Health Insurance Reform
by Jerome Armstrong, Mon Mar 22, 2010 at 09:14:28 AM EDT
Its worth noting that the WH is refering to the reform as "HIR" and not HCR. As framed, there are some very good things in this bill-- C & R notes ten of them.
In terms of Healthcare reform, the jury is still out. The mandate for tens of millions to buy insurance from private corporations is years away, along with whatever enforcement that entails. However, it should be noted that Bernie Sanders was able to include a significant foot in the door in regards to having a public healthcare option available:
Authorizes early funding of community health centers in all 50 states (Bernie Sanders’ amendment). Community health centers provide primary, dental and vision services to people in the community, based on a sliding scale for payment according to ability to pay.
The mandates for private insurance are a terrible idea (especially politically), exchanges are better, but for real HCR, we'll need a national single-payer system that replaces exchanges, mandates, and subsidies. I'm pretty sure too, that it would be wildly popular. Congrats to the Dems in the House for making the first step.
[UPDATE] Good question in the comments of when something like single-payer may actually happen. I would think, that the next window of opportunity is not for another cycle or two. Also, what Jane Hamsher points out about the Mandate Mania, is really the next battle. But unlike Gay Marriage, which is very polarizing, the mandate for indivuduals to buy private insurance is popular with very few besides the liberal political wonks, and toxic among Libertarian Democrats.
FDL counts 31 states where anti-mandate organizing is already happening. Here in Virginia, politicians have already made the mandate a Mandate-In-name-Only, by allowing its citizens to avoid any federal mandate to buy health insurance. The measure passed the Democratic Senate 23-17, and then passed in the Republican controlled House of Delegates by a 80-17 landslide.
So, to answer the question. I except that as the mandate becomes something that a minority of politicians embrace, it's either going to break toward a public plan emerging, or a repeal of the mandate.
The latter could happen from either the Republicans gaining control of Congress and repealing the mandate (tough to imagine that Obama, whom sucessfully used it as a political wedge against Clinton & Edwards in the 2008 primary, would veto this too); or, the Republican 5 on SCOTUS find the mandate unconstitutional.
What's interesting too, is how Democrats in DC view the liability of the mandate as the lesser of evils. What was more important was to get a CBO score that reduced the deficit, hence the mandate to get that number.
How does the break happen toward a public plan? Well, the first step is going to be to have a vote on it. Activists are going to have to really shake up Congress to get there, and knowing where each Democrat stands is only first base, and we haven't even gotten there yet.
So, lets just leave this as recognizing that Democrats accomplished substantial Health Insurance Reform. It took way too long, but its finally, whatever you want to call it, been achieved.
[UPDATE] Not unexpectedly, Republicans are throwing things in the kitchen:
"There will be no cooperation for the rest of the year," McCain said during an interview Monday on an Arizona radio affiliate. "They have poisoned the well in what they've done and how they've done it."
Wil this kill the Energy/Climate, Kerry-Lieberman-Graham legislation is what I'm wondering, as that was the biggest hope of this whole cycle imo.
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