In yesterday’s post I described some highlights of a draft health care reform proposal being circulated in Washington by Senate Finance Committee Chair Max Baucus. Yesterday all I could find were news stories about the proposal. Today the full text of what is called the “Framework for Comprehensive Health Reform” is available.
There’s a lot of interesting details in the proposal. It would dramatically change the way health insurance is priced, purchased and administered. It brings together several proposals to reduce the underlying cost of care (although it fails to bring them together into a single section – a political error in my view). It offers subsidies to make coverage more affordable. requires individuals to obtain coverage, and penalizes businesses of more than 50 workers who fail to offer its employee’s insurance. It does not include a government-run plan, but does create state-level health insurance exchanges and authorizes health insurance co-operatives.
The document is only 18 pages and well worth the reading. Because what is significant about the framework is its embodiment of the more moderate ideas under serious Congressional consideration. The framework is not legislation and the Finance Committee is likely to make significant changes to various aspects of the proposal. But if the legislation that emerges from the committee is anything like what’s being circulated by Chairman Baucus, it is the vehicle for reform that has the best chance of capturing any Republican support and of attracting moderate and conservative Democrats. It is also the legislative package destined to be the target of liberal wrath.
Which is another reason the Senate Finance Committee’s Framework is significant. The proposal is being circulated just before President Barack Obama’s address to Congress on health care reform. In his speech President Obama will be creating the context for the final push toward comprehensive health care reform. Previously the debate had focused on the only proposals on the table – the liberal bills passed by the Congressional committees. You were either for them or against them. The Framework being considered by the Senate Finance Committee brings forward a new option, a more moderate option. It won’t attract the support of conservative Republicans – nothing Democrats propose could. But it may attract some GOP votes and it certainly will bring along many moderate and conservative Democrats.
I have long maintained that health care reform would be decided by such moderates. But it is up to President Obama to make this possible. His speech will either strengthen or weaken Senator Baucus’ proposal. His address is expected to clarify what provisions he considers crucial to reform and which he simply prefers and encourages. If he stakes his position firmly in the liberal camp the chances of moderates prevailing is greatly reduced. If, however, he embraces some of the provisions put forward by Senator Baucus, the debate will shift considerably toward the middle. And the legislation likely to emerge from Congress will look substantially like the Framework.
In other words, President Obama is coming to the health care reform arena with no intention of sitting on the sidelines. Now that there are two teams on the field, he needs to make clear which one he’s on.