Kennedy Health Care Reform Bill Launches New Phase of Debate

The health care reform debate moved to a new phase Senator Edward Kennedy and his fellow Democrats on the Senate Health, Education, Labor, and Pensions Committee (HELP) introduced sweeping legislation. Senator Kennedy is Chair of the ccommittee. What is significant is not what is in the bill — it’s general outline has been known for awhile — but the publication of the bill itself. It marks the beginning of the move from discussions on generalities to negotiations on specifics.

The HELP Committee Legislation is entitled the “Affordable  Health Choices Act.” (Virtually every piece of health care reform legislation will include the word “choice” as the lack of choice — see as evidence The Patients’ Choice Act four Republican lawmakers are planning to introduce. The reason is that many in Washington believe opponents framing of the Clinton Administration’s health care reform plan as limiting choice was a leading contributor to it’s downfall.) The HELP Committee press release proclaims the legislation “reduces health care costs, allows Americans to keep the coverage they have if they want it, and makes health insurance affordable to those who do not have it today.”

That remains to be seen. The 615 page draft health care reform bill covers a lot of territory and it will take some time to sort through its many provisions. A quick skim, however, indicates that it generally hews to the outlines Senator Kennedy has been talking about in recent days. It would create state gateways through which individuals and some businesses could purchase coverage and a government-run carrier would compete with private carriers  Individuals earning up to 150 percent of the Federal Poverty Level ($16,245 for an individual in 2009) will be eligible for Medicaid. Insurance premiums for those earning up to 500 percent of the federal poverty level (currently $110,250 for a family of four) so their payments do not exceed 10 percent of their gross adjusted income.

At this stage, the details actually are not all that important. Discussions among the HELP Committee’s Democrats and Republicans continue (now those would be interesting to watch). And several other bills by different committees in both the House and the Senate are due. All will wind up in the sausage making process. What any one draft contains is not necessarily what will emerge at the end.

For now, Senator Kennedy is anchoring the left in the debate. (Anchoring a position is done by both liberals and conservatives. It is a negotiating tool in which the anchor calls for extreme provisions in the hopes of having any compromise which emerges from moving too far toward the other side). I don’t mean this cynically. Senator Kennedy is no doubt sincere in supporting the provisions of his committee’s legislation. However, he is a practical policitian and knows compromise is inevitable. Being the first Congressional committee to issue a draft, there is no need for him to introduce a watered down bill. After all, he would be foolish to negotiate with himself. Better to stake out his ideal position and see what the other committees produce.

A public hearing on the HELP Committee bill is scheduled for June 11, 2009 and the committee will begin editing the bill at a June 16, 2009 meeting. The Democrat’s press release emphasized that negotiations with GOP members of the committee are ongoing so it will be interesting to see what changes emerge  once mark-up begins.

All this is important and interesting. But again, the details of the Affordable Health Choices Act are less important than the existence of the Affordable Health Choices Act. A new phase of the journey toward comprehensive health care reform has begun. The debate continues.