rssHouse Passes Historic Health Care Reform
Sunday, March 21, 2010 at 11:19 pm
- 46 Comments
House Speaker Nancy Pelosi (D-Calif.), carrying the gavel used to pass Medicare in 1965, and members of the House Democratic Caucus on Sunday (EPA/ZUMApress.com)
With the last-minute support of anti-abortion colleagues, House Democrats on Sunday passed historic legislation to extend health coverage to tens of millions of uninsured Americans, protect patients from the most flagrant abuses of insurance companies, and curb runaway health care costs. All told, the $940 billion reforms represent the most sweeping overhaul of the nation’s health care system since the creation of Medicare more than four decades ago.
[Congress1]The tally was 219 to 212 in support of reforms passed by the Senate on Christmas Eve, with 34 Democrats joining every Republican in the lower chamber in opposition to the measure. An accompanying reconciliation proposal — which tweaks the Senate bill to address what House leaders considered to be inherent weaknesses — also passed, 220 to 211.
Democratic leaders were quick to place the reforms among the most significant in the nation’s history — legislation on par with that establishing Social Security, Medicare and new civil rights protections. “This is an American proposal that honors the traditions of our country,” House Speaker Nancy Pelosi (D-Calif.) said just before the votes. “We may not have chosen the time, but the time has chosen us.”
The Senate bill now moves to the White House, where President Obama will sign it shortly into law. The separate reconciliation bill then goes to the Senate, where Democrats are hoping to pass it before the Easter recess, which begins Friday. Reconciliation rules prevent upper-chamber Republicans from filibustering the proposal, meaning that Democrats need just 51 votes — not 60 — to pass it.
For House leaders, the victory didn’t come easy. Sunday’s vote capped a tension-filled week in which some Democrats who’d previously supported health care reform announced their opposition; others who’d formerly opposed reform announced their support; and party leaders were left with the delicate task of counting heads to ensure they had the numbers to pass the bill.
Quite aside from the unified GOP opposition, anti-abortion Democrats, led by Michigan Rep. Bart Stupak, had vowed to oppose the bill over language they feared would allow federal funds to subsidize abortion services — something that’s been prohibited for more than 30 years. And they had the numbers to kill the proposal. Breaking the impasse required the muscle of the White House, which stepped in Sunday to issue an eleventh-hour executive order stipulating that nothing in the reform bill would dilute the decades-old prohibition on the federal funding of abortion. The move — while blasted by abortion rights groups — caused the abortion opponents to throw their support behind the proposals.
“The real winner,” Stupak said Sunday at a press conference announcing the deal, “is really the American people.”
The rare weekend vote came after more than a year of rancorous debate over how Congress should approach health care reform. The saga first pitted Democrats against Republicans, but later — when it became clear that no Republicans would support the bill — saw liberal Democrats and their moderate colleagues doing battle over the most contentious provisions of the enormous bill. In the end, party leaders, behind Pelosi, convinced enough Democratic critics — both liberal and conservative — that the proposals would at least take steps toward fixing a health care system that all sides agree has grown dysfunctional.
“This is not the bill I wanted to support,” Rep. Dennis Kucinich (D-Ohio), the liberal single-payer supporter, said recently in announcing his reluctant support for the bill. “Hopefully” he added, it will take the country “in the direction of comprehensive health care reform.”
At the center of the reforms are a series of provisions reining in the most controversial practices of the health insurance industry. Under the reforms, for example, insurance companies could no longer deny coverage based on pre-existing conditions. They could no longer drop coverage when a patient gets sick. They could no longer hike premiums indiscriminately. And they could no longer put caps — either annual or lifetime — on coverage benefits.
Among the other major provisions, the reform bills will:
- Increase Medicaid coverage to most folks living below 133 percent of the federal poverty level ($29,327 for a family of four), while providing sliding-scale federal subsidies to those living below 400 percent of poverty ($88,200 for a family of four).
- Require most Americans to buy health insurance or face financial penalties.
- Take incremental steps to close the coverage gap in Medicare’s prescription drug benefit — the so-called doughnut hole — by 2020.
- Hike Medicaid rates on primary care services to equal those of Medicare.
- Extend funding for the Children’s Health Insurance Program through 2015.
To fund the changes, the proposals will:
- Cut more than $500 billion from the Medicare program, largely targeting the private insurance plans that receive huge subsidies to cover Medicare patients.
- Apply a 0.5 percent hike on Medicare’s payroll tax for individuals earning more than $200,000 and families earning more than $250,000.
- Tax the most expensive insurance plans, those costing more than $10,200 for individuals and $27,500 for family plans. (That tax will take effect in 2018.)
The Congressional Budget Office, which has estimated that the bill will expand coverage to roughly 32 million uninsured Americans, said Saturday that the changes will reduce federal deficits by $143 billion over the next decade, and by roughly $1 trillion in the 10 years to follow. The analysis at once convinced some Democratic budget hawks to support the bill, and took the wind from the sails of Republican critics who have said the reforms will bankrupt the nation.
Not that it prevented GOP leaders from attacking the reforms to the last. Rep. Marsha Balackburn (Tenn.), the first Republican to speak on the floor Sunday, set the tone early, blasting the Democrats for reforms that Republicans say will steal patient choice.
“Only they see the death of freedom … as a cause for celebration,” Blackburn said. “It is their children who will pay for their greed.”
Rep. Nathan Deal, the senior Republican on the Ways and Means health subpanel and candidate to become Georgia’s governor, echoed those criticisms. He vowed that, if elected to the governor’s office, he’ll focus on nullifying the reforms, particularly the Medicaid expansion, which many Republicans have called an unconstitutional mandate on states.
“The problem with socialism,” Deal said Sunday, “is that you ultimately run out of other people’s money.”
But in the end, Republicans — while effective in slowing the pace of the legislation — were helpless to prevent its passage.
The historic nature of the vote was not lost on Democratic leaders. Pelosi, who presided over the final vote, waved the same gavel that was used when Medicare passed the lower chamber more than six decades ago. And Rep. Louise Slaughter (D-N.Y.), the head of the Rules Committee who managed part of the day’s debate, was brandishing her own copy of a 1939 letter to Congress from Franklin Delano Roosevelt, a letter urging lawmakers to include a national health care system as part of the Social Security program.
“Good health,” FDR had written, “is essential to the security and progress of the Nation.”
Seventy-one years later, Democrats are hoping he was right.
46 Comments
Pingback posted March 22, 2010 @ 12:25 am
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Comment posted March 22, 2010 @ 4:43 am
I thought I might post a few thoughts about the passing of this bill.
1) As a small business owner that can't afford health insurance for my employee's, I feel I might have to let go a few of a few of them just to afford insurance on some of them. I guess I will have to see when we receive the new instructions. I have always told them all before they were hired that it might not be the best job for them, since I did not carry insurance. It was their choice to work for me or not.
2) I am also a little concerned that some of the smaller, more affordable insurance providers will simply just go under since they will have no cost limits and loss of revenue for pre-existing conditions..
3) The fact that any illegal can still walk into any hospital and get treated, while an average citizen picks up the cost is still outrageous. In California alone, I have seen so many hospitals go under for just this problem. The bill should have just included illegal's.. It would have cost us all less.
5) I am very concerned over back room deals, the c-span coverage that was promised then stopped, and the way the vote was taken.
4) My last concern deals with the fact that the IRS will be expanding, and that normal people could be fined and even jailed for not getting coverage. I find it ironic that if a US citizen doesn't pay, they go to jail, but an illegal doesn't have to and there are no consequences.
I do believe we should have had some kind of health care reform, I just think they should have take more time to make it correct! It's crazy to think that they just grabbed the reigns of 1/6th of the US economy and think things will get better! This is the same government that runs the bankrupt postal service, a terrible medicare system, a failing social security system, and taxes our eyes out any chance they can get.
Just some thoughts…
Comment posted March 22, 2010 @ 5:03 am
Actually, while there is a “tax” for not having insurance, the language that imposed jail time for failure to pay the tax was taken out and instead, if someone chooses not to carry insurance and fails to pay the penalty tax, it will be withheld from their tax refunds, if necessary. There was never any threat of throwing someone in jail if they didn't have insurance. Just FYI. :)
Pingback posted March 22, 2010 @ 7:21 am
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Comment posted March 22, 2010 @ 1:17 pm
Well I am glad it was taken out, but what's the difference. If you don't pay the “tax” and don't add it to your tax forms, what happens then? Tax evasion still send you to jail.
Pingback posted March 22, 2010 @ 3:57 pm
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Comment posted March 22, 2010 @ 4:18 pm
After a few beers at the local bar, a guy jumps up and shouts: “I got it! I'll renounce my citizenship, cross the border illegally and shazam, I've got free health care!”
Think it would work?
Trackback posted March 22, 2010 @ 6:39 pm
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Comment posted March 22, 2010 @ 6:24 pm
“The claim that the bill provides free health care for illegal immigrants is particularly egregious, Tolbert [of the Kaiser Family Foundation, a nonpartisan foundation that studies health care reform] said. “No one's provided with free health care. That's ridiculous,” she said.
[Politifact] looked for promises of free health care for immigrants and found nothing. So we've rated this claim Pants on Fire!”
More myths debunked here:
http://www.politifact.com/truth-o-meter/article…
Comment posted March 22, 2010 @ 6:25 pm
No.
“The claim that the bill provides free health care for illegal immigrants is particularly egregious, Tolbert [of the Kaiser Family Foundation, a nonpartisan foundation that studies health care reform] said. “No one's provided with free health care. That's ridiculous,” she said.
[Politifact] looked for promises of free health care for immigrants and found nothing. So we've rated this claim Pants on Fire!”
More myths debunked here:
http://www.politifact.com/truth-o-meter/article…
Pingback posted March 22, 2010 @ 8:15 pm
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Pingback posted March 22, 2010 @ 8:54 pm
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Comment posted March 22, 2010 @ 8:00 pm
We already have Medicaid and Medicare programs in place, Medicare is a social Federal health insurance program and Medicaid is a medical services program for those with low incomes and little or no resources. Why not enroll the uninsured 32 million Americans on either program depending on their financial status, why not change the rules, age limits of Medicare and Medicaid and put us all under Medicaid or Medicare?
This is costing us a total of $938 billion. Instead of spending $464 billion in subsidies to help the uninsured Americans buy an insurance policy, meaning more money for the insurance companies and forcing others to buy an insurance policy or pay a penalty and force employers to either offer insurance coverage to their employees or pay a penalty or employers cutting down on personnel. Plus they are raising Medicare payroll tax to 2.35% to High-Income workers and impose an extra 3.8% Medicare Tax on investment income of high income people making more than $200K. Wouldn't it be faster to put us all on either program, get our insurance card in the mail ASAP and they increase the portion of the payroll tax paid by the employers and employees for Medicare? Also allow people to purchase a private insurance plan if they wish that fits with their Medicare plan, same as it is already done with senior citizens. Seems to me this new Health Care Reform Bill is un-necessary as 2 Health Care Programs already exist in our country, Medicare and Medicaid that could have been restructured to meet our health care needs. Bottom line, this is an Employer Based Healthcare Bill.
Comment posted March 22, 2010 @ 8:05 pm
The gop have been behaving in disgusting manners and should be punished for this. They are a disgrace to the House and Senate.
Comment posted March 22, 2010 @ 8:19 pm
Initial feedback is split right down the middle & some say our country is now more polarized than ever. Comments I found surfing social media site Twitter http://bit.ly/bms1Sn
Comment posted March 22, 2010 @ 8:38 pm
Have any of you read that they are also creating an insurance program named CLASS ACT – Community Living Assistance Services Support Act to help seniors that need help bathing, getting dressed but you have to be enrolled for 5 yrs before you qualify. Why, isn't this service already covered under Medicare?
Comment posted March 22, 2010 @ 10:11 pm
What has this country gone to?! allowing people like Obama and Bush make decisions that this nation is against? The PEOPLE of the United States should make decicions not some rich guys who dont care about this country. why do we have all these taxes? why not just a ten percent tax off of everybodies income and thats it, no other taxes. this is ridiculous! Why do presidential canidates with the most money win? why are we still fighting wars that are on the other side of the world that is killing our economy. why has nobody impeached our current president for pushing a health care bill that America cant afford. why does Pelosi creep me out? so much for America home of the free.
Pingback posted March 23, 2010 @ 12:09 am
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Comment posted March 23, 2010 @ 3:42 am
Sethw76 – I tried to reply to you but system says “just a moment”
thanks for replying – I'm a business owner and I don't see room for reform to this Bill– It looks like a combo of Medicare & Medicaid – most won’t kick in until 2014 -companies with more than 50 workers either offer insurance or pay a penalty of $750 per worker. If the government subsidies money to help the worker pay for their own policy because they met the poverty level of $88,200 for a family of 4 then the business gets additional $2000 penalty for not providing insurance which drives us to decide if the group policy price we get through the SHOP Exchanges ( the high-risk Pool) is cheaper or more expensive (now it includes their grown children up to age 26 and what if the child has a child of their own-a grandchild) than the penalties/fines we would pay.
Or do we let employees go, keep the business at 50 or fewer workers to be exempt from the requirement and let the employee purchase a plan from the State Exchange pools and pay for it themselves with the help of government money. Employers that offer health care plans will have to cover 60% of the policy plus it must meet specific benefits/services.
Comment posted March 23, 2010 @ 5:22 pm
In that case I expect you to begin immediate work toward repealing all tax cuts on the wealthy imposed since the administration of Ronald Reagan, who began the slow dismantling of the social safety net and the transfer of wealth from regular Americans to the obscenely rich.
Comment posted March 23, 2010 @ 5:23 pm
It was proposed. The Republicans refused. Next question?
Comment posted March 23, 2010 @ 5:33 pm
This is how it works in Massachusetts, which has a universal coverage law AND an individual mandate, just like the new federal law:
You are asked to provide proof of insurance coverage when you fill out your forms or sit down with your tax preparer. This is done either through producing an insurance card or by checking one's Social Security Number, which a tax preparer will have anyway. If you have insurance, the box is checked “yes” and nothing changes. If you don't, your tax preparer will inform you of the penalty, check “no,” and the Commonwealth deducts the amount of the penalty tax from what would have been your refund. If you weren't entitled to a refund, the penalty is included with your tax payment for the year.
No one goes to jail, no one is frog marched into an insurance office, and no jack booted storm troopers show up at your house to force you to buy a policy at gunpoint. If anything, the uninsured will be given information about the Health Insurance Connector, a program that will match them up with affordable insurance plans, the appropriate state subsidy, or the state-run program that will suit their needs and income guidelines.
Results? 97% of Massachusetts residents have health insurance. People who needed medications and treatments are getting them. You can choose your primary care doctor and your specialists. The state doesn't have access to your medical records, and the odds that you'll go bankrupt if you get sick or lose your job are much lower than in other states that don't require their citizens to have insurance.
In short, Romneycare is the one good thing that idiot ever did for the Commonwealth. That he's now trying to lead an effort to repeal the national version speaks volumes about what a contemptible hypocrite our late and unlamented governor is.
Comment posted March 23, 2010 @ 5:48 pm
Hi ellid,
I don't remember Pelosi, President Obama saying that they wanted to put us under Medicare, Medicaid. So what if the Republicans refused, there are more Democrats than Republicans, Dems could have just done it, instead they passed a law that fines us all if we don't have an insurance policy when they could have just increased on everyone of us the Medicare payroll tax we already pay as it is and still allow those that would want a private insurance policy to get one in addition to the Medicare. It probably wouldn't have taken more than 5 weeks to mail us our health cards, Social Security has everyone's info in the system.
Comment posted March 24, 2010 @ 2:20 am
You know this will be going to go to the Supreme Court depending on how they feel that day – they could and I emphasize could find this Unconstitutional along with opening the door on Medicare, Medicade and Social Security to be found Unconstitutional also by Scalia & Gang. This could be a Historic Day indeed – ending all Social Functions of the Fed.
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You know this will be going to go to the Supreme Court depending on how they feel that day – they could and I emphasize could find this Unconstitutional along with opening the door on Medicare, Medicade and Social Security to be found Unconstitutional also by Scalia & Gang. This could be a Historic Day indeed – ending all Social Functions of the Fed.
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Comment posted December 23, 2010 @ 8:06 am
You know this will be going to go to the Supreme Court depending on how they feel that day – they could and I emphasize could find this Unconstitutional along with opening the door on Medicare, Medicade and Social Security to be found Unconstitutional also by Scalia & Gang. This could be a Historic Day indeed – ending all Social Functions of the Fed.
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