| It also would provide the following relief for working families in 2010:
• A $5 bln insurance program to help get coverage for high-risk people who are turned down by private insurers.
• Ending "rescissions" - by which insurers nullify coverage when patients file claims - except in case of fraud.
• Ending the lifetime caps on how much insurers will cover.
• Allowing young people to stay on their parents' policies until age 27.
• Allowing workers who have lost coverage because they lost their job to extend COBRA coverage until the Exchange is in place.
• New incentive programs to increase the number of primary-care doctors, nurses and public health professionals.
• Funding for community health centers to double the number of patients the centers can see.
• A new $10 bln fund to help employers pay for coverage for early retirees.
• For seniors, it eliminates co-payments for preventive services under Medicare and reduces the "donut hole" in Medicare prescription drug coverage by $500 and give seniors a 50% discount on brand-name drugs in the donut hole in 2010. Right now Medicare doesn't cover any drug costs between $2,700 and $4,050. The donut hole will be phased out by 2019.
(See also Dispatches)
By 2013, HR 3962 would create an exchange in which millions can buy insurance - including the choice of a public health insurance option to compete with insurance companies. Businesses with payrolls greater than $500,000 would have to pay at least 72.5% of their employees' insurance and 65% of family coverage. Small businesses would get tax credits to offer health coverage. Lower- and middle-income families up to 400% of the poverty level ($88,000 for a family of four) would get federal subsidies to help them buy insurance.
The bill also would end denials of coverage for pre-existing conditions and it would end co-payments for preventative care.
The bill allows the Secretary of Health and Human Services to negotiate drug prices for Medicare and it requires pharmaceutical companies to rebate the government for drug overcharges that arose after 2003 when low-income elderly people who got their drugs through Medicaid were enrolled in Medicare Part D.
Under the House bill, 36 million uninsured Americans would become eligible for coverage. Medicaid would cover 15 million of the poorest children and adults while 21 million would buy coverage on a national national insurance exchange, either from private plans or from the government-run "public option" with the federal subsidies for low- and middle-income families. The nonpartisan Congressional Budget Office estimated that only 6 million people would choose the public plan, making it a relatively small player.
Among major differences between the two chambers, the House bill would require employers to provide coverage; the Senate does not.
The House pays for much of the 10-year $894 billion cost with a surtax on people earning more than $500,000 a year (or $1 million for couples). The CBO projected that the House bill would cut $104 billion from budget deficits over the next decade. The Senate would impose fees on the health-care industry and a 40% tax on "high-value" insurance plans, which would encourage businesses to cut back on their benefits. That has organized labor as well as business groups howling. On financing, the Senate should defer to the House, which is responsible for originating tax bills anyway.
For those 36 million who will at least have a shot at getting insurance - and for the rest of us who have insurance but cannot be sure that our medical needs will be covered when they come up for review by corporate bureaucrats - we cannot agree with single-payer advocates who say the compromise bill is worse than no bill at all.
This bill will not be the last word on universal health coverage. If we elect more and better progressive populists to Congress, we can try to make it better. But this bill is an important first step.
Now that the House has passed its version of health-care reform, the action moves to the Senate, where grandstanding Sen. Joe Lieberman (I-Conn.) renewed his pledge to join the GOP in a filibuster of any health reform with a public option.
If that's the case, if Democrats lose their 60th vote needed to shut down the Republican filibuster, Lieberman should be stripped of his committee chairmanship, since cannot be trusted on important procedural matters by the caucus. Then Democrats should proceed to pass a Medicare-for-All public option in the budget reconciliation, which is not subject to filibuster.
Sen. Bernie Sanders (I-Vt.) will try to attach an amendment to the Senate bill similar to Kucinich's stricken provision allowing states to proceed with their own single-payer plans. Good luck. But the Senate should reject the House's overreaching language restricting abortion coverage in private insurance plans.
So far it's been progressives who have been called upon to compromise on the principle of universal health coverage. It's past time for Democratic leaders to stiffen their backbones. Republicans like to call Obama a "Chicago pol" but we'd like to see a little more hard bargaining as we near the end-game of health-care reform. Democrats need to show the insurance lobby that the cost of obstruction is greater than the cost of agreeing to a compromise - which is what the House produced and the Senate is preparing to debate. The best way to get the insurance lobby to play ball is to make a credible threat that the alternative to a bipartisan vote in the Senate agreeing to the insurance reforms with a strong public option is a party-line vote that will put the insurance companies on the fast track to going out of business next year. That's the Chicago way.
See the entire editorial at The Progressive Populist. Reposted by permission. |
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