IT IS being compared rightly to the seismic shifts represented by the great United States welfare milestones. In 1935 Franklin D Roosevelt established social security, the now massive pension and unemployment benefits system; in 1964 and 1965 Lyndon Johnson, the Medicaid and Medicare systems, which provide medical cover to the poorest and the elderly respectively.
And, in truth, the agreement by the House of Representatives on Sunday night to a healthcare Bill that will affect virtually every man, woman and child in the US, expands coverage to 32 million more people, guarantees the right to cover and should cut the federal deficit by $143 billion by 2019, is a remarkable landmark moment for the US welfare system, for a dysfunctional Congress and for the Obama presidency.
The ludicrous hyperbole that greeted the Bill from Republicans, suggestions that Mr Obama had introduced “European socialism”, that – in the not-untypical words of one Texas House member, Ted Poe – Democrats were on “the path of government tyranny”, all echoed the vilification that FDR and Johnson faced in their time. It has had an effect. The Bill and Mr Obama have suffered in the polls and the Democrats are fearful that they will too in the mid-term elections this autumn.
But the White House is playing a long game, pinning hopes on the idea that, as with social security and Medicare, untouchable pillars of the welfare system, experience will mellow opposition as voters begin to benefit. Once they discover that they can no longer be rejected for insurance for pre-existing conditions or that they can keep their children on their own insurance plans longer, Obama is betting they will come to appreciate the changes that are to be rolled out gradually over the next five years. Repeal will gradually become a less politically acceptable option.
For Mr Obama, who has invested a year of his presidency in a visionary project that will define it domestically, the vote represents a major vindication that some thought impossible. He delivers. Not many presidents can say that. Bill Clinton became ensnared by a doomed health reform initiative while George Bush long-fingered radical social security privatisation plans almost as soon as he had announced them. Sunday’s success should give a fair wind to Mr Obama’s sails as he turns to other thorny issues from financial regulation to jobs and immigration reform.
But the vote, opposed by all Republicans and 34 Democrats, may also have put paid to one of Mr Obama’s cherished and perhaps always naive objectives: to be a “post-partisan” president, governing on the basis of cross-party support. Yet, never in modern memory has another major piece of legislation passed without a single Republican vote. And when the final element of congressional ratification, the “reconciliation Bill”, goes back to the Senate this week, it is again unlikely to garner any opposition support. American political discourse is now as bitter as it has been in a generation. But, Mr Obama has delivered on his chosen political priority.