Amidst dipping public support for health care reform that dropped from 45% of Americans saying the country would be better off with health reform passage down from 54% in November, according to the Kaiser Family Foundation’s most recent poll, the Senate passed the last two procedural measures needed yesterday and today to cut off debate and move its health reform package forward. With identical votes of 60-39, Senate leaders secured the necessary support to block GOP filibuster attempts, setting the stage for Christmas Eve passage of the bill, H.R. 3590. A compromise was reached between Senate Democrats and Republicans yesterday to schedule a vote for 8:00 AM tomorrow morning.
Of the 47 million Americans currently without health coverage, the Senate health reform package would provide coverage for 23 million uninsured. The House bill would cover 17 million. The price tags of the two chambers’ bills differ as well, with the House bill costing an estimated $1.052 trillion and the Senate legislation coming in at $871 billion.
The Washington Post provides a good interactive comparison of the House and Senate bills.
These differences must all be worked out during conference before a final bill can be approved and sent to President Obama for his signature. Right now, Democratic leaders are looking to complete all conference activities in January in time to have a final bill ready for the President before the State of the Union address.
Turning to the continued discussion over covering the cost of the bill and differences between the House and Senate expenditure estimates, The New York Times states that:
The pharmaceutical industry “is bracing for an increase in its share of the cost of the proposed health care overhaul beyond the $80 billion over 10 years that it had negotiated with the White House.”
The revised bill has now been endorsed by key groups such as the American Medical Association (AMA), yet divisions still exist within the Democratic party itself. Compromises must be reached on controversial issues including the public option, which the House bill includes but the Senate version does not, and limitations on Federal funding for abortion coverage.
As reported by Roll Call:
“Congressional Progressive Caucus Co-Chairman Raúl Grijalva (D-AZ) said in an interview Tuesday that he will push hard for significant changes to the Senate health care bill in conference but stopped short of saying he would vote to kill it.”
Despite the controversy and compromises, the historic nature of health reform passage should not be understated. U.S. presidents dating back to Teddy Roosevelt have failed in attempts to see proposals enacted to expand coverage to all Americans. The current proposal is not the version originally articulated by the Obama administration at the start of the year – in the words of Senator Tom Harkin (D-IA), the bill is “not a mansion. It’s a starter home” to build onto. Yet the package does address critical needs such as eliminating exclusions for pre-existing conditions and lifetime coverage limitations. And as my colleagues point out in our frequent conversations on the topic, proposed initiatives would also fundamentally change the way health care is delivered in this country by expanding access and addressing prevention and wellness needs such as:
- Creating a national plan (either through a council or taskforce) to improve the nation’s health via prevention and wellness activities including the increased development and dissemination of evidence-based strategies.
- Eliminating cost-sharing for proven prevention services in public programs for Medicare and Medicaid beneficiaries.
- Providing incentives for small businesses to create wellness programs. The Senate version allows for reduced premiums, the House version provides grants to conduct the programs.
- Increasing nutritional information available to consumers by requiring, a year after implementation, chain restaurants and vending machines to provide nutritional content on each item sold.
While the forecast for January remains uncertain, President Obama stated in an email to supporters this week:
“After a nearly century-long struggle, we are now on the cusp of making health insurance reform a reality in the United States of America.”
Despite the changes and compromises from where we started eleven months ago, for the millions of Americans currently living without health coverage, this is Christmas gift of most welcome proportions.
Tags: Health Care Reform, Health Policy, Pharma, Public Health
