I suggest a second budget reconciliation bill that would move implementation of all provisions of the HCR law from 2014 to 2011. That would require nothing more than a small temporary income tax increase on the wealthiest Americans. In addition to saving tens of thousands of lives and preventing millions of bankruptcies, that action would eliminate by far the greatest political liability of this excellent law.
As I watched CSPAN yesterday I listened to negative comments on the bill from people who called in. Many were folks who are already in desperate straits and fear that any change at all might go against them. They were unemployed, living on small incomes, or too poor to currently afford insurance or the insurance they have. They are exactly the people most likely to be helped by HCR, but they are too scared to take anyone’s word for that. They will have to be shown, and that means moving up the provisions of the law so that they can experience the gains. It is political lunacy to have to defend this bill through two election cycles before anyone realizes the principal benefits. There is nothing in the law that could not be brought on line in 6 months.
If this rational and sensible approach is unpalatable to Congress I suggest a second course of action. It should be possible to estimate, using CBO and other calculations, the financial effect, and options within this law, in 2014 for almost anybody, based on income, age and family composition. A website could be set up to make the calculations for people. It could not be done under government auspices because of the obvious uncertainties in the calculations, but it could be done by the Democratic party, perhaps in collaboration with AARP, the AMA, unions, and a few other organizations that people respect, maybe also a couple of large insurance companies. We could also set up volunteer offices to enter the data and run the program for people without computers or internet access. People would do it, word would be spread to families and friends, and fears would be assuaged. I suppose the Republican lie machine would set up an alternative website, but if ours had credible sponsorship it would win people’s trust.