Health Care Reform Edges Closer with House and Senate Bills Introduced

It was in June of 2009 that President Obama charged all members of Congress with the task of coming to agreement on proper and forward-thinking health care reform. It was the last week of October before bills were actually introduced to the House and the Senate, as months of fighting between the political parties and struggling with a sometimes misinformed public (and media) delayed the process much longer than anticipated.

The bills began with one for the Senate, introduced by Senate Majority Leader Harry Reid (D-NV) on October 26. The plan was bolder than predicted, as it included a public option to be run by the government and offer a Medicare-style alternative to traditional insurance company plans. However, also included in the plan was a condition that allowed states to opt out of the plan, and it was stipulated that many Americans, especially those with a current plan offered by an employer, would not be eligible to participate. Early estimations showed that it would only solve the health care conundrum for about 10 million of the 47+ million people without coverage.

Three days later, House Speaker Nancy Pelosi (D-CA) announced the introduction of the House bill with its own version, however more conservative, of the public option. Though it would potentially cover 36 million Americans in need of insurance, it would also issue penalties on individuals and small businesses and requires rates to be negotiated just as they would be through private insurers, thus lessening the competitive blow to insurance companies. The House version of health care reform puts more emphasis on reducing the deficit—by $30 billion over the next decade—but does little to curb the effects that private insurance companies have had on the market as a whole.

Some of the specifics of Pelosi’s legislation include requirements that insurance companies across the board offer more comprehensive coverage to members as well as cease discriminatory practices based on pre-existing conditions. It also suggests a form of exchange that will offer subsidies to low- and middle-class households in order to allow them to afford insurance plans.

Most analysts expect that Reid and Pelosi will work together with other members of Congress to find a compromise between the two bills before one is presented for a vote, which is anticipated before November 11th. But there seems to be little consensus among Senators and Representatives on what compromises could actually be met. The vast majority—possibly all—of Republicans are vowing to vote against any plan that even hints of a public option, and some have threatened to filibuster if necessary to stop reform from passing through Congress. Some Democrats have also vowed to vote against the bill for various reasons, and Independent Senantor Joe Lieberman has vowed to filibuster along with Republicans. This opposition has led to concerns that there will be enough votes to pass the legislation out of the House or Senate, specifically the latter, much less avoid a filibuster.

Yet others continue to lobby for a bill that will apply more heavy-handed standards to remove some of the power from insurance companies and give it to the public in the form of a competitive system prompted by a truly progressive public option. Those like Representative Anthony Weiner continue to work diligently for deeper health care reforms, but the knowledge that Congress will have difficulty passing any reforms at all has kept most members of Congress from supporting proposals from the likes of Weiner. And it seems that in order to prevent a filibuster, Congress will be forced to push for an even more conservative plan that what was introduced by Reid or Pelosi.

Expecting action by November 11th, considering the depth of the divide that continues to separate the various proposals thus far, may be a generous prospect. But for the sake of the ever-growing tens of millions of Americans who lack health insurance, lose coverage, and face outrageous rates, the weight remains on the shoulders of Congress to act soon.