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HEALTH CARE

The Progressive Case For Passing The Bill

After months of debate, countless revisions, and significant right-wing obstructionism, the Senate is just days away from its self-imposed Christmas deadline to pass a health care reform bill. Since the public option and Medicare buy-in provisions were dropped, the bill has faced criticism from some on the left like former Vermont governor Howard Dean, Sen. Bernie Sanders (I-VT), and liberal bloggers. Despite the loss of some progressive measures, the Senate bill is still very much worth passing. As John Podesta, Center for American Progress Action Fund President and CEO, writes in defense of the bill’s advancements, “It would represent the most significant public reform of our health care system that Congress has passed” in generations. The bill would expand coverage and “lay a foundation that will begin to lower costs for millions of families,” Podesta says, “and provide all Americans with the access to adequate and dependable coverage when they need it most.” Seven presidents since Teddy Roosevelt have tried to reform America’s health care system without success; this is the furthest any attempt has progressed. President Obama has stressed the historic nature of this moment and urged that it not be wasted. “Now is the time to deliver,” he told Congress.

AFFORDABLE HEALTH CARE FOR ALL: Rising health care costs are crippling the economy, squeezing middle class families’ budgets, and making health care unattainable for a growing number of Americans. More than 14,000 people lose their coverage every day. Approximately 46 million Americans went without insurance in 2008 — a figure expected to rise in 2009 due to the recession — causing an estimated 45,000 premature deaths. Over the next decade, the cost of private health insurance is expected to double. The Senate bill has a number of provisions to contain costs and “ensure that working class Americans will no longer go without basic health care coverage,” Podesta writes. It would lower insurance premiums by an average of 8.4 percent , provide subsidies for people who cannot afford insurance and “represents the largest single expansion of Medicaid since its inception.” According to the Congressional Budget Office (CBO), the bill covers 31 million currently uninsured Americans, extending coverage to 98 percent of legal residents. And according to the CBO, the amount that subsidized individuals would pay for insurance coverage “would be roughly 56 percent to 59 percent lower on average than the nongroup premiums charged under current law.” Dean and other progressives bemoaned the loss of the public option, which they rightly claimed would have been an effective way to reduce costs. But as Obama has said, the public option is just one “small part” of the overall reform effort. The Wonk Room’s Igor Volsky explains that “the heart of health care reform was never about the public plan. The real game was in improving affordability standards, enhancing the exchanges, and figuring out the payment reform.” The Senate bill makes major strides in these areas and should not be dismissed simply because it lacks a public plan. As the Los Angeles Times editorialized, “Compared to the benefits these [other] changes would bring, the public option just isn’t that important.”

REFORM FOR EVERYONE: Every American would benefit from the Senate bill, even if their health care is not directly affected. The Senate bill would stop insurers from standing between patients and their doctors. Insurance companies would no longer be able deny coverage because of a pre-existing conditions, nor rescind coverage or impose lifetime limits on care. As Podesta notes, ”the bill also ends insurer discrimination against women — who currently pay as much as 48% more for coverage than men — and gives them access preventive services with no cost sharing.” The Senate bill also saves us from the “looming disaster” of Medicare by extending the trust fund for nine years. Without this measure, analysts say the fund will become insolvent in 2017. It makes a commitment to close the so-called doughnut hole that affected 3.4 million seniors enrolled in Medicare Part D in 2008. The bill will lower the deficit by $127 billion over the next decade and by $650 billion during the decade after that, according to the CBO. Perhaps most importantly, a “CAP-Commonwealth Fund analysis concludes the bill could reduce overall spending by close to $683 billion over 10 years — with the potential to save families $2,500. Even the most conservative government estimates conclude that the bill would reduce national health care expenditures by at least 0.3% by 2019.” Dean claims that the bill simply “expands private insurers’ monopoly over health care and transfers millions of taxpayer dollars to private corporations.” White House communications director Dan Pfeiffer responds by documenting the ways that “this bill will finally wrest power away from the insurance industry.”

NOW OR NEVER: Obama stressed the need for urgent reform yesterday, warning that the government “will go bankrupt” if health care costs are not checked. “If we don’t pass [health care reform],” Obama told ABC’s Charlie Gibson, “your premiums will go up, your employers are going to load up more costs on you, and potentially they’re going to drop your coverage, because they just can’t afford an increase” in costs. As he said earlier this year, “[L]et there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year.” While some progressives want to hold out for a stronger bill, Volsky explains that “delaying a vote on health care reform” will mean going into the new year “with no certain prospect of securing anything genuinely worthwhile and no guarantee that other issues or senators wouldn’t derail reform.” Drawing on his personal experience from having “a ringside seat for the slow death of comprehensive care in 1994,” Podesta notes,  “I am keenly aware of the real alternative to the bills now before us: millions more Americans without health care and billions more for health care spending as the same challenges President Clinton tried to resolve continue to metastasize unchecked.” Stalwart progressive leaders like Sens. Jay Rockefeller (D-WV), Tom Harkin (D-IA), and Sherrod Brown (D-OH) believe that the bill represents the best chance for passing health care reform in the foreseeable future. “I’m going to vote for it,” Brown told reporters. “I can’t imagine I wouldn’t. I mean there’s too much at stake.”