After months of tea partying, Stupak (“baby killer!!”), death panels, and “bipartisanship,” Congress passed legislation late Sunday night designed to greatly expand health care coverage and combat the tyranny of medical insurance companies. Despite my reservations about the bill, I am confident that this step is significant for millions of Americans in a similar way that Civil rights legislation was to previous generations under Johnson in 1964. President Obama and Congressional Democrats weighed reelection and popularity with the plight of the under-insured – particularly the lower classes – and thankfully, their ideological beliefs trumped potential losses in the 2010 and 2012 cycles. George Packer at the New Yorker writes:
“Civil rights brought an oppressed minority of Americans closer to equality, and—as Johnson knew—was so hated across the South that it was bound to cost the Democrats the region. Health-care reform, if it does what its supporters claim, will humanize a system in which the vast majority of Americans feel trapped. It will redress social and economic, not racial, injustices. Its breadth and potential effect will resemble those of Social Security and Medicare far more than civil rights—programs that became prime instances of popular activist government and tied substantial segments of the electorate to the Democratic Party for decades.”
The reform purportedly will cost $940 billion over 10 years. Not too shabby, recalling that the US budgets $700 billion annually for the military. The real test, of course, is whether the legislation actual delivers on the glossy prediction of increased equality. Among other things, the legislation:
- Expands coverage to 32 million currently uninsured Americans
- Bans denial of coverage or higher premiums based on pre-existing conditions (phased in by 2014)
- Bans higher premiums for women
- Creates an exchange market in which small business owners can shop for insurance coverage for their employees
- Taxes households making over $250,000 in order to pay for the expanded coverage to the lower classes
- Allows young adults to stay on their parents insurance through age 26 regardless of college enrollment
- Requires everyone to have insurance, either under Medicare/Medicaid or private insurance (those without insurance coverage will pay a $695 annual fine. No word on who exactly enforces this clause…)
- Closes the Medicare prescription drug donut hole
- Consolidates all student loans under the government starting in July and greatly increases Pell Grant funds
- Places a 10% tax on tanning salons (sorry, Jersey Shore)
The bad news:
- Abortion – a legal medical procedure – is still not covered by federal funds (though, without a public option, this basically maintains the status quo of Hyde.) Jos over at Feministing fears that the incredible silence on the part of pro-choice organizations will lead to a further marginalization of women’s rights, and she’s right.
- Women insured by private companies will be forced, by the Nelson “compromise,” to pay separately for abortion coverage and the rest of their health insurance. Political scientists predict that this clause will ultimately lead to the elimination of abortion coverage by all private insurance companies. Stellar.
- The bill lacks a public option. We are very much still at the mercy of insurance and Big Pharma, and anyone who tells you otherwise is greatly deluded.
- It prevents undocumented immigrants from purchasing insurance through the exchange.
The conversation is far from over. Major props to Ezra Klein for his start-to-finish coverage of the process of health care reform, and to the Tea Party for providing plenty of comic relief. Lest we forget: underneath all of the bantering from both sides about the faults of government-run health care, there are millions of uninsured Americans declaring bankruptcy and in some cases dying for lack of health care. This is unacceptable in any society, and it is about time that the United States takes care of its citizens. Is the legislation perfect? Not at all, especially because it lacks a public option. But passing legislation which begins to establish equality in access to a necessity for survival is something I can and should support. Here’s hoping for continued reform and expansion (and abortion coverage).