President-elect Barack Obama won’t take the oath of office for more than two months, but the drive for health care reform is about to get under way. Senate Health, Education, Labor and Pensions Committee Chair Ted Kennedy has been working from his home, where he’s fighting brain cancer, seeking to pull together a consensus bill. Meanwhile, Senator Max Baucus, Chair of the Senate Finance Committee introduced his health care reform plan today.
Senator Baucus’ Finance Committee and Senator Kennedy’s Health, Education, Labor and Pensions Committee share jurisdiction over this issue. According to Politico, the staffs of the two committees have been meeting with stakeholders since the summer and the two committee chairs have been in contact. The details of Senator Kennedy’s plan have not yet been released.
Senator Baucus’ health care reform plan contains several elements that align with the reforms President-elect Obama called for during the campaign. These include the creation of government-run “exchanges” to allow Americans to shop for coverage from multiple carriers and a requirement that carriers accept all applicants regardless of pre-existing health problems. Significantly, Senator Baucus goes a step further and would require all Americans to purchase coverage “once affordable options are available.”
Requiring everyone to purchase coverage was a contentious issue during President-elect Obama’s hotly contested primary fight against Senator Hillary Clinton. She was for a mandate to buy; he opposed it. As has been previously noted, a requirement to sell insurance without a requirement to buy results in higher premiums. Senator Baucus apparently agrees noting that the uninsured incur medical costs that are then shifted to those with insurance. By bringing everyone into the system, Senator Baucus believes the average cost of insuring each American will be reduced. By including an alternative for those who cannot afford coverage he avoids one of the most vociferous objections to requiring consumers to buy coverage.
Senator Baucus’ health care reform plan would also allow those between the ages of 55-and-64 to purchase Medicare if they lack access to public insurance programs or a group health plan. According to the New York Times, four million people in this age group are currently uninsured. He would expand the State Children’s Health Insurance Program to include children in families at or below 250 percent of the federal poverty level ($44,000 for a family of three) and he would lift the ban preventing legal immigrants to enroll in SCHIP until they’ve been in the country for five years. Like President-elect Obama, Senator Baucus supports tax credits for small businesses that provide health insurance coverage and for individuals and families, below 400 percent of the federal poverty level, who purchase their own coverage.
We haven’t heard from the Republican side of the aisle on this issue yet, but it shouldn’t be long now. There proposals will likely be more market oriented and less far reaching.
The key question is whether lawmakers in Washington have the bandwidth to fashion a comprehensive health care plan while simultaneously dealing with a crashing economy, a host of international issues and energy policy. Personally I think they’ll make the time. Health care reform is too entwined with people’s sense of financial and is too much a part of the economy to be put off. As I’ve written before, if health care reform is positioned not as a cost item, but as in investment in the nation’s infrastructure, it becomes very compatible with other economic stimulus efforts.
On the other hand, it is interesting that Senator Baucus, the Chair of the Senate Finance Committee, has apparently left out the funding mechanism for his reform package. That in itself is a telling reminder of how difficult achieving meaningful reform in today’s economic climate will be. That it is difficult, however, does not mean it’s impossible.
Note: I haven’t been able to find