Sunday night the U.S. House of Representatives passed health-care legislation with no Republicans voting yes. Voting for the bill from the St. Louis area delegation were: Democratic Reps. Lacy Clay and Russ Carnahan, both of St. Louis. Voting against were Republican Reps. Todd Akin of Town and Country and John Shimkus of Collinsville. The only Missouri Democrat voting no was Ike Skelton of Lexington. Democrat Jerry Costello of Belleville, whose vote had been uncertain, voted yes.

Comments from voting members of the local delegation:

"Today Americans are reacquainted with the danger of an arrogant all powerful government, a deadly enemy within, a clear and present danger in Washington," said U.S. Rep. Todd Akin, R-Town and Country. "In spite of nationwide opposition socialized medicine is being forced down our throats. That medicine is toxic to freedom. But freedom dies hard in America.

"I do not believe that the majority of Americans will submit passively to the gold chains of socialism.... I have confidence that freedom will rise from the ashes of socialism and that this nation under God will have a rebirth of liberty and a government of the people, by the people and for the people."

"But the status quo has fought change tooth and nail, playing political games to block, delay, distort, intimidate and say no to progress. Today, hope and change has triumphed over fear and obstruction....

"An American president once said, 'There has long been a need to assure every American financial access to high quality health care. As medical costs go up, that need grows more pressing. Now, for the first time, we have not just the need but the will to get this job done.' That president was Richard Nixon in 1974.

Indeed, the fight for quality, affordable health care dates back nearly 100 years... Today, we have finally fulfilled this century-old mission."

Before the vote, U.S. Rep. Ike Skelton, D-Lexington, released the following statement: "In reviewing the bill...I have not seen anything that eases my concerns over the direction of health-insurance reform legislation. At the end of the day, each of these proposals still could have serious unintended consequences for those with private insurance and could negatively impact rural health care.

"Therefore, I will not vote for them," said Skelton. "It is time for Congress to focus on the true challenges facing this nation: getting Americans back to work and protecting the United States from dangerous enemies abroad."

Rep. Jerry Costello, D-Belleville, whose vote was not certain until the last minute, had this to say about his yes vote:

"This has been the hardest decision regarding a vote I have had to make during my service in the House of Representatives. During that time, I have strived to serve the people I represent with diligence and integrity, while remaining true to my core individual beliefs.

"One of those core beliefs is my support of protecting the unborn. I along with Congressman Bart Stupak, D-MI, and other pro-life Democrats have worked hard through... to ensure that current law Hyde amendment abortion restrictions are applied to the final legislation. However, we were successful in convincing President Obama -– a pro-choice president -- to issue an executive order that clearly states that the Hyde amendment will apply to the bill....

"I stated that I would not vote for the Senate-passed bill in its current form. With the presidential executive order approving the Hyde abortion language and the fact that H.R. 4872 eliminates the 'Cornhusker Kickback' and other state-specific promises, combined with assurances from the Senate that H.R. 4872 will pass that body, I feel I can now support the Senate bill as amended.

"The fact is that this may be our last best chance to address a health care system that is unsustainable, that is spending $1 billion annually on medical costs for the uninsured while insurance premiums rise uncontrollably. Our current system is grossly inefficient and jeopardizes our future economic health. This legislation will insure 32 million additional Americans, eliminate pre-existing condition restrictions, allow for the interstate sale of health insurance, eliminate lifetime caps on insurance benefits, allow dependent children to stay on their parents’ insurance until age 26, and improve health care for seniors, all while reducing our budget deficit by $138 billion over the next 10 years, and by $1.2 trillion over the next 10."

"While we are in tough economic times, this bill increases taxes for individuals and employers," said Shimkus. "The only jobs created by this bill are to hire more IRS agents to enforce mandates and new bureaucrats to run this government takeover of health care.

"Additionally, gimmicks were used to make it appear as though the deficit would be reduced. This bill will not save the government money; it will cost the government money, which means it will cost you, the taxpayer, more money, lots of money."

Shimkus cited the impact on Medicaid: "The mandated increase in Medicaid forces a $2 billion additional cost on the state of Illinois -- another unfunded mandate in a state that's already $11 billion in debt."

U.S. Roy Blunt, R-Springfield, also voted no. Blunt is vying for the GOP nomination for U.S. Senate to replace Sen. Christopher S. "Kit" Bond, who is retiring.

"The bipartisan vote tonight was the vote against the colossal government intrusion into health care that passed the House. Like the thousands of Missourians I've heard from, a bipartisan coalition of Democrats and Republicans opposed Nancy Pelosi's government takeover of health care," said Blunt.

"This fight is not over. Our goal should be to improve what works and fix what's broken, but this bill does not achieve that end. I'll keep working to repeal this colossal government takeover of health care and replace it with sensible solutions.

"The plans I've proposed tackle everything from medical liability reform, to portability across state lines, to small business health plans. These bills can be debated one at a time, won't break the bank, and are common-sense updates to our health care system."

 Comments also came from other political leaders across the state.

U.S. Sen. Christopher S. "Kit" Bond criticized the House Democrats' vote.

"House Democrats have arrogantly defied the wishes of the American people who don't want the higher taxes, increased health-care costs, cuts to seniors' Medicare services, and new job-killing mandates on small businesses this bill will impose," said Bond.

In a similar vein, Lloyd Smith, executive director of the Missouri Republican Party, said in a statement: "The Democrats' bill does nothing to control costs; in fact, it was raise taxes, raise premiums, slash Medicare, and force a one-size-fits-all health care mandate on more than 300 million people.

"Americans have consistently made their opposition to the bill known -- at townhall meetings, massive rallies, and at the ballot box in states like Massachusetts, New Jersey, and Virginia -- but Democrats have ignored their wishes. Russ Carnahan, Lacy Clay, and Emanuel Cleaver have ignored the pleas of Missourians, instead siding with Nancy Pelosi to make her reckless bill the law of the land. Make no mistake: In November, Democrats across the nation and in Missouri will pay for abusing their power and thumbing their noses at the American people."

In contrast, Julie Terbrock, program director for Missouri ProVote, which campaigned for health-care reform, praised the House -- specifically Clay, Carnahan and Cleaver, for what she called a "courageous, history-making vote that will make Americans stronger and more secure."

"But make no mistake: Special interests and opponents of reform will be organizing from Day One to repeal this bill and take away our access to affordable health care. Our job is to stand our ground and not let that happen."

Ultimately, said Terbrock, "All Americans should have the same insurance choices members of Congress and their families enjoy. All of us can agree that if it's good enough for members of Congress, it's good enough for the people they represent."