WASHINGTON — Democrats in Congress raised their arms in celebration on Sunday night, after a sweeping health care bill passed the U.S. House with only a handful of votes to spare.

Oregon Democrats, local seniors and the region’s largest hospital company hailed the passage of a $940 billion health care bill that would expand coverage to 32 million people. But Oregon’s lone Republican congressman and a handful of local doctors said they’re skeptical that the bill will deliver everything it’s promising.

The bill will ban insurance companies from denying coverage based on pre-existing conditions, end lifetime caps on insurance coverage and require nearly all Americans to have health insurance.

And for Oregon, the bill will mean a short-term influx of money for hospitals and doctors, through higher Medicare payments, and the prospect of higher payments in the long term as well.

After the bill passed, Rep. Peter DeFazio, D-Springfield, said it ranks as one of the most positive of the historic votes he’s taken.

“I’ve been through a couple of wars, an impeachment. None of those was really productive,” DeFazio said. “This should benefit the American people for years to come, with a few changes.”

Rep. Greg Walden, R-Hood River, didn’t shift from his stance of staunch opposition to the sweeping measure. Walden said that even a provision designed to increase Medicare payments to Oregon doctors may end up delivering less than Democrats are promising.

Although the vote was close, the outcome was sealed late Sunday afternoon, when Michigan Democratic Rep. Bart Stupak announced that he had reached a deal with President Barack Obama on how to treat insurance coverage of abortion. Obama agreed to issue an executive order reaffirming that federal money can’t be used to fund abortions.

Walden said it appeared that Stupak and a handful of other anti-abortion Democrats sold their votes cheaply, given that an executive order can be reversed by legislation.

“I can’t imagine if that was your core issue, that (executive order) is a solution to your problem,” Walden said.

Politically, Walden said it’s clear that the bill has done more to stir up anger among the Republican base than it has to satisfy the Democratic one. The National Republican Congressional Committee polling shows people strongly opposed to the bill outnumber people strongly in favor of it by about 2-1.

“That’s what drives turnout, that’s what drives action,” Walden said.

Walden also said he’s skeptical that a deal to increase Medicare payment rates to Oregon and 16 other states would help local doctors as much as Democrats believe.

Medicare provision

The deal reached early Saturday provides $800 million over two years to 17 states with low Medicare reimbursement rates. President Barack Obama also pledged to launch two studies to rewrite the Medicare payments formula after 2012, to make it fairer to those states, Walden agreed that the deal would help Oregon health care providers in the short term, but he was skeptical that a new formula would ever take effect, given likely opposition from states like New York, which would see cuts in Medicare payments to their doctors.

“I’m not betting that New York and Florida and California are going to agree to decrease their payment rates,” Walden said.

Meanwhile, the National Republican Congressional Committee attacked the provision as a “backroom deal,” to help buy the vote of Rep. Kurt Schrader, D-Canby. Schrader announced he would support the health care bill after the deal was reached. DeFazio had threatened to vote against the bill unless the provision was added.

Schrader called the provision “a pretty front room deal,” and said it will end up saving Medicare money and helping doctors in Oregon.

“Make my day by bringing that up as a campaign issue,” Schrader said.

Walden, who is a top lieutenant at the NRCC, said he wasn’t involved in the attack on Schrader. Asked if the provision amounted to a backroom deal for Schrader, Walden said “I don’t know what discussions he was in.”

On Sunday afternoon, DeFazio acknowledged that sweetheart deals remain in the bill, which he blamed on Senate Democrats. But he forcefully rejected that the Medicare provision was undeserved, in an interview just off of the House floor.

“If they think it costs 3 1/2 times as much to do the same medical procedure in Miami or Boston or New York (as in Oregon) and we’re not wasting an incredible amount of money, if they know any seniors who can’t get into see doctors because our doctors are being reimbursed below their lowest cost of care and our hospitals for insured people, are shifting costs onto them from the under-reimbursement of Medicare, if they think that’s all good, if they think it’s good that seniors can’t get in to see doctors, then more power to them.” DeFazio said.

Rep. David Wu, D-Portland, said President Barack Obama’s promise to rewrite the formula for Medicare payments will make the program more fair for dozens of states, not just Oregon.

“It’s not a matter of cutting out a handful of states,” Wu said. “That’s the old politics.”

The bill is a first step, said Gary Plant, a physician with the Madras Medical Group.

“Just getting that many more people insured is going to have a tremendous impact, certainly in Jefferson County,” Plant said, noting that about 10 percent to 15 percent of the patients at his practice are uninsured.

And without insurance, people let medical problems go, turning simple problems, like a small skin infection, into bigger, more costly issues.

“A lot of people have ended up using the emergency room as their primary care clinic, which of course is the most expensive way of getting the care they need, and tend to not get their chronic conditions taken care of,” Plant said.

Bob Hakala, the co-medical director at Volunteers in Medicine’s Clinic of the Cascades, said that he doesn’t expect any immediate improvements from the bill.

Implementation delay

“In the immediate time frame, it probably won’t change the population we serve because it’s going to take a while to implement this,” he said. “There are so many people in our county right now that need our services, that we can’t meet the need currently. I don’t think that’s going to change.”

Bend retiree Jack O’Malley, 71, said the health care bill isn’t everything he hoped for, but it’s better than the status quo.

“What’s happening in Congress is not perfect, but it’s a start,” said O’Malley, who is also a volunteer spokesman for AARP. “Medicare wasn’t perfect either when it was passed.”

‘Donut hole’ closure

O’Malley said the eventual closure of the “donut hole” in Medicare’s prescription drug coverage would be the most important feature for him and his wife, who is a nurse at St. Charles Bend. The donut hole is a gap in coverage that begins after Medicare customers spend more than $2,700 in a year, and ends once they spend $6,100.

For the country, the bill’s provisions to expand coverage to about 32 million people who are currently uninsured is the biggest achievement, O’Malley said.

“If 30 million people can somehow get coverage, to me that’s well worth it,” O’Malley said.

While many of the speeches delivered Sunday were gravely serious, members had time for wisecracks, on and off the floor.

“I regret that I have but 15 seconds to give for my colleague,” said Rep. Darrell Issa, R-Calif., when a fellow Republican ran out of time to speak on the floor.

Outside the House side of the Capitol, a throng of protesters kept up a steady song of chanting, cheering and jeering throughout the day. “Kill the bill!” was most popular, but “Naaaancy!” after House Speaker Nancy Pelosi, D-Calif., and snippets of the Tom Petty hit, “I won’t back down” were also heard.

Walden took part, too. Standing on the balcony overlooking the protesters, Walden held the “I” in string of handwritten signs spelling “Kill the bill.” He also posted a picture of the protest to his Twitter page.

Asked about other members of Congress who were egging on protesters, Blumenauer said they were “just idiots.”

Wu had a sunnier assessment.

“This is what makes America great,” Wu said.

A package of amendments to the bill will to go to the Senate for a vote later this week.

Now, Walden said, he has his staff combing through the bill, so they’re ready to answer constituent questions about what it will mean for them.

“We need to be prepared to start answering those questions,” Walden said.