Last month, history was made. The House of Representatives passed a health care bill that gave the American people what they want.
In poll after poll, people wanted most of all to have the choice of a public health insurance option, to keep their health care benefits untaxed, and to have affordable health care both at work and out of it. The House bill came incredibly close to those goals. It was truly history-making.
Early this morning, the Senate took its first step towards passing a health care bill. While the Senate bill is a major piece of legislation, it looks small in comparison with the House. And progressives are, as Richard Kirsch said, "Very, very angry and disappointed."
Shortly, the two bills will head into conference. In the next few days, I’ll elaborate on what exactly needs to be fixed in the Senate bill and how it’s better in the House bill, but for now, the key differences can can be broken down into two areas, elaborated after the jump.
1. Make health care affordable
Low and middle income families must be able to afford health insurance if they do not get it through work, and employers must be asked to provide good health coverage for their employees so health care is affordable at work.
The House bill asks employers to pitch in, and is much more affordable for lower-income people who don’t get coverage through work. The Senate bill lets employers off the hook, increasing the cost to employees for health coverage, though it is more affordable for middle-income people who don’t get coverage through work.
Also, the House bill finances reform with a surtax on the richest families – those making over $1 million per year. The Senate bill finances reform by taxing middle-class health care benefits, which will only increase cost or decrease coverage for millions.
The final bill should ask employers to pitch in and share responsibility for full and part-time workers, and should make health care affordable for all incomes. And t he final bill should get rid of this tax on health benefits, something President Obama ran against. Instead, the wealthiest in society who can afford to help should be asked to pitch in their fair share to pay for reform.
2. Hold insurance companies accountable
Insurance companies must be held accountable with strong regulations and consumer protections, and we mustbe given the choice of a national public health insurance option available on day one. The House bill gives us that choice.
One are we’ve seen the Senate bill improve upon since dropping the public option is improved insurance regulations such as the Patient’s Bill of Rights. But the House bill is still stronger in a great many respects. The final bill needs tough regulations and real choices, to give the American people what they want and need.
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In all of these areas (except some aspects of affordability, to be elaborated upon in the next few days), the House bill does a better job than the Senate bill of standing up for what the American people want and need. Speaker Pelosi has a document on the differences between the bills that’s worth checking out, which lays things out along similar lines.
This process isn’t over, not by a long shot. This what we should fight for in conference. (And yes, there will be a conference.)
Over the last few weeks, progressives have been shocked and demoralized by the way the debate in Washington has played out. But we can’t stop fighting, and we can’t stop pressuring our leaders in Congress and the White House to do what’s right.
A good bill, like the House bill, that does right by Americans can still be delivered to the Oval Office. Congress and the President have a choice: They can give us that good bill, or they can leave us disappointed and angry. A message to them: Choose wisely.
(also posted at the NOW! blog)
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19 Comments







Yikes, Jason what have you been smoking? Is that prescription included in the new wonderful House bill? I doubt it.
So how does Stupak figure in your calculation that the House bill is so wonderful?
Where is the cost containment in the House bill?
I think this post is a prank, no?
Stupak is an issue that needs to be removed from the House bill, as well as Nelson’s language from the Senate bill, absolutely. Health care should be about more choices, not less, and these bills do so much for women. It’s a punch in the gut that they take such a leap backwards at the same time.
As for cost containment, the House has plenty. The Senate, not so much.
So how will this happen, when the Senators have told the House they can’t change the bill?
http://www.democracynow.org/2009/12/21/health_bill_passes_key_senate_hurdle
Well, House members are telling Senators it must change:
http://conyers.house.gov/index.cfm?FuseAction=News.PressReleases&ContentRecord_id=b25f68c9-19b9-b4b1-12f7-46266b312356
So….
Yeah, they stood up so well for women before. I can see we should give them more chances. Besides:
link for last quote up there. http://www.pnhp.org/news/2009/december/better-to-start-over-than-to-pass-these-bills-0
what cost containment and how much can we expect costs to be controlled? please document your claim with evidence.
I agree with these fixes. I also have few thoughts of my own.
Of course, we need to not limit women’s choices and rewrite abortion access laws in America in health care legislation.
We should also work hard to get the House conferees activated.
We have been calling neighbors around CA to ask them to call their representatives and to tell those members of Congress to see that the HOUSE stands up for its health care bill.
If we are going to give up the public option, we should get some turkey for it.
It seems pretty clear the public option is not going to fly with two donkeys in the Senate, but there are ways to tighten the regulations and improve the bill.
Regulations should start in 2010 and the exchanges sooner than 2014–as in the Senate measure. The House had it right with 2013, if not 2012.
Yes, the exchanges and the subsidies should start in 2013. This is a Depression. Forget the impact on the CBO score, or make the hike of the medicare tax on 200k earners 1.2% or 1.5%.
what else?
Americans can still insist on improvements to the Senate bill and that has to come from House conferees who point out that they gave up the public option to give a healthy stroke job to Lieberman and Nelson.
If we can’t have a public option, we should require insurance companies to spend 90 percent of premium on medical care, pre-existing condition ban for everyone not just kids starting in 2010, the House 2x rating for older insured and, we must have a permanent COBRA extension for workers who lose their jobs.
Particularly important is for the HOUSE to stand up for COBRA extension for the unemployed, which is in the House bill, Section 113. We need to help the unemployed keep their insurance until the exchanges start, without forcing them into expensive high-risk pools.
Section 113 of the House bill permits the unemployed, many of whom can’t get individual coverage because of pre-existing conditions, to buy into their old group insurance until the insurance exchanges start in 2013.
And one other thing. These are the insurance companies we are fighting, not folks who make cars or milk.
These are folks who call the service they provide — that is the medical care of their clients — they call it a loss; specifically the medical loss ratio.
These are folks who profit if you die. Who make more money if you dont get care. They are carrying on the concept of unsafe at any speed into the 21at century and America is the only country on Earth where they get away with it.
These people are the personification of greed. They dont do medical care. They dont change bed pans. They dont type blood or implant a heart valve. They dont make a product or really provide a service. They are the purveyors and beneficiaries of an elaborate marketing, public relations scheme backed by actuarial competence and manipulative brilliance.
Where is the outrage in Congress. Where is the rhetoric to shame these people from the White House?
Under either bill, if I keep my present insurance (as Obama said I could) will I still be required to pay to the health system?
not unless you go for tanning or earn more than 200k a year. then you get a larger medicare tax.
I’m not sure what you mean. Unless you make over $1 million, under the House bill you’ll pay no more.
double post–sorry.
bullshit. it doesn’t even come close to meeting the hcan 10 principles, which you told me (back in april when you were selling “obama’s plan”) were necessary and that any legislation that did not meet them would not be supported by you, jason, or by hcan.
if there is a case to be made for this bill, please make it honestly.
http://seminal.firedoglake.com/diary/18962#comment-108213
Yeah, yeah, we go round and round on this.
And no more documenting for you, we’ve been round and round on the cost control, too. If you don’t want to listen to the arguments, that’s fine. But trolling makes nobody look good.
oh, so expecting evidence is now trolling? must be a new rule.
here’s jon walker at fdlaction:
if any readers have info (positive or negative) on cost controls, i’d be very grateful for a link. thanks.
No, you asking for “evidence” every time, even though it was provided the last time.
RE: the actual point, the public option was scored by the CBO as doing some to control costs. Probably not enough, but it’s a lever with which pressure can be put on insurance companies. The Senate bill lacks any such lever.
i don’t remember you every providing any evidence for “plenty” of cost containment in the house bill (as you claimed in your comment @2). but even if it had only been my bad memory (after all, there have been a lot of versions of the bill), that’s certainly no justification for name calling.
……
“some to control costs. Probably not enough” — (as per your comment @17) is more in line with what i thought i remembered. thanks for the correction.
I appreciate your can do spirit, Jason. But don’t make excuses for anyone if none of that occurs, and the senate bill is passed as is.
Where is the constituency for the Individual Mandate? Who wants that?