Jonathan Cohn on the Senate’s progress on a final health care reform bill, The Starter Home
But let’s not kid ourselves: If and when a bill goes to President Obama for signing, it’s not going to look radically different than the measure Reid put forth today. Ben Nelson, the sixtieth vote, made that clear when he warned that he was prepared to change his vote if the bill came back from conference looking radically different.
That’s frustrating. But it shouldn’t take away from what a huge accomplishment this is. As Dodd reminded people in his remarks, this measure is going to make life better not just for millions, but tens of millions of people. Those without insurance will get it; those with it will have guarantees of financial security they never had before. The government will begin creating an infrastructure for making our health care system focus on better quality care, even as it tries to make the system less expensive.
With the added reminder that like Social Security and Medicare health care reform will get tweaked oer the years and will be a better bill. TPM looks at the Nelson compromise,
But what he did get might still draw the ire of pro-choice activists and legislators. According to a senior Senate leadership aide, under the Nelson compromise, “[i]ndividuals receiving subsidies will have one premium that they pay with two distinct transactions.”
Put another way: If you’re buying insurance with help from the government, and the policy you want to buy covers abortions, you have to write two checks (or authorize two credit card transactions, etc.) for your plan. If the plan costs $1000 a month, and the insurer plans to sequester $50 to put into a pool that covers abortions, you have to make one payment of $950 and a separate payment of $50.
Or put yet another way an individual woman will have to buy separate coverage. While I have no reason to believe that the National Organization for Women is arguing in bad faith they may not understand the full implications of arguing to blow up the bill completely. As Paul Krugman notes, blowing this opportunity will mean trashing health care reform for perhaps a decade,
And here’s what happens if a bill isn’t passed now: Democrats lose seats — maybe a lot of seats — in the 2010 midterms. A weakened President Obama wins reelection, maybe – but even that isn’t certain. No way he has the votes for another try at health care before 2015. Quite possibly, there isn’t another chance until 2021.
Some people say that we should throw it away and start over; is this what they have in mind? Because that’s the reality of what would happen.
If the bill is passed, it will make health insurance available to millions of people who can’t get it now either because of preexisting conditions, or because they just don’t make enough: community rating and the subsidies — remember, we’re talking about almost $900 billion in aid — will make a huge difference. Yes, there will be some people forced to buy insurance by the individual mandate; everything I’ve seen says that the number of people for whom this will be a real hardship will be far less than the shouting suggests.
It’s actually strange the Right is trying to paint the bill as a way to subsidize abortion contrary to the Stupak (D-MI) amendment. NOW says it undermines a woman’s legal right to choose. Sens. Barbara Boxer (D-CA) Patty Murray (D-WA) are the reliable sources in this case. The bill let’s a woman use her own private funds to buy abortion related coverage. Conservatives will have to oil up the spin machine to explain why an individual American should not be allowed to enter into private contracts with free market entities. In some comment sections and rabid right blogs I’ve already read the argument that tax money located in the mere proximity of someone who might exercise domain over what to do with their own body is forcing tax payers to pay for something they do not like. We do not have tobacco subsidies anymore, but I and every tax payer has to help pay for the Tobacco Transition Payment Program. I personally do not mind, but others might object to helping subsidize the tobacco industry abet indirectly for four more years. Tobacco kills actual human beings, which people like House Republican leader John Boehner have no problem with. I have mixed feelings about nuclear power. The energy itself is clean, but waste disposal remains a genuine problem. Nuclear waste kills and yet regardless of one’s feelings about the issue tax payers are forced to subsidize the nuclear power industry directly or through guaranteed loans. We know that lack of health insurance kills 44,000 Americans a year. We also know that women suffer disproportionately from our current broken system – if conservatives really cared about women and children ( born or unborn) they would support health care reform. As usual, conservatives in reality are pro zygote, but do not care very much about living breathing citizens. AMA president says pregnant women are barred from buying individual health policies
In 39 states, listed here , insurers can turn down anyone for virtually any reason. It can be because you have a pre-existing condition, like cancer or diabetes. And pregnancy almost always counts too, according to the National Association of Insurance Commissioners, which represents the state government officials who regulate insurance sold within their borders. So if you’re pregnant and living in one of these 39 states, you’re very likely out of luck in securing individual health coverage. You’ll have to pay for your care out of your own pocket or seek out charitable assistance.
And the coverage isn’t much better in the remaining 11 states. These states have “guaranteed issue” laws that say insurers cannot turn applicants down based on their health or risk status. But there’s a caveat: Even if an insurer must offer you a plan, it can place exclusions on what the plan covers. Typically, the NAIC says, these exclusions last from six to 12 months, which rules out most or all maternity coverage.