gwen: it's the law of the land. most expansive health care overhaul in history. we'll tell you how it happened, what's in it and why fight's still not over. tonight on "washington week." >> today, after almost a century of trying, today, after over a year of debate, today, after all the votes have been tallied, health insurance reform becomes law in the united states of america. gwen: it was a fight to the finish. >> please let me answer. gwen: complete with sore losers. >> you kids -- >> we will work in every way to repeal this legislation and start over. gwen: and astonished winner. >> i believe that this is what we came here to do.

>> yes, we can! gwen: changes to medicare, extended coverage for young adults in the -- and the uninsured and for prescription drugs. plus a nearly trillion dollar price tag. also this week, big developments with old allies and former enemies. as tensions build between the u.s. and israel over a settlement freeze. >> it exposes daylight between israel and the united states that others in the region hope to exploit. gwen: and the u.s. agrees to a nuclear deal with russia. covering the week, ceci connolly of "the washington post." alexis simendinger of "national journal." helene cooper of "the new york times." and paul richter of the "los angeles times." >> award winning reporting and analysis, covering history as it happens. live from our nation's capital, this is "washington week with gwen ifill."

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>> we're giving away millions for ideas that make the -- move the world forward. every pepsi refreshes the world. >> additional fung for "washington week" is provided by exxonmobil. the annenberg foundation, the corporation for public broadcasting and by contributions to your pbs station from viewers like you. once again, live from washington, moderator gwen ifill. gwen: good evening. no doubt about it. the president of the united states was one happy man this week, in iowa, he rubbed it in a bit. reminding supporters that republican fears about his health care plan had not immediately come to pass. >> after i sign the bill i look around to see if there were any destroyeds -- asteroids falling or -- >> [applause] it turned out it was a nice day. people still have their doctors. gwen: but the president and his

aides know well the political problems have not gone away. a new national journal insiders poll shows virtually all, 97%, of congressional insiders, say their party will be more energized by the health bill's passage. >> the american people aren't going to take this lying down. the ink isn't even dry. and there's a grassroots revolt over this bill. gwen: of course, those are republicans. this white house chief of staff, rahm emmanuel, pushed back on the cbs newshour. >> i'm not in the business of giving political advice to rerns but that's not what the american people want and if that's the tone and tenor there's a political price to pay in november. gwen: but before we get to the political fight to come, let's recap the one just completed. ceci, how did these things come together? how did this come together in the end? >> as you all know, a very long year of twists and turns, it in the end came down to 61 critical final days that was

really on the president at this point finally. and we saw him do the outside game, the sort of rallies, he was in philadelphia and ohio and revving up the troops. but more important was the inside washington game that he was very intimately involved in. it was the traditional arm twisting. it was giving members rides on air force one. it was even cornering some of these poor lawmakers at parties where they thought they were coming to have a cocktail and celebrate one piece of legislation and suddenly he was draping his arm over them talking about health care and needing their vote. gwen: alexis, while the president was doing this, revving up, drawing his arm around people and basically twisting arms and all kinds of creative ways, republicans, not one of whom voted for this, were they pushing or twisting back? >> they were actually thinking very confidently about the trajectory, the strategy that they crafted very early in 2009. their whole idea was to start

with the obama agenda and vote no as often as possible and on health care they felt very strongly based on the polls and talking to their constituency, their base, that they were right to vote no all the way through. so they were actually very, very pleased with themselves, the solidarity. they were very interested in the kind of ex-al tation that the grassroots uprising that you heard there, mr. boehner talk about in the house. and there was lots of feeling that they were on the right path. that they can do two things. one is that they can broaden their majorities in the house and senate perhaps take over one or both chambers, and that this will be something that will wrap around president obama's neck and perhaps make him a one-term president. they feel very sure about that. gwen: i want to ask both of you because people are sitting at home tonight, fine, you've been talking about it forever and finally got it and it's now law, what difference does it make to me? isolate some very important parts of the law that will affect the most people. >> well, it's important to say that many of these provisions are not going to kick in until 2014. it's -- it takes a while to

implement this kind of change. and for about 160 million americans today who have health insurance through their jobs, they're not going to see too many big changes. but right away, in a matter of months, people who are under age 26 can be -- stay on their parents' health insurance policy. a lot of those seniors who get medicare, falling into the doughnut hole now, where they have to pay full coverage for their drugs, they'll get a rebate this year and then they'll start getting discounts every year thereafter. that's a couple of them. gwen: and a couple more? >> well, the impositions on the insurance companies kick in right away. basically this is the kind of thing that the president and democrats are really trying to tout. that right away, insurance companies can't dump you off the coverage. right away, children are not supposed to be expelled from insurance because of pre-existing conditions. right away, you are supposed to be able to not have a lifetime cap on your insurance. so the benefits are supposed to

be the front-loaded part of this. that we've all talked about. and then when you start seeing the wealthier medicare recipients pay more taxes later on, when you start seeing some of the taxes on the cadillac plans, most expensive health care plans, is way into the future. so right away, this year, they're really trying to emphasize the next six months and right away on the republican side they're emphasizing how hard it's going to be to implement. >> one of the bigger things that -- what are the bigger things that happen in 2014? >> the new set of exchanges, like an insurance marketplace or bazaar where people can do some comparison shopping. especially if you're an individual who's having trouble getting insurance or small businesses. over the next few years, they will also be providing some more tax credits to small businesses. and other -- another group that has a lot of trouble getting health insurance. and then we'll also start to see some of the changes in the way our health care system

works. and the idea is to start getting hospitals and doctors to kind of focus more on quality and less on quantity. and they'll do it by changing the way that they pay them. >> the other thing i would add is if this is supposed to be a right, this is what is so landmark about this, that all americans are supposed to have this right now, to health insurance -- gwen: or mandate. as republicans call it. >> that's when the 2014 big change happens. is the mandate that you must have insurance. or your -- you're taxed if you don't have it. and that's true for employers and for individuals. that's a huge change. >> you'll start paying penalties and knows will be increasing. -- and those will be increasing. >> i'm curious about -- i know this is so washington. but looking at just how president obama did it, were there lawmakers that he wasn't able to -- who was he not able to convince, for instance? >> incredible powers of persuasion. >> yes, i really think one of the big disappointments for him early in the year was olympia snowe, the republican senator from maine who obama just believed he was going to bring

her on board and he couldn't. in this final push, it was a congressman from pennsylvania, outside of pittsburgh, jason altmire, who was showered with presidential attention. two parties at the white house. phone calls from the president. rahm emanuel talking to him. cabinet officials calling. and in the end altmire who knows a lot about health care and worked in the insurance industry just said it's not popular in my district. gwen: wow. >> and then congressman kasich came to another conclusion. >> yes, he did. >> dennis kucinich. gwen: kasich a former congressman. >> kucinich who is advocate of a single payer government system, very liberal, he had been in the white house for meetings, too. and wasn't budging. and then he had this ride aboard air force one in the presidential cabin. gwen: air norse one rides. -- air force one rides.

>> it's a little bit of extra razzle-dazzle. but what he said and others have sort of confirmed, my reporting on this, is that the president made a very personal appeal and said you were with me in the early days of the presidential contest when you told your iowa delegates, if i -- kucinich doesn't win on the first ballot, go ahead and give your support to obama. that meant a lot to obama. and he was able to sort of bring that back to him and say, look, we've been through so much. my presidency is on the line. gwen: paul, do you have a question? >> a lot of the families that i know are really interested in this idea that the -- their young adult children will be able to stay on health care right away. is that as easy as it looks? or is there going to be some snag with that? gwen: so the -- said the parent at the table. >> you're right. that's the thing that i have heard from people in my office and on the street and

everything else. we'll have to see. but i think that insurance companies are going to know that they shouldn't be messing around with that one. because it's going to be so popular. there would be an uprising and i think the white house would probably pounce on them if it didn't occur. gwen: we've merd a lot this week about -- heard a lot this week about the pushback. the republicans didn't say it's law, we'll go home. we saw attorneys general, states attorneys general saying they were going to challenge the law. we saw everyone from john mccain to mitch mcconnell saying we would replace and repeal it. john kyl, one of the ranking republican members of the senate was on the newshour earlier this week and he said we know we're not going to really do that which i was surprised at. how serious -- candor -- how serious are they about not letting this die? >> well, the interesting element of it is the range of opposition. all of this is to legitimize what has just happened, to make this law seem a question mark in most voters' minds still. because there is this long

rampup to the implementation of it, the idea is in the states, mostly republican attorneys general, at least tere's 14 of them, so far, have -- at least bonded together in this case and in florida they're challenging this on constitutional grounds, the commerce clause, saying the federal government doesn't have the right to impose this on the states. most legal experts and certainly the white house are arguing that this is for political show. these cases are being either combined or being filed individually in the states and will not have merit. despite the fact that some of the republican attorneys general are saying this is going to go to the supreme court. gwen: and i want to ask you both, and everyone, we've all been in washington for a while and covered big stories like this before, but i've never seen this kind of rancor, this kind of anger on both sides. and this kind of partisanship almost seems too small a word for what we've seen. >> i think that rancor is more along the lines that i would think. because frankly, this was never

going to be a bipartisan endeavor. maybe president obama was the only person in this town who thought this there was a realistic chance of that. but the stakes have become so high because as alexis was pointing out, republicans think they have a chance at winning back congress or maybe one of the chambers. and they see that opportunity now. it's reminiscent of newt gingrich, i would say, and the takeover in 1994. >> the other thing i was going to add is we're all too young to remember this. but in 1988, there was catastrophic health care with medicare and what happened in 1988 was that there was uprising a year later by older americans who you may remember stormed -- from your history book, stormed dan rostenkowski and that was a bipartisan bill. that was supposed to be a pay as you go extra benefit. that was bipartisan. this is a very partisan bill. and to see the uprising is what

has given mcconnell and boehner and other republicans hope. gwen: nothing like an election year to test that theory. thank you both very much and i hope you get to take a break now. while the president was celebrating his admittedly huge domestic victory the ground was shifting on foreign policy matters. consider the curious case of this testy exchange of views with israel. at issue is israel's decision to build housing in east jerusalem. a move the u.s. considers bad for the peace process. >> the jewish people were building jerusalem 3,000 years ago. and the jewish people are building jerusalem today. jerusalem is not a settlement. it's our capital. >> the status quo is unsustainable for all sides. it promises only more violence and unrealized aspirations. as israel's friend, it is our responsibility to give credit when it is due and to tell the truth.

when it is needed. gwen: helene, is it me or friction came on suddenly or was it there under the surface all along? >> it's been under the circus -- the surface for as long as benjamin netanyahu has been prime minister for the past year. his latest reincarnation. i think there's been a lot of frustration that's been building at the white house with prime minister netanyahu. and that goes back to last june when the white house and the obama administration came out very strongly saying that they wanted a settlement freeze and no way and the white house backed down. and president obama i think has been sort of smarting from that. ever since. vice president joe biden, paul was with him on this trip, went to israel two weeks ago and was in the eyes of the white house, humiliated when on the same trip that he went to israel to -- jump-start peace talks and get -- make amends and get this relationship back, moving again. there was another announcement

of more housing construction in east jerusalem. president obama was furious. he called biden twice on this trip. he was very, very angry. and i think the obama administration, president obama, leading the way, sort of decided that they were going to draw a line in the stand. gwen: it is a different tact for the american administration. when israel does something that is interpreted as being provocative in this process, whether it's at the u.n., or anyplace, the u.s. says, looks the other way. and that's not happening now in this administration. >> it's certainly not happening now. and that goes back again to the fact that the president personally felt affronted and felt put out. and that clip that you just showed of netanyahu at the apac conference where he comes, presumably again to make amends, you skeel a meeting the next day -- schedule a meeting the next day with obama and he stands up at that speech and he pretty much pounds his chest. jerusalem is not a settlement. it's our capital. and that's very in your face. and that angered a lot of people at the white house again.

so -- and then the next day when he went in for his meeting with president obama, an hour before the meeting started, there was another announcement of more housing construction in east jerusalem. and i think that's just the combination of, you know, keeps ramping up like that. and you just saw that all collide. and it's been really surprising now. because everybody sort of expected that after sort of laying down how the u.s. felt about it, the obama administration would then drop back. and, you know -- gwen: not happening. >> and that's not happening. >> that makes me want to ask, does president obama believe that prime minister netanyahu can make peace, that he is a man who could deliver this? >> in many ways, that's exactly what all of this is about. i don't know the answer to that question, but i can certainly say with some -- i definitely think that president obama does not know for sure that he is. gwen: can i ask one question? since you were on that trip, did you get some sense of the insult from vice president

biden or from anybody who was traveling on this trip when this happened? >> apparently, vice president biden himself took it calmly, was business-like, there was not a great explosion about biden himself but from all indications when word got to washington, the president was -- vice president actually in his speech on thursday, at tel aviv university, spoke very favorably of prime minister netanyahu. it looked like the storm had passed. we got on the plane. we're heading back to the u.s. and we hear that -- the secretary of state hillary clinton has gotten on the phone with netanyahu again and read him the riot act. >> that's what's so interesting about this because a lot of that was coming from obama back in washington. gwen: and from secretary clinton we think. >> if you look at the history of the clinton administration, secretary -- bill clinton and bebe netanyahu did not get along very well. rahm 'em nume. there's a lot of bad blood there.

>> i would suspect that there could be ramifications at home for president obama. how do you see it playing out domestically? >> it's a really tricky rope that he's walking right now. because he's already getting a lot of criticism from republicans who say that israel is our ally, he should be beating up on iran, why is he doing this? the apac lobby and a lot of the pro-israel lobby in washington and all around the country is not entirely sure, you know, that they trust president obama anyway. that he hasn't proven his metal to them. -- mettle to them. it is a risky strategy for him but in a lot of ways almost like he's shooting for the fences. he's got health care. >> and why not peace? >> and people are looking to see if he's tough enough. gwen: and relations tenuous with israel they moved forward with russia as the intention to sign on to a long promised arms treaty. nor president obama this means a chance to keep another promise moving toward a

nuclear-free world. so how significant in reality is this, paul? >> i think it's very significantly. the two presidents, president of russia and the u.s. were on the phone today to seal the final details of this treaty which they'll call the new start treaty. and essentially, it lowers the number of deployed long distance warheads by 30%. that's a big deal. and it will bring the arsenals of the two countries, essentially back down to 1960's levels. which was -- still pretty high but that's a big number. for obama, it means that a couple of things. a couple of favorable things. one is that this is a very tangible foreign policy achievement. at a time when he hasn't had a lot in the recent past. second of all, it's a step forward with russia. the administration has been saying for years that they wanted to reset relations with russia. that's a good thing. and perhaps its biggest

significance is it opens the way for this entire nonproliferation program that obama has been working on. some people in the administration think this may be his biggest, his most long-lasting legacy. in fact, on foreign policy. this allows the u.s. to say, look, we in the united states are cutting back on our nuclear arsenal so all of you medium sized countries who might be interested in getting bombs of your own, please, head with us in the other direction. >> paul, i thought i heard secretary clinton say, and of course i expect this to be passed in the senate, is it really that easy? gwen: ratified. >> ratified. is it that easy? >> the administration is confident. that it can get through. on the other hand, the republicans are not in a koop active mood these days you -- a cooperative mood these days you may have noticed. there's an issue of time. the last couple of big treaties on this subject have taken one -- one took more than a year. the other one took nine months. it's going to be a crowded

schedule for the senate. some of the republicans are already saying that they're going to scrutinize this treaty closely to see if it really protects our interests on verification and on missile defense. and the text. treaty is not yet out. so there's a certain amount of uncertainty about what we're really going to find in there. >> what are the ramifications for other interests that the united states and russia might be thinking about or working on? are there some other natural outgrowths of goodwill and success? gwen: say iran, for instance. nuclear ambitions. >> well, the whole iran portfolio, if you have been watching this closely, is a very uncertain one. what we saw today seemed to be a very positive step for the u.s. and russia. and yet other things that are not going quite as well. you noticed secretary clinton was in moscow last week. and she basically chewed out the russians for going ahead with their construction of an iranian nuclear reactor.

peaceful nuclear reactor, which she said was contrary to the spirit of all these efforts of world powers are making to try to isolate iran and keep them from going ahead with their nuclear program. so it's a very panchy situation. we've seen a positive step, it's not all sweetness and light with the russians. >> is this agreement or theory substantive? or is it more symbolic? is this a real, you know, -- gwen: quick answer. >> it's heading us in the right direction. on the other hand, the russian nuclear arsenal was already coming down. it's an aging arsenal. the russians don't want to spend their limited resources on these bombs that they probably won't use. so at the beginning of the administration, the russians and the u.s. were looking at this treaty as low hanging fruit. something that they would be able to do. gwen: it still took a year. >> they fought over it for eight months. verification and the whole missile defense issue were big

on. gwen: it seems like nothing is easy for this or any administration probably. paul, thank you. welcome to "washington week." thank you, everyone else as well. i didn't mean to ignore you. we have to go but the conversation continues online. head to pbs.org/washingtonweek. and you can follow us on facebook, tweet us on twitter, watch our online only "washington week" webcast and one of my favorite features the vault where you'll find classic, free facebook is what that means, "washington week" episodes. this week's feature, the 15th anniversary of the program from 1982. keep up with daily developments on the pbs newshour and we'll see you gn around the table next week -- see you again around the table next week on "washington week." for those celebrating, have a blessed passover. good night. >> "washington week" was provided by weta which is solely responsible for its content. corporate funding for "washington week" is provided by -- >> natural gas is a cleaner

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