WASHINGTON — With the stroke of President Obama’s pen, his health care overhaul — the most sweeping social legislation enacted in decades — became law on Tuesday.
Mr. Obama affixed his curlicue signature, almost letter by letter, to the measure, the Affordable Health Care for America Act, during a ceremony in the East Room of the White House, surrounded by House Speaker Nancy Pelosi, Senate Democratic Leader Harry Reid and a raft of other lawmakers who spent the past year on a legislative roller-coaster ride trying to pass it. Aides said he would pass out the 20 pens he used as mementoes.
The ceremony included two special guests: Vicki Kennedy, the widow of the late Senator Edward M. Kennedy of Massachusetts, who had been a driving force for health care legislation before his death last year, and Connie Anderson, the sister of Natoma Canfield, the Ohio cancer survivor whose struggle to pay skyrocketing health insurance premiums became a touchstone of Mr. Obama’s campaign to overhaul the system.
Mr. Kennedy’s son, Representative Patrick Kennedy of Rhode Island, was also there, carrying a gift for the president: a copy of a bill his father introduced in 1970 to provide national health insurance. On it, the younger Mr. Kennedy had written a personal message to Mr. Obama.
Vice President Joseph R. Biden Jr. began the ceremony with remarks lauding the president’s “perseverence” and “clarity of purpose.”
The White House took on a festive air for the occasion, as senators mingled in the grand foyer of the Executive Mansion before the signing ceremony. A Marine pianist was playing as lawmakers and other guests, including patients and their advocates, chatted in anticipation of Mr. Obama’s arrival. As they filtered into the East Room, many lawmakers took out cameras to photograph one another and record the moment.
The landmark bill, passed by the House on Sunday night by a vote of 219-212, will provide coverage to an estimated 30 million people who currently lack it. Its passage assures Mr. Obama a place in history as the American president who succeeded at revamping the nation’s health care system where others, notably Bill Clinton, tried mightily and failed.
The measure will require most Americans to have health insurance coverage; would add 16 million people to the Medicaid rolls; and would subsidize private coverage for low- and middle-income people. It will cost the government about $938 billion over 10 years, according to the non-partisan Congressional Budget Office, which has also estimated that the bill would reduce the federal deficit by $138 billion over a decade.
Despite the president’s signature, the legislative work on the measure is not over, nor is the intense partisan fight over it. Republicans are already vowing to repeal the bill. And the legislative battle will flare anew in the Senate on Tuesday, where lawmakers are set to take up a package of changes to the measure under the parliamentary procedure known as reconciliation.