Health Reform Bill Passes US Congress

After Dems Pass Health Reform Bill, Now What?

The Democratic-led Congress made history last night when it narrowly approved the version of the health care reform bill that the US Senate passed approximately two months ago.

Even with the unanimous opposition of Republican lawmakers and some 34 dissident Democrats, with a 219-212 vote, this Congress accomplished exactly what, for nearly a hundred years, many before it contemplated but for a variety of reasons failed to realize.

The bill, now headed to President Obama’s desk for his signature, among other things, promises to crack down on some of the worst insurance industry abuses (notably pre-existing condition and automatic indiscriminate termination clauses), infuse new efficiencies into the system, lengthen age requirements to allow coverage to children through age 26, and extend health care to tens of millions of currently uninsured Americans.

By far the most objective, independent review of this bill came from the nonpartisan Congressional Budget Office. The CBO confirmed that it would extend coverage to 32 million Americans who lack it and, in ten years, cut deficits by an estimated $138 billion.

However, even as we are all agog with jubilation, it is important to remember the hard lessons from this 14-month process. This health reform bill was almost not to be; it was on a few occasions, declared dead on arrival. The Obama Administration and the Democratic Congressional Leadership all but squandered the mandate they garnered from American people in the 2008 general elections.

There is little doubt that we certainly could have had a better bill had the Democrats displayed a unified sense of purpose and the right dose of assiduousness earlier in the process; that is, long before they lost their filibuster-proof majority in the Senate last January when they inexplicably turned over the Massachusetts seat previously occupied by the late Ted Kennedy.

The Senate bill falls woefully short of guaranteeing every American health coverage. Even the most generous estimates suggest that, fully realized, only 95 percent of all eligible individuals under age 65 would be covered.

The decision to rubber-stamp the Senate bill was itself borne out of desperation and political exigency. Feeling enormous pressure from President Obama, the Republican opposition and some core internal constituencies, the Democratic Leadership in the US House of Representatives basically caved, they realized that the surest way to get anything done and, by so doing, avoid political suicide in the mid-terms, was to adopt a two-step process that would allow the Senate version to be passed “as is” even as lawmakers sought to address any outstanding concerns with a “fix-it” companion bill.

The reconciliation bill that was also approved Sunday night with a 220-211 vote in the House and is now headed to the Senate for deliberations introduced the following key fixes to the Senate bill: address the donut hole (close the gap in Medicare prescription drug coverage by 2011 and extend a $250 rebate to seniors impacted this year by the gap), grant full-rate reimbursements to doctors caring for Medicaid patients, lower monetary sanctions for not buying insurance from $750 to $695, increase tax credits for middle-income families buying insurance, impose a Medicare tax on unearned income for families making more than $250,000 and cover 100 percent of Medicaid cost increases for all states until 2016.

Although like many people, I have lingering reservations about the both the Senate bill and this companion bill, as the debates over the proposed changes get underway this week in the Senate, Senate Democratic Leaders must not allow Republicans to scuttle or hamstring the process with time-tested legislative delay tactics.

They should expect the insurance industry (which, till date has spent hundreds of millions on a media blitz) and GOP senators to ratchet-up their theatrics and assault. Drawing from the same worn Republican theme book, there will be more outlandish, doomsday claims about a “government takeover of our lives” or how they “reflect the will” of American people or how the country is teetering towards socialist “totalitarianism.”

My hope, especially given that only a simple majority vote would be required to pass this bill in the Senate, is that the Democrats would persevere this time; that they would not allow Republicans to kill it with unending, mindless amendments and challenges.

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