We’re now in the final stretch of the health care reform battle. Within the month we’ll either have a vote or the Democrats will give up on health care reform for the near term (or make some tiny improvements). President Obama is out giving a strong defense for the need for health care reform (many of us would have liked him to be this forceful earlier). Now that it’s in the final push, we need to make sure that our legislators know that we want health care reform and not let the argument get dominated again by the forces of crazy.
Chris Bowers at Open Left has a post about how progressives helped shaped health care reform for the better. Don’t lose sight of the fact that despite the fact that progressives lost a battle (public option), overall we’re winning the war. We can’t win the final war without pushing the bill over the finish line.
By comparing the current state of health reform legislation to the most conservative proposals that were passed out of Congressional committee, a healthy list of concessions progressives forced out of the right-wing of the party becomes visible. If there were no alterations from the most conservative health reform proposals that were passed out of Congressional committees in 2009, then the current state of health reform legislation would have:
1. $125 billion less for Medicaid, CHIP and exchange subsidies (total across all three programs);
2. Numerous exceptions to Medicaid eligibility even for people below 133% of the federal poverty level (FPL from here on out);
3. No minimum medical loss ratio for health insurance plans, instead of an 85% minimum medical loss ratio;
4. The Stupak amendment, instead of the Stupak state opt-out that is in the Senate bill;
5. No extra money for federally funded Community Health Centers, instead of increased funding to provide primary care to 16.2 million patients annually;
6. An excise tax on high end insurance plans would start in 2013 (giving most unions no time to renegotiate contracts), and a lower threshold (making it less progressive);
7. No 2.9% tax increase on unearned income, making the funding mechanism for the overall bill less progressive;
8. A stronger individual mandate and fewer responsibilities for employers;
9. No national exchange, instead of what appears to be both a state-based and a national exchange in the proposal form the White House.
Bowers has a scorecard of sorts over the big fights that occurred in the health care reform bill. Here’s his list of the top 10 fights and their results:
1. The public option – conservaDem victory
2. Repealing the health insurance industry’s anti-trust exemption – conservaDem victory but pending (repeal has passed the House)
3. Instituting a minimum medical loss ratio for insurance policies – mostly progressive victory
4. Expanding primary care in low-income areas through Community Health Centers – mostly progressive victory
5. Medicaid expansion – even
6. Exchange subsidy levels – mostly conservaDem victory
7. Tax structure for funding the bill – mostly conservaDem victory
8. Insurance exchange structure – unclear
9. Reproductive rights – mostly conservaDem victory
10. Mandate – mostly conservaDem victory