On November 8, the House of Representatives passed H.R. 3962, the Affordable Health Care for America Act, by a razor-thin 220-215 margin. It sounds good, but what does it actually mean? Has free, universal health-care finally arrived in the States? Have Obama and his cabal of socialist advisers pulled the wool over the eyes of an unsuspecting public and converted America into a full-fledged worker’s paradise? Well, not really. In fact, despite what you may have heard from any number of teabaggers (whose scare tactics seem increasingly desperate), comprehensive health care reform is hardly guaranteed.
It’s understandable that people are confused. Unfortunately, there isn’t a lot of objective, non-jargony information available on the internet, especially about a topic as complex as health care reform.
Of course, here at 4080 we’re all about that sort of thing, so here’s our attempt at a quick and dirty guide to the current state of the “Obamacare” agenda:
The Affordable Health Care for America Act
The bill passed by the House on Sunday has several key components:
- It would establish a Health Insurance Exchange. A one stop shop for the uninsured, the Exchange would allow consumers to compare and purchase insurance from a diverse menu of health insurance options, including private plans, health co-ops and a new, public health insurance option. Its proponents claim that by facilitating open competition, the Exchange would drive down prices and improve care. Americans who are happy with their existing insurance may keep it.
- It would prevent insurers from increasing premiums or denying care based on “pre-existing” conditions.
- It would require every American to get insurance, either through their employer or own their own through the Exchange. The federal government would provide “affordability credits” to make premiums affordable.
- Employers who choose not to insure their employees would have to pay a fee of eight percent of payroll.
For more information about the specifics of the bill, check out the House Committee on Education and Labor website.
You win some, you lose some
Democrats had to make some major compromises to push H.R. 3962 through the House, the most significant of which related to abortion funding. As The Globe and Mail reports, “House Speaker Nancy Pelosi, a fervent defender of abortion rights, yielded to conservative Democrats and included a provision in the bill to prohibit publicly subsidized health insurance from covering abortions.”
The Democrats also worked hard to attract the support of moderate Republicans in an effort to make the bill seem like a bi-partisan initiative. One Republican, Anh Cao of Louisiana (Update: on an interesting but likely unrelated note, Talking Points Memo points out that Cao is one of the only Republicans to have actually experienced a communist regime), did end up voting for it, but calling H.R. 3962 ‘bi-partisan’ because a single Republican supported it is like calling the L.A. Lakers ‘world’ champions because they play in a league with one Canadian team.
Next up, the Senate
The U.S. Congress is a bicameral legislature, meaning that a bill must be approved by both the House of Representatives and the Senate for it to become law. So now H.R. 3962 heads to the Senate, where Democrats and their friends hold 60 of the 100 seats. But a number of Democratic and Democratic-leaning Independent Senators have already indicated that they won’t support it. For these moderates and conservatives, H.R. 3962 and its public option are simply unacceptable. Joe Lieberman, for example, thinks that it will create a level of “debt [that will] break America and send us into a recession that’s worse than the one we’re fighting our way out of today.”
The filibuster threat
If Obama and his lieutenant in the Senate, Harry Reid, can’t muster 60 votes, the bill will likely succumb to a Republican filibuster. A filibuster is a technique in which one party extends debate on a bill indefinitely, preventing the Senate from voting on it. A filibuster can only be ended with the support of 60 Senators.
Reaching the magic number
In the bill’s current form, securing the support of 60 Senators will be challenging, if not impossible. It looks like progressive Democrats may have to bite the bullet and drop the public health insurance option. While this might seem like a defeat to some, the bill would still represent the most significant reform of the American health insurance industry in several decades.
Clearly, the health care reform debate is far from over. In the coming weeks, the Senate will debate the bill’s cost and implications, and Obama will likely continue expending valuable political capital to drum up the necessary support. Whatever its outcome, the health care debate will likely be remembered as one of the defining characteristics of Obama’s first (and perhaps only) term.