President Barack Obama lobbies a Member of Congress while en route to George Mason University in Fairfax, Virgina, to deliver remarks on health insurance reform, Friday, March 19, 2010.

President Barack Obama on Sunday won a stunning legislative victory for health care reform in the House of Representatives, in the face of implacable Republican Party opposition. Final approval of the reform package is expected this week in the US Senate, on a simple majority vote. The US then will no longer be the exception among developed countries in not providing universal health care coverage.

The reform which will provide coverage for over 30 million uninsured Americans - - a number that in the absence of reform could have swelled to 68 million in a decade - - was first advocated by President Teddy Roosevelt in the first decade of the last century, is also a triumph for the leadership of Speaker Nancy Pelosi and Senate Majority Leader Harry Read. The reform will also mean that people would no longer be denied insurance coverage because of preexisting conditions. Over 65s are covered by the federal Medicare Act, which was approved in 1965 with some Republican Party support.

With the country split on the issue; millions of dollars spent on lobbying and Catholic nuns defying the comfortable male hierarchy of bishops, who argued that anti-abortion measures were not strong enough, the House approved the $940 billion Senate bill that had been passed in December by a vote of 219 to 212; then turned its attention to remaining issues, including the package of fixes, known as a reconciliation bill, that is to be taken up in the Senate this coming week. The amendments were aimed at making the final bill more palatable to House members.

Columnist, E.J. Dionne Jr. writes in The Washington Post today:"On Nov. 19, 1945, President Truman stated facts that are true to this day. 'People with low or moderate incomes do not get the same medical attention as those with high incomes," he said. "The poor have more sickness, but they get less medical care. People who live in rural areas do not get the same amount or quality of medical attention as those who live in our cities.'

The nation, Truman added, needed to resolve 'that financial barriers in the way of attaining health shall be removed' and 'that the health of all its citizens deserves the help of all the Nation.' Nearly 65 years later, Truman's wish has come to pass."

On Saturday, some conservative protesters at the Capitol, shouted the racially-charged term "nigger" at black lawmakers and House Majority Whip James Clyburn, the highest-ranking black official in Congress said:  "I have heard things today that I have not heard since March 15, 1960, when I was marching to get off the back of the bus."

CNN reported that protesters also hurled anti-gay comments at Rep. Barney Frank of Massachusetts, who is openly gay, as he left a health care meeting. A CNN producer overheard the word "faggot" yelled at Frank several times in the lobby of the Longworth building. Frank said he heard someone yell "homo" at him.

"I'm disappointed,"Frank said. "There's an unwillingness to be civil."

On Thursday, the nonpartisan Congressional Budget Office estimated that the House approved compromise plan would cost $940 billion over 10 years while reducing the deficit by $138 billion -- $20 billion more than the bill passed by the Senate.

The latest health care scenarios released last week by researchers from a Washington DC think tank offered grim food for thought as health reform moved toward final passage in Congress. If the legislation didn't pass, the worst-case projection was that the number of Americans without coverage will climb from 49.4 million to 67.6 million in 2020, meaning that nearly one in four Americans too young for Medicare would be uninsured.

The best-case scenario also wasn't very reassuring. Should economic conditions improve over the next decade, there would be 57.9 million people without coverage 10 years from now -- about one in five Americans younger than 65. The research was funded by the well-regarded Robert Wood Johnson Foundation. The authors of the report, which was released last Monday and titled "The Cost of Failure to Enact Health Reform: 2010-2020,'' were from the nonpartisan Urban Institute.

Under any scenario, the analysis showed a tremendous economic strain on individuals and employers of all sizes. While all income levels would be affected, middle-income families would be hardest hit. Within 10 years, under the worst-case scenario, we estimate that:

• The number of uninsured Americans would increase from 49.4 million in 2010 to 59.7 million in 2015 and 67.6 million in 2020.If states were to cut back eligibility for public coverage or make the enrollment process more difficult, the number of uninsured would be even higher. Even in the best case, the number of uninsured would rise to 57.9 million in 2020.
• A larger share of the uninsured would come from middle- and higher-income families.The share of the uninsured from families with incomes higher than 200 per cent of the federal poverty level (FPL) would rise from 44 per cent to 56 per cent in 2020.
• Premiums would become increasingly expensive for employers and their workers.Premiums for both single and family policies would more than double by 2020, increasing from $4,800 to $10,300 for single policies and from $12,100 to $25,600 for family policies. Even in the best case, single premiums would rise to $7,800 and family premiums would rise to $19,500 by 2020, increasing much faster than incomes.
• Offers of coverage would fall significantly for workers in small and medium firms.Small firm workers would see offer rates almost cut in half, dropping from 41 per cent to 23 per cent in 2020. Workers in medium-size firms would see offer rates fall from 90 per cent to 75 per cent. Overall, the rate of employer sponsored insurance coverage would fall from 56 per cent in 2010 to 48 per cent of nonelderly Americans in 2020. Even in the best case, the rate of employer sponsored insurance coverage would fall to 53 per cent in 2020.
• Medicaid and Children's Health Insurance Program (CHIP) enrollment and costs would increase substantially.Enrollment would increase from 45.4 million in 2010 to 58.2 million in 2020, an increase of 12.8 million nonelderly Americans. Medicaid and CHIP spending for the nonelderly would increase from $278 billion in 2010 to $576 billion in 2020, an increase of 108 per cent. Even in the best case, spending would increase by 59 per cent to $442 billion in 2020.
• Employers would see large increases in premium costs.Employer premium spending would increase from $430 billion in 2010 to $851 billion in 2020, a 98 per cent increase. Even in the best case, employer premium spending would increase by 67 per cent in ten years. These increases would be even higher if employer coverage rates were to hold steady over this period rather than decline as predicted.
• Uncompensated care costs would more than double.The cost of uncompensated care would increase from $64 billion in 2010 to $140 billion in 2020. In the best case, the cost of uncompensated care would increase by 74 per cent and total $111 billion in 2020. Together with increased spending on Medicaid and CHIP, this would mean higher federal, state, and local taxes even without reform.
• Health care costs paid directly by families would increase significantly.Individual and family spending on premiums and out-of-pocket health care costs would increase from $315 billion in 2010 to $564 billion in 2020. In the best case, these costs would rise to $471 billion by 2020.

SEE also, Finfacts article, March 2010:Without reform, annual per employee health care costs for American companies will triple to nearly $29,000 by 2019