The Senate HELP Committee has just passed their health reform bill. As Jon Cohn noted yesterday, this isn’t quite historic, as HELP’s predecessor committee passed a bill out during the health reform fight under Clinton, but taken in context, health reform is moving in a way it never has before.
As a review, here’s what HELP was discussing, and likely what just passed (I’ll have an update once I’ve seen all the amendments):
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.
Yesterday, the House unveiled their tri-committee health reform bill and the Education and Labor Committee will start marking it up today. That bill contains:
- Generous subsidies, available to people making up to 400 percent of the poverty line
- Expansion of Medicaid to cover people making less than 133 percent of the poverty line
- Guarantees of solid benefits for everybody, with limits on out-of-pocket spending
- Strong regulation of insurers, including requirements that insurers provide insurance to people with pre-existing conditions without higher rates
- An individual mandate, so that everybody (or what passes for everybody in these discussions) gets into the system and assumes some financial responsibility
- A public plan, one that appears to be strong, although I’ll reserve judgment on that until I hear from the experts
- Choice of public and private plan, at first just for individuals and small businesses, but later for larger businesses and–possibly–eventually for everybody
- Efforts at payment reform, if not necessarily as strong as they could be
- Investment in primary care and prevention, which is not sexy but potentially important for general health.
So, let’s review the political space. The Senate HELP Committee has just referred a bill to the floor of the Senate with a strong public option. The House is starting in on a bill that meets all of Health Care for America Now’s principles for actually achieving quality, affordable health care for all in this country. And the President and his grassroots army are out there pushing for strong reform by the August recess.
Yes, we’ve got one more committee that has yet to start in on their work, the Senate Finance Committee, but overall, reform is moving forward like it wasn’t in the 1990s. There’s no Harry and Louise on the air. Republicans can barely muster a response. Progressives are united behind real reform, and we’ve actually got something in Congress we can support. It’s really happening, folks.
(also posted at the NOW! blog)
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