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House passes health care, kicks-off to Senate
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Pelosi & Hoyer after passing health care in the House
After a long day, with 14 hours of debate and compromise, last night, the House of Representatives passed a health care bill by a vote of 220-215, just two votes higher than the required majority of 218. The historic vote was not entirely along party lines with 39 Democrats voting against it and one Republican, Rep. Ahn Cao, R-LA, having the courage to step across the political line in the sand and vote for it.
Last night’s vote was historic, because passing the bill on the floor of the House was a major roadblock that had to be passed, a giant step towards achieving solid health care reform. But before anyone breaks out the cheap champagne, it must be understood that it is still way too early to begin celebrating victory. The House has merely scored a field goal, and kicked-off to the Senate. In the Senate, the majority leadership is brokering and compromising within its own caucus in a desperate attempt to get the 60 procedural votes to get their version of the bill onto the Senate floor where they would then need only 51 votes to pass.
A year ago, few would have thought even getting this far would be possible. Barack Obama was the new President-Elect, the economy was collapsing around us, millions of people were losing their jobs and with it their health insurance. To some, the economic crisis signaled the need to put everything on hold. Conservatives suddenly got fiscally responsible and called for the need to stop spending, give the rich more tax breaks, and if their strategy worked, to wait another five or 10 years for the economy to recover, if it ever did. They wanted to slow down, and essentially do nothing. Meanwhile the insurance companies would continue to get richer and millions more Americans would lose their coverage.
Instead, 219 House Democrats and one Republican recognized that without some sort of mechanism to keep health care costs at a level that is affordable for more Americans, the economy would be negatively impacted even more. These 220 courageous men and women recognized that without legislation to regulate an industry which for decades has been going rogue, the insurance companies would get even more rogue, and that’s a bad thing for the health of America. This majority-plus-two understood that the American people need for Congress to stop the rhetoric and act for the betterment of America’s health.
The insurance industry has long made practices such as declaring people uninsurable due to pre-existing conditions the industry standard. They have dropped sick people from coverage, and have been raising rates for coverage faster than all but the richest Americans can bear. The insurance industry has abused low-income Americans for years with unfettered abandon as they enjoyed unprecedented protections and exceptions by the federal government. Not surprisingly, they’ve been amassing record profits while the rest of America faces severe recession.
H.R. 3862, called the “Affordable Health Care for America Act,” includes a public option and national exchange for the uninsured and small businesses to purchase affordable health insurance. Insurance companies are prohibited from denying coverage based on pre-existing conditions, and they can’t drop you when you need coverage the most. Deductibles are somewhat brought into line with the annual out of pocket spending by any individual capped at $5,000. The Department of Health and Human Services will negotiate the rates of reimbursement doctors and hospitals will receive for their services instead of the insurance companies setting the amount they will cover for treatments, care, and other medical related services.
The bill uses other measures as well, to increase coverage by an estimated 36 million people. It increases the age to 27, up to which an individual can remain insured under his or her parent’s family coverage. H.R. 3862 expands Medicaid eligibility from low-income individuals whose earnings are at 100 percent or lower of the Federal Poverty Level, to include eligibility for those whose income is at 150 percent of the poverty level. It provides tax subsidies for individuals on a sliding scale of between 150 and 400 percent of the poverty level, and provides subsidies for small business employers as well.
H.R. 3862 also eliminates the Medicare “doughnut hole” over 10 years. After a Medicare patient reaches the prescription drug coverage limit, that Medicare recipient is forced to pay 100 percent of their prescription costs until their expenses reach the catastrophic coverage threshold. It is a “doughnut hole” in their coverage. It is more like a “manhole” into which Medicare recipients fall as mounting health care costs rob them of their retirement.
The numbers of those who could be considered the “losers” if this bill becomes law in its current form, are certainly fewer than the number of American citizens who would benefit from its passage, and among them are the rich. The rich insurance executives will have to cut profits and dividends and maybe even take less of a raise in order to insure everyone, including the high-risk patients. Not any less distasteful to insurance executives, insurance companies will have to deal with numerous regulations to keep them honest, something they have fought ferociously with lies and misinformation. But though the insurance industry leaders and lobbyists may carry on as though this legislation marks the end of the private insurance industry and even America as we know it, and that it will kill millions more jobs, just couldn’t be farther from the truth. It will regulate them but it will not kill them. Under this bill, the insurance industry will still have enormous potential to make profit and even gain market share, but it will force them to begin cutting waste, standardize practices and stopping cheating Americans out of life. Some critics of the bill might say, not enough.
But aside from rich insurance executives, any individual whose annual income is over $500K or couple whose joint income is over $1,000,000 may consider themselves losers because they will see their taxes increased to pay for a bill that the Congressional Budget Office estimates will actually decrease the deficit while at the same time expand coverage to tens of millions of more Americans. It is not the redistribution of wealth the Right-Wing Machine is claiming, it is simply a question of everyone who can, doing their part to improve the quality of life in America.
In a last minute compromise, one which outraged social liberals in the House, a special provision was amended into the bill which prohibits federal funds from covering abortions. Women who are having an abortion would need to purchase extra coverage in the form of a rider to insurance purchased on the exchange. This amendment unfairly discriminates against a woman who is facing a difficult time, however it is a compromise that must be tolerated. Social conservatives in both parties will kill any bill that even hints at funding abortions, so it is an ideological sticking point which must be eliminated and the House leadership did just enough to finish what needed to be done, and that was to reach 218 votes.
Speaker Nancy Pelosi and other House Democratic leaders should be commended for what they’ve accomplished, overcoming the obstructionism of the Republicans and the social conservatives, and successfully passing health care reform that can help the majority of Americans. Representative Cao, the lone Republican should be commended for voting with his heart and not based on a forced partisan predetermined ideology. Those are the kinds of things that prove our system still works.
Photo credit: House Majority Leader Steny Hoyer and Speaker Nancy Pelosi arrive for a press conference after the passage in the house of the health care reform bill at the U.S. Capitol. Saturday, November 7th, 2009 in Washington. (AP Photo / J. David Ake)
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