Finally, Health Reform Passes
Well, here we go! In a historic 219-212 vote late Sunday night, the U.S. House of Representatives passed a $914 billion health reform package extending health coverage to as many as 32 million Americans
The bill will affect virtually every man, woman and child in the United States in some way, from the 20-somethings who constitute one of the largest uninsured groups to poor, childless adults who don't qualify for Medicaid in most states to well-paid professionals who could see their benefits shrink. The health-care debate touched on many highly charged moral issues in American life, and a handful of antiabortion Democrats held up a final deal until late Sunday afternoon, before reaching a breakthrough with the White House.
Here's a round-up of reaction so far:
Jonathan Chait, at the New Republic offers what he calls "a ludicrously premature opinion:"
Barack Obama has sealed his reputation as a president of great historical import. We don't know what will follow in his presidency, and it's quite possible that some future event -- a war, a scandal--will define his presidency. But we do know that he has put his imprint on the structure of American government in a way that no Democratic president since Lyndon Johnson has.
Insurance broker and blogger Alan Katz offers this analysis that's worth keeping in mind for your follow-up stories.
As a result of tonight's action, Congress has addressed the easiest part of health care reform: changing how insurance companies act and are regulated. These "market reforms" are meaningful. Some, although not all, were necessary. But in a real sense the measures enacted represent low hanging fruit. Because the reality is that insurance companies don't determine insurance premiums in a vacuum. Congress has taken on the easy villains in this drama: the greedy insurance companies. But everyone knows (and a few will admit) that health costs will continue to increase at an unacceptable rate. This means lawmakers will soon be forced to address the real driver of increasing health insurance premiums: medical costs that increase at twice the rate of general inflation. Doing so will be more difficult than beating up on insurance carriers, but eventually there's no escaping the need to address root causes.
On the conservative side, the editors of the National Review write:
It takes some ingenuity to add to the costs, inefficiency, and dysfunctions that government has already bequeathed to our health-care system, but the Democrats have proven themselves up to the challenge. Almost nothing about this legislation is free of dispute, but we are convinced that it will increase taxes, increase premiums, and increase debt, while decreasing economic growth, job growth, and the quality of health care.
Ezra Klein, who has been a vocal supporter of sweeping reform, takes a different view:
The legislation builds a near-universal health-care system, but it only uses the materials that our system has laying around. It leaves private insurers as the first line of coverage provision, but imposes a new set of rules so that we can live with -- and maybe even benefit from -- their competition
It is the most sweeping piece of legislation Congress has passed in recent memory, but it is much less ambitious than the solutions that past presidents have proposed. It is routinely lambasted for being too big and comprehensive, but compared to the problems it faces, it is too small and too incrementalist.
But it's a start.