Health Care and the House

Previously I blogged about President Obama's Health Care address that he gave in the beginning of September, and last night there was a large and important step forward in his vision for providing health insurance to all Americans. Last night the House passed a $1.1 trillion, decade-long plan to completely re-tool the US's health Care system so that it actually provides health care to millions of American citizens who are currently just out of luck.

As far as I could tell, the Republicans did not reprise their theatrics of holding up hastily scribbled signs, which is really a shame because it made last night's vote lack that whole drunken high-school football game feel that I so enjoyed about September's address . Instead, Republican representatives settled for reading into the congressional record their absolute disdain for providing health insurance to more of their constituents. I may be biased but I thought the signs were way cooler.
For one thing, when you engage in horse-play on the Congress floor, guffaw, and hold up signs, you're just telling the world that you don't take the issue at hand seriously and that you're a person who knows how to have a good time at work. But when you act all serious and publicly voice your displeasure at providing affordable health care to the fellow citizens of your country you are just telling the world that you are sort of an asshole. This seems obvious to me and so I think I should be a political consultant.

Anyway, in reading through different news reports, I think the Washington Post gave one of the better breakdowns of what this would mean for the average citizen as far as what they would get and what it would cost:

"The complex package would affect virtually every American and fundamentally alter vast swaths of the health insurance industry. Starting next year, private insurers could no longer deny anyone coverage based on preexisting conditions, place lifetime limits on coverage or abandon people when they become ill. Insurers would be required to disclose and justify proposed premium increases to regulators, and could not remove adult children younger than 27 from their parents' family policies.

For the elderly, the group that has been most skeptical of Obama's initiative, the House package would immediately offer discounts on prescription drugs and reduce a gap in Medicare prescription drug coverage, closing it entirely by 2019. Uninsured people who cannot get coverage could join temporary high-risk insurance pools, and unemployed workers would be permitted to keep their COBRA benefits until the public plan and insurance exchanges started in 2013.

In four years, the measure would establish a new insurance system. Businesses with payrolls exceeding $500,000 would be required to offer their workers insurance or pay a fine of as much as 8 percent of payroll. Individuals would be required to obtain insurance or pay a fine of as much as 2.5 percent of income. States would be required to extend Medicaid coverage to as many as 15 million additional people. Low- and middle-income individuals who still could not afford coverage could apply for federal subsidies through an insurance marketplace that would negotiate with private insurers to provide comprehensive policies alongside a government-run "public option."

Congressional budget analysts say the package would cover an additional 36 million Americans, leaving 18 million people without insurance by 2019, about a third of them illegal immigrants. To avoid increasing the deficit, Democrats would pay for the coverage expansion by slicing more than $400 billion from Medicare over the next decade, and by imposing a variety of new taxes, primarily a 5.4 percent surcharge on annual income over $500,000 for individuals and $1 million for families. Initially, the tax would hit only 0.3 percent of taxpayers, but that number would climb rapidly, because the income thresholds would not be indexed to inflation."

There are all kinds of things that remain unclear, and of course the final bill could end up looking much different from this. Since I work with many clients who have only part-time employment, I'm wondering if the plan would call for employers to cover all employees or just full-time employees, and how much the government subsidies will be, to list just a couple questions.

Despite all the questions that are unanswered, all the problems with the bill, and all the work left to be done, I think it is a huge step forward. Activists have been working for decades to see something like this, even if it is far from perfect (the bill will still leave millions of Americans without insurance. Hopefully it passes the Senate, and hopefully the Senate Republicans bring their signs and Sharpies.