and that our system can afford." On Tuesday he did just that, putting under his belt the greatest achievement in social policy in the past forty years. It wasn't the end to the process. The Senate still needs to pass its reconciliation bill. But it was certainly a time to reflect on and savor what has been accomplished.
Speaking before Obama, Vice President Joseph Biden praised the president for "delivering on a promise," and showing the resolve to get reform done.
"Your fierce advocacy, the clarity of purpose that you showed, the perseverance, these are in fact -- it is not hyperbole to say it -- the reasons why we are assembled in this room together," Biden said. "Mr. President, you are the guy that made it happen... you have done what generations of not just ordinary, but great men and women, have attempted to do -- Republicans as well as Democrats."
Photos: The journey of health care reform: