Courageous leaders bring needed change
After 14 brutal months, House Democrats, led by their redoubtable Speaker Nancy Pelosi, stepped up Sunday night to pass comprehensive health care reform. Sadly, not one Republican joined in the measure, as the party continued its consistent strategy of obstruction.
The debate was fierce, with a hostile crowd insulting legislators outside Congress. "Totalitarianism." "Socialism." "The path of government tyranny." "A fiscal Frankenstein." Anti-abortion Democrat Bart Stupak (D-Mich.) was called a "baby killer." And all that was from Republicans on the floor of the House; the invectives from the demonstrators, egged on by conservative legislators, were even more extreme, featuring racial and homophobic slurs.
Now the bill goes to the president's desk and the "reconciliation" measure that fixes parts of the bill goes back to the Senate for final passage. It is worth dipping beneath the over-the-top rhetoric of the opposition to remember what is in the bill.
Within 90 days, people denied insurance because of pre-existing conditions will have access to high-risk pools that will give them the chance to buy insurance.
Within six months, insurance companies will be barred from revoking people's coverage once they get sick. Insurance companies will be barred from denying coverage to children who have pre-existing conditions. They will be barred from imposing any lifetime cap on coverage. Millions of Americans frozen into their current jobs because they can't afford to lose their health insurance can now move without fear.
Starting this year, young people can stay on their parents' policies until age 26. Over the years, insurance companies will be required to spend 80 percent of premium dollars on medical services--an effort to limit the amount they spend trying only to insure those who won't get sick.
Then subsidies will kick in for families making less than about $80,000 a year. Employers will be required to provide coverage or pay a penalty. In 2014, most people will be required to obtain coverage also. By 2019, 32 million more Americans will have health insurance. And according to the independent Congressional Budget Office, the bill will save more than $100 billion over the next 10 years and more than $1 trillion over the next 20.
It isn't a single-payer plan like Medicare, much less "socialism." It isn't a "government takeover" of health care. It does only what every other industrial country and most poorer nations in the world already do: guarantee insurance for all citizens.
Americans have been terrorized with absurd claims about "death panels," granny killing, images of concentration camps. They've seen a Republican legislator shout "You lie!" to the president during a State of the Union address, watched tea parties and fierce lobbying and dealmaking.
But Sunday night, due significantly to the stalwart leadership of Pelosi and the commitment of President Obama, the Congress passed a landmark reform that will go a long way toward making affordable health care a right, not a privilege.
And as a bonus, in the reconciliation bill that fixed the worst parts of the Senate bill, the House also passed quietly the most significant reform of college-student lending in a generation. The initiative ends the billions in subsidies handed out to private banks to provide government-guaranteed loans. And it uses the savings to invest in Pell grants for low-wage students, in community and historically black colleges and to allow graduates to limit loan repayments to 10 percent of their income.
Democrats took this vote--although many were warned they would pay a harsh political price in the fall. Republicans have already vowed to "run on repeal." But I believe they got it wrong. They have cursed at a bill not nearly as bold as Medicare, which was signed into law a generation ago. They have demonstrated how extreme they are, not how extreme the bill is. Democrats will have to do more to strengthen this bill--pass a public option, expand Medicare to workers over 55, do more to break up the insurance company monopoly.