The president's top domestic policy priority is one step closer to being made  law. As you've read elsewhere, the full House passed its final health care reform bill late Saturday night by a slim 220-215 margin. Although 39 Democrats eventually voted against the bill, none of Democrats hailing from President Obama's home state -- including Reps. Melissa Bean and Bill Foster -- dissented.

While not perfect, the package approved by the House would dramatically improve the lives of millions of Americans. According to the Congressional Budget Office (CBO), 36 million people currently uninsured would gain access to health care. The bill, which includes an employer mandate and a "level-playing field" public option, is also deficit neutral over the next 10 years and would impose a whole host of important consumer protections.

Unfortunately, House leadership had to strike a Faustian bargain to gain the support of conservative pro-life Democrats, including Reps. Dan Lipinski and Jerry Costello. Included in the legislation was an amendment introduced by Rep. Bart Stupack (D-Michigan) limiting elective abortion coverage from both private and public insurers on the health insurance exchanges. Lipinski, who made clear this summer that he "strongly opposed any bill that's going to have public funding for abortion," even spoke in favor of the amendment on the floor minutes before the vote took place, earning praise from the Family Research Council for his efforts.

What Lipinski forgot to mention was that House tri-committee bill does not threaten the Hyde Amendment, which forbids Medicaid from using any federal money to pay for an abortion procedure. And in practical terms, it will have a devastating effect on working women. Ezra Klein explains:

If this amendment passes, it will mean that virtually all women with insurance through the exchange who find themselves in the unwanted and unexpected position of needing to terminate a pregnancy will not have coverage for the procedure. Abortion coverage will not be outlawed in this country. It will simply be tiered, reserved for those rich enough to afford insurance themselves or lucky enough to receive [it] from their employers.

From the House floor, Rep. Jan Schakowsky called the Stupack amendment a "back door way of overturning Roe v. Wade" and "an insult to millions of women." Here's an excerpt from her statement: 

“This health reform bill is about improving access to care, not further restricting a woman’s right to choose.  Our bill is about lowering health care costs for millions of women and their families, not further marginalizing women by forcing them to pay more for their care.    This amendment is a back door way of overturning Roe v. Wade; it is a disservice and insult to millions of women throughout our country.

In his own floor speech, Rep. Mike Quigley echoed that sentiment: 

QUIGLEY: But this amendment disrupts that sense of equality. This amendment says only women who can afford insurance deserve access to reproductive health care. This amendment says that women who need a little help paying for health care have to surrender their right to privacy. This amendment will serve only to hurt low-income women and restrict their ability to access reproductive health care, even with their own money.

Joining Lipinski and Costello in backing the Stupack amendment, though, was Rep. Mark Kirk, a candidate who has earned endorsements from Planned Parenthood in several elections because of his pro-choice voting record. Kati Phillips, spokesperson for Alexi Giannoulias, offered this assessment of the Republican Senate candidate's latest flip-flop:

"Mark Kirk proved tonight he will abandon all of his principles to curry favor with right wingers like Sarah Palin. He flip-flopped on the Clean Energy bill because the right wing demanded it, and now he has abandoned his once pro-choice voting record to take private insurance coverage away from women. Mark Kirk has sold his soul in the pursuit of Sarah Palin's endorsement."

Democratic Senate contender Cheryle Jackson chimed in, as well:

Mark Kirk says he is pro-choice but Halloween has come and gone and now that mask has been stripped away and we see him for what he is – an anti-choice, right-wing extremist who panders to Sarah Palin and turns his back on the women of Illinois. The final health care bill must provide access to reproductive health services for all women and girls, whether or not they are poor and receive government subsidized care. We cannot allow income to determine who gets care and services, and who does not.

Aside from the abortion measure, Kirk threw his lot in with the Republican leadership's bare-bones reform plan, which was promptly defeated 258-176. It's no surprise why; the CBO estimated that the Democratic plan covers 12 times as many uninsured people and saves $36 billion more than the Republican bill. Rep. Tim Johnson must have been the only Republican member to read the report, as the Urbana lawmaker was the lone member on his side of the aisle to vote against the substitute bill. He also sided with the Democrats on a motion to recommit vote intended to derail the legislation entirely.

The focus now turns to the Senate, where Sen. Dick Durbin says the going will get tough. Formal debate should begin after Thanksgiving.