Outside the Senate…

Today, there was a rally and “die-in” in Washington, DC by “tea party” opponents of health reform, chanting “kill the bill.” One of the speakers was Rick Scott, the disgraced former CEO of Columbia/HCA and now head of Conservatives for Patients Rights. Other speakers were talk radio hosts, Dick Armey, the former Republican Majority Leader of the U.S. House, and current elected officeholders like Representative Michele Bachmann and Senator Jim DeMint.

Judging from watching the rally on C-SPAN, the news of the removal of the public health insurance option in the current Senate bill may have gotten a few Senators votes, but did nothing to minimize opposition from these speakers.

Why not?

Maybe because they recognize that there is more at stake than the public health insurance option.

For those of us who think the public health insurance option is important, we need to continue to advocate for it–there’s still conference committee, and there will be opportunities in implementation, both in DC and here in California.

But a public health insurance option as envisioned really only works if it is in the context of a broader framework like proposed in this bill. A public health insurance option, to be successful, needs to operate by the same rules as the private insurers it competes with. So if insurers are allowed to deny patients for pre-existing conditions, the public health insurance option will have to follow suit. It’s only in the context of a framework of a regulated exchange with guaranteed issue and modified community rating, like the current health reforms provide, that a public health insurance option can both thrive on its own, and be a competitor for insurers rather than a dumping ground.

It’s an entire framework that would change the health system we have. One that would:
* Makes almost 4 million uninsured Californians eligible for coverage
* Means that when you lose your job or get divorced, you don’t lose your health insurance
* Requires insurance companies to take everyone
* Prevents insurance companies from dropping you when you get sick
* Makes health insurance more affordable for millions of Californians
* Begins to reduce health care spending overall
* Imposes rate review on insurers
* Says the insurers must spend at least 80 cents out of every premium dollar on health care
* And provides for the largest expansion of public programs (still) since Medicare and Medicaid were created.

But there are other aspects of the framework that the Senate bill is deficient, in some cases seriously so. How much do we ask of low- and moderate income families in terms of getting affordable coverage? What is the minimum level of coverage that a health plan should provide? Should all large employers contribute into the health care system? How is this financed? Are we going to impose cumbersome verification procedures for people to buy coverage that make it harder for people to get coverage?

As evidenced by the opposition rally today, the opponents of health reform aren’t done in there efforts to either stop the process or make the bill worse.

We can’t let up. Our task is to continue to work to both move the process forward, and to make it better.

Health Access California promotes quality, affordable health care for all Californians.
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