So it's on to the Senate. And if you think it was tough getting health care reform through the House, wait until the self-proclaimed "world's greatest deliberative body" gets hold of it.
In the end, majority rules in the House. So while the process of making law resembles the making of sausage, in the end, something usually comes out. If HR 3962 were to become law, most Americas who do not have insurance will no longer have to choose between death and destitution if a serious illness arises; Americans now insured through group plans arranged by their employers will no longer have to fear being thrown to the wolves running the market for individual insurance policies if they lose their group coverage; and Americans swimming in the individual coverage pool will no longer have to fear being denied coverage or priced out of the market due to a previously existing condition, or having coverage rescinded if a claim is made. We will all be free of the fear of running into a life-time cap which means a catastrophic illness leads to bankruptcy.
This is not to say the House bill is perfect. It is to say that it is a start, a compromise which brings the United States out of the wilderness and into the community of developed nations which guarantee a basic level of access to health services to its citizens. It is significant that HR 3962 had the support of AARP and the American Medical Association. Both required compromise and their support is cautious and qualified to be sure, but still indicative of the urgency of the problem of health care reform.
One can be sure that going forward AARP will be particularly vigilant to insure that the changes in Medicare, which faces major funding cuts as part of the reform legislation, achieve cost savings through elimination of bureaucracy and fraud while maintaining the level of care America's retired deserve.
The AMA, for its part, predicates its support for HR 3962 on the passage of HR 3961, a standalone bill that would spend $210 billion (latest CBO score) to cancel the Sustainable Growth Rate Formula cuts and pays for it by adding the full cost to the deficit. That will be a tough sell in both houses. But almost every year since Medicare was enacted, Congress has stepped in to block the cuts in Medicare reimbursements mandated by the formula. It's time to get rid of it completely and deal with the fiscal impact some other way.
Just to demonstrate how close this vote was, an eleventh hour change dealt with a ban on the use of taxpayer money to pay for abortions. Even though the provision already exists for other Federal programs, this hot button issue enabled abortion opponents to add stronger limits, as they apparently held votes necessary for passage.
Over on the Senate side, the compromise and wheeling-dealing are often not enough. Nor does the majority rule. You won't find it in the Constitution, but the rules of the Senate allow a member to take the floor and hold it until he keels over from exhaustion. This filibuster has been used to delay or completely block legislation, most notably laws designed to protect the civil rights of citizens.
Already Senate opponents of health care reform vow to keep the legislation from even coming to a vote. As the great sage Yogi Berra once said, "It ain't over 'till it's over."
