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Mr Obama had no difficulty. To circumvent the "Medicare-for-all" bill passed by the House (which was NOT HR 676, "single payer") Harry Reid in the US Senate chamber read the PPACA, as drafted by lobbyists, provision by provision as amendments* to a highway appropriation bill that had pass the House and was waiting ratification by the Senate chamber. I have posted here an image of amendments en bloc read into the Congressional Record (@thomas.loc) that day. The Senate passed the appropriations bill as amended and Mr Obama signed it into law, March 2010. Even ProPublica --in its better days -- ran a series of articles explaining the novel employment of House Rules to circumvent required conference committee reading and reconciliation before referring any bill for POTUS signature. Subsequently the odious spent the next 18 months or so between chambers correcting (emending) operating limits and appropriations "details" and political defects in the Act discovered by opponents and "concerned citizens"; litigation also ensued.
The question whether HR 676 --"single payer" which had/has double digit co-sponsors in the House-- was "impossible" to enact is irrelevant to the facts. A false dichotomy. Obama and Democratic Party "leaders" (1) never endorsed the concept and (2) sabotaged the Medicare-for-all bills (sponsored by Dingle or Kennedy) before and during Obama's tour of MAGA.
*another most recent demonstration of devious legislating with Republican Party co-operation.
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