The Affordable Health Care for America Act was approved by the U.S. House Saturday night with overwhelming support from progressive Democrats in the chamber and a president who was elected with the enthusiastic support of progressive voters.

But that does not mean that informed and engaged progressives are entirely enthusiastic.

In fact, some are openly opposed to it -- among them former Congressional Progressive Caucus Chair Dennis Kucinich, D-Ohio, and CPC member Eric Massa, D-N.Y., both of whom voted “no” when the House approved the measure by a narrow 220-215 vote Saturday.

How can this be?

Well, of course, the debate over this 1,900-page behemoth of a bill is more complicated than the easy spin of political insiders -- and media cheering sections -- would have Americans believe. Indeed, some key interest groups and congressional representatives suggest that the bill as currently constructed could make a bad situation worse.

Many sincere progressives in the House, and outside of it, backed the bill as the best that could be gotten. Others supported it on the theory that flaws could be fixed in the Senate and in the reconciliation of the House and Senate bills.

But those repairs will only be made if activists are conscious of what ails this bill.

For that reason, even supporters of the House legislation would be wise to consider these six smart progressive complaints about the bill:

1. FROM THE NATIONAL ORGANIZATION FOR WOMEN: This bill obliterates women’s fundamental right to choose.

“The House of Representatives has dealt the worst blow to women’s fundamental right to self-determination in order to buy a few votes for reform of the profit-driven health insurance industry. We must protect the rights we fought for in Roe v. Wade. We cannot and will not support a health care bill that strips millions of women of their existing access to abortion. ...

“The Stupak Amendment (to the House bill, which was approved and attached on Saturday) goes far beyond the abusive Hyde Amendment, which has denied federal funding of abortion since 1976. The Stupak Amendment, if incorporated into the final version of health insurance reform legislation, will:

“• Prevent women receiving tax subsidies from using their own money to purchase private insurance that covers abortion.

“• Prevent women participating in the public health insurance exchange, administered by private insurance companies, from using 100 percent of their own money to purchase private insurance that covers abortion.

“• Prevent low-income women from accessing abortion entirely, in many cases.

“NOW calls on the Senate to pass a health care bill that respects women’s constitutionally protected right to abortion and calls on President Obama to refuse to sign any health care bill that restricts women’s access to affordable, quality reproductive health care.”

2. FROM THE CALIFORNIA NURSES ASSOCIATION: This bill fails to control costs.

“While the current bills will provide limited assistance for some, the inconvenient truth is they fall far short in effective controls on skyrocketing insurance, pharmaceutical and hospital costs, do little to stop insurance companies from denying needed medical care recommended by doctors, and provide little relief for Americans with employer-sponsored insurance worried about health security for themselves and their families.”

3. FROM CONGRESSMAN ERIC MASSA: This bill will enshrine in law the monopolistic powers of the private health insurance industry.

“At the highest level, this bill will enshrine in law the monopolistic powers of the private health insurance industry, period. There’s really no other way to look at it. I believe the private health insurance industry is part of the problem.

“This bill also, I believe, fails to address the fundamental question before the American people, and that is how do we control the costs of health care. It does not address interstate portability, as Medicare does. It does not address real medical malpractice insurance reform. It does not address the incredible waste and fraud that are currently in the system.”

4. FROM PLANNED PARENTHOOD’S CECILE RICHARDS: This bill embraces religious-right extremes.

“It is extremely unfortunate that the United States Conference of Catholic Bishops and anti-choice opponents were able to hijack the health care reform bill in their dedicated attempt to ban all legal abortion in the United States.

“Most telling is the fact that the vast majority of members of the House who supported the Stupak/Pitts Amendment in today’s vote do not support HR 3962, revealing their true motive, which is to kill the health care reform bill.”

5. FROM CONGRESSMAN DENNIS KUCINICH: This bill worries about the health of Wall Street, not America.

“We have been led to believe that we must make our health care choices only within the current structure of a predatory, for-profit insurance system which makes money not providing health care. We cannot fault the insurance companies for being what they are. But we can fault legislation in which the government incentivizes the perpetuation, indeed the strengthening, of the for-profit health insurance industry, the very source of the problem. When health insurance companies deny care or raise premiums, co-pays and deductibles they are simply trying to make a profit. That is our system. ...

“But instead of working toward the elimination of for-profit insurance, H.R. 3962 would put the government in the role of accelerating the privatization of health care. ...

“During the debate, when the interests of insurance companies would have been effectively challenged, that challenge was turned back. The ‘robust public option’ which would have offered a modicum of competition to a monopolistic industry was whittled down from an initial potential enrollment of 129 million Americans to 6 million. An amendment which would have protected the rights of states to pursue single-payer health care was stripped from the bill at the request of the administration. Looking ahead, we cringe at the prospect of even greater favors for insurance companies. ...

“This health care bill continues the redistribution of wealth to Wall Street at the expense of America’s manufacturing and service economies which suffer from costs other countries do not have to bear, especially the cost of health care. ...”

6. FROM “SICKO’S” DONNA SMITH: The bill does not cure what ails us.

“Passing a health care reform bill that does not provide me with better access to care or protection from bankruptcy and financial ruin is not what I asked you all to do. Stripping away all reference to a progressively financed, single standard of high quality health care for all -- also known as single-payer -- is done only to more deeply ensconce the deep pocketed interests in health care: the private, for-profit insurance giants, the big pharmaceuticals, the medical equipment companies, the hospital corporations and all the other making huge profits as thousands die needless deaths.”

Watch Smith’s video: “American Sickos: Will the Current Bills Help? No.” And follow Smith’s organizing for real reform at the website of Progressive Democrats of America. She is the national co-chair of PDA’s “Health care NOT Warfare” campaign.

John Nichols is the associate editor of The Capital Times. jnichols@madison.com

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