In defense of the Senate Health Care Reform Bill
The health care bill that has just passed in the Senate is a major accomplishment and a big step in the right direction for this county. There are faults in the current Senate legislation which have been listed on this site in great detail. But for me and many other people, the good far outweighs the bad in this bill. Here are only some of the important provisions that are in this bill:
- It drastically reduces the deficit — which has gotten completely out of control — saving the taxpayers hundreds of billions of dollars in the coming decades.
- It prevents insurance companies from dropping coverage for preexisting conditions. Never again will these corporations be able to discriminate against the sick and those most in need of coverage. Rescission of insurance coverage after a person gets sick is eliminated.
- Several health insurance options would be offered on a statewide basis and at least one of these national exchanges must be a non-profit. The Office of Personnel Management will negotiate for lower premiums just as they do for federal employees, including members of Congress.
- It closes the doughnut hole in Medicare Part D coverage so more seniors can afford their prescription drugs while saving the Medicare Trust Fund for nine more years and cutting waste, fraud, and abuse.
- The Senate bill expands the eligibility level for Medicaid to 133% of the poverty line (the House bill does 150%).
- Something for us students: unmarried children get to keep their coverage under their parents’ health insurance plan until the age of 26 (or 27 in the House bill). This will be a big help for those of us who will be paying off student loans for a long time to come.
- The Children’s Health Insurance Program (CHIP), which Bush vetoed a few years ago, will be reauthorized and funded for an additional two years.
- Those with incomes up to 400% of the poverty level would be eligible for public subsidies to help them pay for insurance from a state exchange program.
- Small businesses can receive tax credits for up to 35% of their insurance coverage costs.
- High-risk pools are established and funded so that those most at risk of medical illness can still buy insurance.
- It restricts the amount that insurance companies can charge for coverage for senior citizens, and keeps them accountable to their costumers by having to pay at least 85% of their revenue from premiums for providing coverage, rather than having much more of their money go to paying huge bonuses and advertising.
- The proposal sets an out-of-pocket expenses cap at $5,950 for an individual ($11,000 per family). At the same time, it ends arbitrary dollar limits imposed by the insurance companies on annual and lifetime benefits.
- It lowers costs, with the Congressional Budget Office saying that the cost of premiums will decrease for 93% of insured citizens.
- The Diabetes Prevention amendment that invests in wellness and preventive services was attached to the final bill. It also promotes preventive operations such as mammograms by banning co-pays for these procedures. Wellness measures such as gym memberships and nutritional counseling will be covered.
- A “Value Index” is instituted for Medicare payment that will adjust rates based on quality of care, not quantity.
- The bill includes $10 billion of investment in community health centers that provide low-cost localized services.
- Bottom line: the bill extends coverage to 31 million additional Americans.
These are just a few of the giant improvements that this bill provides for our health care system.
It’s also compelling to examine the reasoning expressed by some of the national figures who are supporters of the Senate bill. Every single Democratic senator is in favor of this bill. That means not just the conservatives and the establishment types like Reid and Schumer, but even the liberal core of the Democratic caucus is unanimously in favor of the Senate proposal. Every member of the Senate Democratic Caucus from every faction, from independents Joe Lieberman to Bernie Sanders and every senator in between (including Robert Byrd, Barbara Boxer, Sherrod Brown, Al Franken, and Russ Feingold) are supporters. And anyone who knew Ted Kennedy knew that he too would have voted for this proposal. His widow Vicki Kennedy wrote in a column earlier last week,
“Health care would finally be a right, and not a privilege, for the citizens of this country. While my husband believed in a robust public option as an effective way to lower costs and increase competition, he also believed in not losing sight of the forest for the trees.”
Bernie Sanders said essentially the same thing:
“The choice is doing nothing and allowing tens of thousands of Americans to die every year because they lack health care, or passing a bill which, while not perfect, does expand health care insurance for 31 million Americans, ends the odious practice of denying care for people with pre-existing conditions and, by expanding health centers, provides 25 million more Americans with primary health care and low-cost prescription drugs.”
And even though it was a different bill, members of the Progressive Caucus were nearly unanimous in their support for the health care reform bill in the House of Representatives. 81 of the 83 progressives in the House voted for the bill, including liberal luminaries like John Conyers, Maxine Waters, Lynn Woolsey, Jerry Nadler, John Lewis and many others. The only two dissenters were Dennis Kucinich, who always finds a way to take a principled stand against any major piece of legislation that comes before him, and Eric Massa, who is facing a very tough re-election campaign next year. Acclaimed liberal economist Paul Krugman summed up my feelings exactly and said in his New York Times column a few days ago, “Count me among those who consider this an awesome achievement. It’s a seriously flawed bill, we’ll spend years if not decades fixing it, but it’s nonetheless a huge step forward.” Yale professor Jacob Hacker, the creator of the public option idea, also endorsed the bill and said that it implements vital reforms.
There are also many smart, persuasive, and passionate progressives who are against this bill like Howard Dean, Keith Olbermann, and Eric Massa. I respect their opinion, but I honestly believe that they are wrong. It’s sad that a turncoat like Joe Lieberman could hold the entire process hostage to get revenge on the liberal base that defeated him in the primary in 2006. But Senate rules being what they are and almost all Republicans’ unwillingness to even come to the bargaining table, this is the final product that can actually become law. It’s not the bill I would have written — it’s not even close.
However, it is a major step forward for this country and this is the last best opportunity that we will have for decades to pass substantive health care reform. I congratulate the Senate Democrats for reaching a consensus on this extremely complicated issue and passing the bill earlier this morning. I am convinced that in the coming years the Patient Protection and Affordable Care Act of 2009 will be viewed as a massive success and I am proud to support it.
