The Senate HELP Committee beat everyone to the punch, passing out a marked up bill before Senate Finance and the House Tri-Committees. Here are the basic outlines that HELP has been working within:
The individual mandate: If you have affordable coverage available to you — and I don't know exactly how, or if, "affordable" is defined — and you don't purchase it, HELP envisions a penalty of not less than half the price of the coverage.
The Health Insurance Exchanges: States would run them. They would be available for the uninsured, people on the non-group market, and small businesses. There would be a so-called "firewall" preventing larger employers from using the exchanges. In the scenario where employees of a large employer are not offered coverage meeting the minimum standards and costing less than 12.5 percent of their income, then and only then can they go to the exchange. (For more on health insurance exchanges, see this primer.)
The public plan: In a slightly weird turn of events. HELP is calling its public option "the Community Health Insurance Option." You have to wonder if that's not an effort to steal some of Sen. Kent Conrad's co-op compromise thunder. It's a level-playing field style plan, and it's available on only the health insurance exchanges.
All of the financing mechanisms for the legislation, including any changes to Medicaid, are under Finance's jurisdiction, thus the HELP bill is somewhat incomplete. Politically, the HELP Committee finishing its work is before the Senate Finance Committee puts much more pressure on Baucus to grind this out, sooner rather than later.
"There's a lot of pressure on the Finance Committee to get something done," said Sen. Patty Murray (D-Wash.).
What does the bill's passage say to the Finance Committee?
"It says, 'Welcome. Come and join us,'" Dodd told the Huffington Post after the vote.
It also highlights that Bloomberg story I posted about earlier. If the message coming from the White House that their definition of a bipartisan bill--"whether Democrats have accepted Republican ideas during the process of negotiations"--has already been met by the HELP Committee. Here's Dodd, again.
"Even though it wasn't a bipartisan vote, it was a bipartisan effort," said Dodd. "There were numerous contributions made, not just technical amendments, that our Republican friends were able to add to the bill. And they made it a better bill. That's the way it's supposed to be and I regret they didn't feel it was significant enough to support our effort this time around."
But he was going forward without them, he insisted. "I still believe, as my colleagues do as well, that we can achieve that bipartisanship, but the important issue is a good bill. Getting a bipartisan bill that doesn't do anything for the people out there who are depending upon it, is not going to be warmly received. A good bill that is bipartisan obviously has a chance of not only succeeding but also being sustained, so there's a value in achieving that bipartisanship," he said.
But not at the expense of a good bill. "I will not sacrifice a good bill for that. That's not the goal here," Dodd said.
Here's one of the more fun Republican amendments adopted by the committee:
Under a Republican amendment approved Tuesday in the HELP bill, every member of Congress and their staffs would be required to enroll in the public insurance option. Sen. Tom Coburn (R-Okla.) authored the measure, which has become a rallying point for conservatives opposed to the public option. Sen. Ted Kennedy (D-Mass.), who voted by proxy, and Sen. Chris Dodd (D-Conn.) called their bluff and voted with Republicans to pass the amendment -- effectively neutralizing the issue for now. It seems unlikely that it would survive the many stages of the legislative process. Then again, Kennedy apparently likes it, according to his spokesman: "Sen. Kennedy believes strongly in the public option and its ability to provide quality and affordable healthcare while keeping the insurance companies honest. This was a no-brainer."
Sounds bipartisan to me. President Obama's statement on passage of the bill is below the fold, stressing againg the "urgency for both the House and Senate to finish their critical work on health reform before the August recess."
Today, thanks to the unyielding passion and inspiration provided by Senator Edward Kennedy, the HELP committee he chairs has produced a proposal that will finally lower health care costs, provide better care for patients, and ensure fair treatment of consumers by the insurance industry.
Like the legislation produced by the House of Representatives, this proposal would offer Americans quality, affordable health care that is there when they need it. No longer will insurance companies be able to deny coverage based on a pre-existing medical condition. No longer will Americans have to worry about their health insurance if they lose their job, change their job, or open a new business.
This proposal will bring down costs, expand coverage, and increase choice. Through a health insurance exchange, families and small businesses will be able to compare prices and quality so that they can choose the health care plan that best suits their needs. Among the choices that would be available in the exchange would be a public health insurance option that would make health care affordable by increasing competition, providing more choices, and keeping the insurance companies honest.
This proposal would also control rising costs by investing in preventive care and wellness programs, rooting out waste and fraud in the system, and changing the incentives that automatically equate the most expensive care with the best care.
When this proposal is combined with other proposals that the Senate Finance Committee is working on, it's estimated that health reform will cover 97% of all Americans.
The HELP committee's success should give us hope, but it should not give us pause. It should instead provide the urgency for both the House and Senate to finish their critical work on health reform before the August recess. I want to commend Senator Kennedy, Senator Dodd, as well as Senators Harkin, Mikulski, Bingaman, and Murray on the leadership they've shown and the foundation they've laid to reform our health care system.
