US & World

Obama Signs Historic Health Overhaul Legislation

President Barack Obama smiles before signing the health insurance reform bill March 23, 2010 in the East Room of the White House.
President Barack Obama smiles before signing the health insurance reform bill March 23, 2010 in the East Room of the White House.
Mandel Ngan/AFP/Getty Images

President Obama's yearlong health care overhaul battle culminated in today's signing ceremony at the White House. But now that the bill has become law, the next big step is selling the sweeping changes to a skeptical American public.

President Obama signed his sweeping health care overhaul into law on Tuesday, marking the culmination of a year-long struggle with Congress to make good on the central issue of his administration's domestic policy agenda.

Congressional backers crowded into the East Room, along with several ordinary citizens bringing stories of health care hardships, to witness the historic bill-signing. Victoria Kennedy, widow of the late Sen. Edward Kennedy, was in the audience.

"I am signing this bill for all the leaders who have taken it up in the past, from Teddy Roosevelt to Franklin Roosevelt," Obama said.

The president said it is time that "all the overheated rhethoric will finally confront reality." He also cautioned that some of the provisions were still years away, because "we need to implement reforms responsibly."

"We need to get this right. But a host of desperately needed reforms will take place this year. Right away," Obama said.

The president said passage of the bill was "a testament to leadership" and thanked Democrats in Congress, who he acknowledged had "taken their lumps during this difficult debate."

"Yes we did!" someone yelled from the room to laughter.

The outlook for overhaul legislation looked grim just two months ago, when Democrats lost the Senate seat held for nearly five decades by Edward Kennedy. Republican candidate Scott Brown's victory deprived Democrats of the magic 60 votes needed to forestall a certain GOP filibuster on health care.

On Thursday, Obama planned to visit Iowa City, Iowa, where as a presidential candidate he announced his health care plan in May 2007, to talk about how it will help lower health care costs for small businesses and families.

The White House has characterized the trip as a victory lap, but it is more likely aimed at shoring up support for the bill. Popular support for the measure has waned amid a withering months-long attack from conservative groups and the health insurance industry, which have collectively spent tens of millions on advertising aimed at killing the legislation.

White House aide David Axelrod said in an interview Tuesday that Obama administration officials need to explain the benefits of the new plan to the American public.

Axelrod and Republican Party Chairman Michael Steele appeared on television network morning programs. Steele accused Axelrod of offering the public a lollipop before rendering a needle.

On Monday, however, GOP lawmakers were turned back in their attempt to strike down reconciliation, the process under which the overhaul has been fast-tracked to avoid a GOP filibuster in the Senate.

Speaking with NPR's Morning Edition on Tuesday, Sen. Judd Gregg, the ranking Republican on the Senate Budget Committee said the reconciliation bill "should be adjusted."

Gregg said GOP Senators would try to eliminate the House bill's key provisions, such as expanding coverage to 32 million uninsured Americans, as well as its funding mechanism – new taxes on the wealthiest Americans' so-called "Cadillac" health plans.

"We'll offer amendments to try to improve things like eliminating the individual mandate or addressing the issue of tax policy or getting proposals, which cause us to look at delivery of quality and value ration than quantity and repetition," Gregg told NPR.

In other words, as Rep. John Boehner (R-OH) said last week ahead of the House vote, Republicans are "going to do everything we can to make it difficult for them, if not impossible, to pass the bill."

A dozen Republican controlled states have said they will band together to block specific provisions in the bill as an unconstitutional intrusion on state and individual rights, arguing that Congress has no authority to force people to buy insurance. Some states, such as Virginia and Idaho, have enacted specific laws to rebuff the federal mandate that everyone buy insurance beginning in 2014 or face a fine.

"We believe clearly that the United States government does not have the authority to mandate that everyone buy health insurance," Virginia Attorney General Ken Cuccinelli told CNN. Copyright 2010 National Public Radio. To see more, visit