Although most measurements of success for a US President have rested solely on economic factors, the legacy of President Obama (and perhaps a second term) rests largely on another key factor: health care reform. Since taking office, Obama has stressed the need to pass “meaningful health care legislation this year,” but with recent distractions, this year is starting to look troublesome.
Senate HELP Committee Hearings
Chairman Kennedy (D-MA) has worked on universal health care and legislation for almost his entire career. Throughout the past year his HELP Committee has held numerous hearings to investigate and research the most effective and efficient options for meaningful changes in the health care system. As a result, his Committee produced the ‘‘Affordable Health Choices Act’’.
Important components of this legislation include being able to keep your present insurance if you like it; stronger prevention, better quality of care and use of information technology, while rooting out fraud and abuse; making information widely available in medical settings, schools and communities; coordinating patients’ care to individual health needs; and long term care and services.
Seemingly, without a Finance Committee bill for comparison, the internal debate among Democrats on both committees for changes is beginning to ignite.
House Discussion Draft
Leading the way for health care reform legislation, The House Committees on Ways and Means, Energy and Commerce, and Education and Labor were able to produce their ‘discussion’ draft of health care reform almost three weeks ago.
The version of their legislation focuses on creating a Health Insurance Exchange and offering a public health insurance option; guaranteeing coverage and insurance market reforms; protecting consumers by prohibiting lifetime and annual limits on benefits; offering essential benefits through a new independent Advisory Committee; sliding scale affordability credits; capping annual out-of-pocket expenses; increasing competition; expanding Medicaid; improving Medicare; expanding community health centers; and many other options.
In looking at the House and HELP Committee versions the goals seem to be the same, but the means of achieving those goals are likely to change once the Finance Committee and conference report come into play.
Senate Finance Committee Stalls
While the Senate Finance Committee Chairman Max Baucus released his Call to Action Healthcare Reform the day after the election and has held three roundtable discussions to begin the health care reform discussion process in late April and May, they have still yet to produce a bill.
As a result, Obama has called Democrats on the Senate Finance Committee to urge them to stick to his timetable for a final bill to reach his desk in October, according to the New York Times.
According to the Wall Street Journal, “Sen. Baucus is working on a centrist plan that would expand coverage, but not by creating a public plan to compete with insurers. Instead, he would create a network of nonprofit cooperatives that would compete in the private sector.”
The New York Times notes that the bill could include a new tax on some employer-provided health benefits, and a requirement for employers to help pay the cost of insurance for some of their low-income workers. Senators are also looking to expand Medicaid to cover more people, but this effort might get pushed back to 2013 to keep costs low. Interestingly, Baucus said, “The Congressional Budget Office has given the Committee options to write a $1 trillion bill, fully paid for.”
Consequently, the political dynamics of Senators Baucus and Kennedy are different: Baucus hopes to gain bipartisan support for his bill, while Kennedy’s more liberal agenda is likely to force Republicans out of the negotiating table.
Obama Goes to Governors, People
With Democrats deeply divided over health legislation, President Obama is now trying to involve the nation’s governors, as well as grass-roots supporters in order to increase pressure on lawmakers to meet his deadline.
Recently, Obama met with five governors including Republicans, in which he stressed language governors should use with lawmakers, avoiding terms like “rationing” and “managed care.” These terms scare the public with regards to long lines for medical care, and longer waiting lists for procedures. These terms are also negative reminders of the failed Clinton-era attempts at health reform.
Obama also plans to travel to Virginia to hold a second town-hall-style meeting on health care, the first meeting taking place in Wisconsin. This strategy, while keeping Obama away from Democrats’ internal fights also poses the problem of waiting too long to create compromise. In fact, President Obama could lose control of the final reform process if legislators begin to go behind closed doors.
Ultimately, this measure can and will affect nearly every family, employer and health care provider in the country. Coupled with the fact that Democrats are nowhere near where they had hoped to be should be a red flag for the American public: more time and research is needed. It may take fifty years before we know the effects the stimulus bill has on our economy, but a health care bill will take only a matter of days: when your doctor tells you, “three months for an x-ray.”