House passes health reform bill

Last night the House of Representatives voted 219 to 212 in favor of the Senate health reform bill. Republicans unanimously opposed the bill and were joined by 34 Democrats. The bill now goes to President Obama’s desk for his signature. The House also voted 220 to 211 in favor of changes to the legislation that came out of negotiations between the House, Senate, and White House. The Senate must approve these changes.

This bill is a major expansion and improvement of the U.S. health care system. This long overdue legislation is the result of almost a century of organizing and political action. It is a considerably weaker bill than we started with about a year ago, though. There is no public option included, surely a win for insurance companies but a loss for the rest of us, and it is not without very serious problems.

The bill would:

• Expand coverage to 32 million uninsured in the U.S.
• Create insurance exchanges. The uninsured, self-employed and small businesses could purchase insurance through state-based exchanges. There are subsidies to help purchase insurance through the exchange for those who make between 100 and 400 percent of the federal poverty level.
• Expand Medicaid to cover those who make up to 133 percent of the federal poverty level. Undocumented immigrants are not eligible for Medicaid.
• Close the so-called Medicare “donut hole,” a costly gap in prescription drug coverage for seniors.
• Ban higher premiums and denial of coverage because of preexisting conditions.
• Ban higher premiums for women.
• Require coverage of maternity care.
• Allow children to continue being covered by their parent’s plans through age 26.
• With some exceptions, require all U.S. citizens to purchase insurance or face a $695 annual fine.
• Require those with 50 or more employees to insurance or pay a $2000 fine per employee every year if any employee receives federal subsidies for purchasing insurance. The actual employer mandate was removed by the Senate.
• Ban undocumented immigrants from purchasing insurance with their own money in the new exchanges.
• Ban the use of federal funds to pay for abortion in the exchange, which experts say will eventually eliminate even private insurance coverage for abortion.

Additional summaries of the bill can be found here and here. Many more documents, including the full bill and summaries, can be found at the Speaker of the House’s website.

I want to be overjoyed by the passage of this bill. It’s so much less than we started this process with, but it is still a major expansion of health insurance coverage. In many ways it’s a big human rights win. But the severe restriction of abortion access and exclusion of undocumented immigrants from coverage are unconscionable. The limits on abortion access go back on a commitment by democrats that this legislation would maintain the (horrible) “status quo” on abortion coverage. This legislation is about giving people in the U.S. access to what should be a basic, fundamental human right: health care. I am so glad that 32 million people who are uninsured will be able to receive care. But abortion is health care. Women who need abortions and undocumented immigrants are just as deserving of basic human rights as anyone else. This legislation fails to recognize these facts, so I have a very hard time celebrating the aspects of the bill that are clearly a victory.

What are your thoughts on the bill passed by the House?