It’s been 13 days; 13 days of markups(which Senator Dodd quips might be a new record), 13 days of partisan games, 13 days of financial hijinks and fake scandals, and finally, on the 13th day, the Health Education and Labor & Pensions(HELP) Committee passed the “Quality, Affordable Health Coverage for All Americans” bill! The bill has emerged from committee, passing along partisan lines, and is now ready for the next step of being combined with the Senate Finance Committee bill before being voted on by the entire Senate. So what does it look like?
Not much has changed since the Congressional Budget Office gave the bill a surprisingly low score on cost: it’s still got the all-important public plan and the employer mandate, which would make health care affordable and ensure that employers are providing coverage to those employees who choose to stick with their current plans. It also sets up Health Insurance Gateways, which will be run by states and act as the access point to health care insurance for the unisured and small businesses, who can choose between the public plan or any number of private insurers who choose to participate. Check out the below review of these pieces if your wonky side is a bit rusty:
- Community Health Insurance Option(Public Plan): Will ensure competition on a level playing field with private providers and offer competitive rates and premiums. Presumably, the plan will be able to use its administrative efficiency and its market power (assuming it is able to attract a significant number of applicants and providers) to lower premiums.
- Employer mandate: Large employers would have to provide coverage to their workers or pay $750 per full-time employee, $375 for each part-time employee. Businesses with less than 25 employees will receive a tax credit, on a sliding scale, based on the number of workers. Ezra Klein points out, “the CBO estimates that “a mere 150,000 will lose their coverage. That’s nothing. And it means that a lot more Americans end up insured and the government spends a lot less in subsidies.”
The Secretary of Health and Human Services will establish the public option in every single Gateway and provide the national plan with start-up funds that will have to be repaid in 10 years.
The rates negotiated with providers shall not be higher, in aggregate, than the average reimbursement rates paid by health insurance issuers offering qualified health plans through the Gateway.
It also includes what might be the only helpful Republican amendment, which requires every member of Congress and their staff to get health-insurance from the public plan if they are forced out of coverage due to reform (ironically enough, it doesn’t appear as if the ranking Republican on the Finance Committee, Senator Grassley, is quite ready to give up his special treatment). And while the legislation is not as good as the House bill, the fact that the Senate could even get a public plan out of committee is heartening for reform. Obama has also come out in support of the bill.
In other news, Republicans have responded to the House Democrats’ bill with a scary flow-chart. To which the Democrats have responded to with a chart of the Republicans’ plan:
The New Republic has also responded with a real chart detailing our current health care system. It’s quite possibly the most intimidating flow-chart I’ve ever seen.
But to get serious again: Despite the apparent victories, there’s still a long way to go. The Finance Committee’s bill, which includes important areas not under HELP’s jurisdiction (including Medicare), has yet to be finalized, but rumor has it that it sucks. Once that committee’s bill is passed, the Senate will have to somehow fuse the two bills, hopefully before it hits the floor for debate, and hopefully without gutting HELP’s public plan in favor of the suck-y Finance plan.
After debate tears through the Senate and a final bill is passed (probably along partisan lines, according to David Axelrod and Rahm Emanuel), it still needs to be harmonized with the House bill. The House bill, despite being <!– /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:”"; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:”Times New Roman”; mso-fareast-font-family:”Times New Roman”;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.25in 1.0in 1.25in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} –>
the strongest of the bills on the table now, is facing opposition from Blue Dog Democrats, who have threatened to block it in committee. In other words, the war is far from over.
The first steps will be taken on July 29th, when the House plans to vote on the Democrat plan. We’re working with HCAN to organize a day of action around that time to demand real health-care reform from the House, so stay tuned for the details, but until then, remember that every letter or call to your Congressmen counts. Remember that despite the power of special interests and insurance companies, you have a voice in this debate too, and you need to make sure Congress hears it.