Living through the last few days has been like living through the collapse of the reality-based left.
Dean and others are saying the bill should be jettisoned and the process re-started.
But that's not what's going to happen. It dies and it's dead. We will have to wait years and years -- again.
They claim that the bill is not progress. They ignore the subsidies and the expansion of Medicaid. Dean, when he ran for president, had a health care plan that didn't do as much as the Senate one did. But somehow this one is unacceptable.
People are yelling and screaming about private health insurance, but there are models all over the world of universal or near-universal health care based on regulated private insurance.
Why is it that so many progressives who really know health policy support the what the Senate has wrought? Because it does good things.
Here's Podesta
I come down on the side of the Senate passing the bill.
Here’s why:
The Senate health care bill is not without its problems. But if enacted, it would represent the most significant public reform of our health care system that Congress has passed in the 40 plus years I have worked in politics. The bill will give health care coverage to a record 31 million Americans who are currently uninsured, lay a foundation that will begin to lower costs for millions of families, and provide all Americans with the access to adequate and dependable coverage when they need it most.
All of us are anxious to see the final language from the Senate. And a final bill must ensure that the subsidies provided are sufficient to make insurance truly affordable for working families. But based on what we know, here are my top ten reasons for why progressives should support the Senate passing the bill:
1. Largest Expansion Of Coverage Since Medicare’s Creation: Thirty-one million previously uninsured Americans will have insurance.
2. Low/Middle Income Americans Will Not Go Without Coverage: For low-income Americans struggling near the poverty line, the bill represents the largest single expansion of Medicaid since its inception. Combined with subsidies for middle income families, the bill’s provisions will ensure that working class Americans will no longer go without basic health care coverage.
3. Insurance Companies Will Never Be Able to Drop or Deny You Coverage Because You Are Sick: Insurers can no longer deny coverage because of a pre-existing condition. They can’t rescind coverage or impose lifetime or annual limits on care. Significantly, 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.
4. Lowers Premiums For Families: The Senate bill could lower premiums for the overall population by 8.4%. For the subsidized population, premiums would decrease even more dramatically. According to the CBO, "the amount that subsidized enrollees would pay for non-group coverage would be roughly 56 percent to 59 percent lower, on average than the nongroup premiums charged under current law."
5. Invests in Keeping People Healthy: The bill creates a Prevention and Public Health Fund to expand and sustain funding for public prevention programs that prevent disease and promote wellness.
6. Insurers Can’t Offer Subprime Health Care: Insurers operating in the individual and small group markets will no longer sell subprime policies that deny coverage when illness strikes and you need it most. Everyone will be offered an essential benefits package of comprehensive benefits.
7. Helps Businesses Afford Coverage: Small employers can take advantage of large risk pools by purchasing coverage through the bill’s state-based exchanges. Employers with no more than 25 employees would receive a tax credit to help them provide coverage to their employees. The bill also establishes a temporary reinsurance program for employers providing coverage to retirees over the age of 55 who are not eligible for Medicare.
8. Improves Medicare: The bill eliminates the waste and fraud in the Medicare system, gets rid of the special subsidy to private insurers participating in Medicare Advantage and extends the life of the Medicare trust fund by 9 years. It also closes the doughnut hole that affected 3.4 seniors enrolled in Medicare Part D in 2008.
9. Reduces The Deficit: Not only would the bill expand coverage to 30 million Americans without adding to the nation debt, it would also reduce the deficit by up to $409 billion over 10 years.
10. Reduces National Health Spending: 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.
Ultimately, I'm convinced by Paul Krugman
It would take a big step toward greater security for Americans and greater social justice; it would also save many lives over the decade ahead. That’s why progressive health policy wonks — the people who have campaigned for health reform for years — are almost all in favor of voting for the thing.
If we're not for saving lives, what are we for? And let's be real -- this goes down and the same system is in place for a very long time. More people die under the current system, which will spiral down year after year, than with a flawed system that can, like every other past reform, get better. A loss kills the presidency and every good thing we want to do.
I can't see how no bill for many years is a better choice.