As the vote near on the House health reform bill, it is easy to sink into the specifics of the bill, be obsessed by the debate on key details, and mourn amendments that we really wanted but that weren’t included.
But we should look at this bill in its totality, and appreciate how signficant it is, and how much help it would provide if it passes. Here’s my top ten reasons why this is an impressive bill:
1) Near-universal coverage for all, largely through group coverage with its efficiencies and purchasing power to get the best price.
2) The biggest expansion of Medicaid since its creation 40 years ago, completing a unfulfilled commitment for millions in and near poverty.
3) Sliding scale subsidies tied to income: Consumers will pay for coverage not based on how sick they are, but what they can afford.
4) The end of “junk” insurance, and bankruptcies due to medical bills, with a cap on out-of-pocket costs, and even no cost-sharing for preventative services.
5) Fair share financing that is progressive and pays for itself (in fact, it decreases the deficit), including an employer assessment as important as setting the minimum wage for pay back in the 1930s.
6) New consumer protections: New rules & oversight on insurers that include the abolition of underwriting and “pre-existing conditions,” minimum benefit standards, limits on age-based rates and on premiums dollars going to administration and profit.
7) A public health insurance option to provide choice, competition, and offer a safe haven against private insurer abuses.
8) The tools for cost containment and quality improvement in health care generally, from health information technology to transparency of cost and quality to a strong emphasis on prevention.
9) More sustainability and improvements for existing programs–like filling the donut hole in Medicare and streamlining Medicaid paperwork.
10) Momentum to do more in the future, politically and policy-wise, in health care and beyond.
Yes, it still needs to be merged with the Senate, which shares many but unfortunately not all of these characteristics. But for the House of Representatives to pass this proposal, and move us closer to these multiple victories, would be a historic achievement.