After a 14-month acrimonious battle, and with their political future in question, Democrats in the U.S. House of Representatives on Sunday passed significant health care reform legislation, putting the Senate-passed legislation before President Barack Obama for his signature into law.
Making health care available to millions of uninsured Americans and putting an end to the practice of denying coverage to people with preexisting conditions is not radical reform. It is a step in the right direction.
Would any American deny that this nation’s health care system is broken? Under today’s system, too many people have no health insurance coverage, too many people are denied treatment for pre-existing conditions, and too many people are dying unnecessarily while insurance executives look for loopholes to deny treatment.
It will take future improvements in the legislation to drive down the escalating cost of health care, but there is no doubt that the health insurance reform legislation that passed the House on a vote of 219-212 is a major achievement. Republicans, the party of “no,” moved in lockstep voting against the reform plan, joined by 34 dissident Democrats. Supporters passed the bill with just three votes to spare.
The simple truth is that it will take years for all the reforms to be put in place. Republicans have vowed to reverse the plan if they are restored to power. Do they really believe that we should return to today’s system with 47 million uninsured Americans and countless individuals forced into bankruptcy because of outrageous medical bills?
Additionally, Republican attorneys general — including shamefully Rob McKenna of Washington — have announced plans to challenge the health care legislation, claiming it treads on state sovereignty. Rep. Brendan Williams, D-Olympia, said it best: “Clearly, Mr. McKenna needs to recover his far-right, anti-government credentials after handing out $600,000 in bonuses to his staff. However, he should not do so at the expense of working families in Washington denied health care by the greedy insurers that back him. Nor should Washington join secessionist states like Alabama and South Carolina in firing upon the union.”
INSURING THE UNINSURED
The nonpartisan Congressional Budget Office said the act will extend coverage to 32 million Americans who lack it, bans insurers form denying coverage on the basis of pre-existing medical conditions and cuts deficits by an estimated $138 billion over the next 10 years.
The keys to reform:
• Cost: An estimated $940 billion over 10 years.
• Coverage: With 32 million Americans having access to health insurance coverage, 95 percent of eligible Americans will have coverage in 2014 when that portion of the plan is phased in. That’s up from 83 percent today.
• Insurance mandate: Almost everyone is required to be insured or else pay a fine. There is an exemption for low-income people.
• Insurance reforms: In addition to banning insurers from denying coverage to people with pre-existing conditions, or charging them more, the legislation bans higher premiums for women. Insurers cannot put lifetime dollar limits on policies or deny children access to coverage because of medical problems. Parents will be able to keep their kids on their insurance plans until age 26.
• Medicaid: Expands the federal-state Medicaid insurance program for the poor.
• Taxes: High-income families will be hit with a tax increase on wages and a new levy on investments. A new 3.8 percent tax will be imposed on interest, dividends, capital gains and other investment income for individuals making more than $200,000 a year and couples making $250,000. The bill also increases the Medicare payroll tax by 0.9 percentage points to 2.35 percent on wages above $200,000 for individuals and $250,000 for married couples filing jointly.
• Prescription drugs: Gradually closes the “doughnut hole” gap in Medicare drug coverage that seniors fall into once they have spent $2,830.
• Insurance plans: There is no government-run insurance plan. Small businesses, the self- employed and the uninsured will be able to pick a plan from new state-based purchasing pools called exchanges. People working for small to large companies will not see major changes.
• Abortion funding: The proposal keeps the Senate’s language on abortion. After passage of the health care reform measure in House, Obama issued an executive order that reaffirms restrictions on the use of federal funds for abortion. While the legislation as written maintains current law, the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation’s restrictions against the public funding of abortions cannot be circumvented.
For insured, middle-class America, there is little in the way of change in this legislation. This bill is aimed at the poor and the uninsured. Unfortunately, it does little to address the issue of health care costs. That’s the next challenge facing lawmakers.
Republicans have only themselves to blame for being squeezed out of the process. They have let conservative talk radio hosts drive the opposition. Using fear and false claims, those pundits made it impossible for rational Republicans to participate fully in the legislative process.
As for claims about lack of transparency — that the health care reform legislation was crafted behind closed doors — Americans know that every detail of this legislation has been discussed in the public square over 14 grueling months. In fact, we can’t remember a more public debate on major legislation.
Obama and Democrats in Congress have done something several previous administrations have been unable to do — pass substantive reforms to our broken health care system. In the process, they will have improved the lives of countless Americans, and for that they have earned our thanks.