Ending the Democrats’ century-long pursuit to reform health care standards, the Democratic-controlled Congress approved historic legislation Sunday night extending health insurance to tens of millions of uninsured Americans.
The bill passed the House on a 219 to 212 vote without a single Republican vote. 34 Democrats joined the opposition.
Alvand Abdolsalehi talks with political expert Ange-Marie Hancock on the cost of the bill.
Toll of the Bill
This legislation will touch the lives of nearly every American if it is passed by the Senate.
If realized, the expansion of coverage would include 95% of all eligible individuals under age 65.
The bill would make a nearly $1-trillion commitment in taxpayer money over the next decade to help an estimated 32 million uninsured Americans get health coverage. It also would ban insurers from denying coverage on the basis of pre-existing medical conditions and cut deficits by an estimated $138 billion over a decade.
For the first time, most Americans would be required to purchase insurance and would face penalties if they refused. Large employers will have to provide employees with health benefits or face penalties.
The most expensive feature in the bill, racking up to $500 billion, is devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.
The bill would open the nation’s Medicaid insurance program for the poor to all Americans earning less than 133% of the federal poverty line - $14,404 for an individual or $29,327 for a family of four.
The government would also create new state-based insurance marketplaces for millions who do not get coverage through work. Commercial insurers would offer plans in these marketplaces and they would be required to provide a minimum set of benefits, including mental health services, maternity care and preventive care.
For younger America, the bill is offering sweeping changes in the student loan program. It would have the government originate all student loans, denying banks and other private lenders of a lucrative business they have long had. Much of the savings would go into increased Pell grants for needy college students, but black and Hispanic colleges would also benefit.
The final obstacle for the bill’s passage concerned abortion but the White House reached a compromise with a group of anti-abortion Democrats led by Rep. Bart Stupak of Michigan. They had withheld support over concerns that the legislation did not sufficiently ensure that federal funding would not be used for abortion.
The president agreed to issue an executive order directing his administration to develop guidelines to prohibit the use of taxpayer subsidies to pay for abortion services.
To pay for the legislation, Democrats approved a new 3.7% tax on investment income for individuals earning more than $200,000, and couples earning more than $250,000. In 2018, people with high-end health plans would be subject to a new tax on their benefits.
Medical device makers, pharmaceutical companies and insurers would be subject to new excise taxes.
The bill would also cut more than $400 billion over the next decade in what Medicare pays to hospitals, nursing homes and insurance companies that provide Medicare Advantage plans. Proponents hope this provision would ultimately help make the system more efficient.
Republicans have agreed the bill would affect everyone in America but not positively – warning repeatedly of the burden imposed by more than $900 billion in tax increases and Medicare cuts combined.
“With this legislation, we as a country are one step closer to addressing the skyrocketing health care costs that have burdened and even bankrupted American families for decades,” Mayor Antonio Villaraigosa said.
He thanked President Barack Obama, Speaker Nancy Pelosi and all those who voted for the bill on behalf of the estimated 2.7 million people in the city and county of Los Angeles who have no health insurance.
Assembly Speaker John Perez, D-Los Angeles, said the bill should help the state’s economy and citizens, with one in four Californians uninsured and millions more businesses and families struggling to afford health care.
“Affordable health care is a key part of any realistic job creation and economic recovery effort, and (this) vote will remove a major obstacle to our work to turn the economy around and sustain real job growth for the future,” Perez said.
California Republican Party chairman Ron Nehring predicted the passage of the bill would invigorate voters.
“Make no doubt about it, this November the people of California will go to the ballot box in droves to elect Republican candidates who will listen to them and focus on creating jobs for the Golden State, not a government takeover of their health care.”
Democratic Reps. Lucille Roybal-Allard, Xavier Becerra and Diane Watson of Los Angeles, and Laura Richardson of Long Beach were among those who voted for the bill.
Facing the Senate
Though much of the country is celebrating this historic moment, the challenge is not over for the reform bill.
The House passed the Senate’s health care reform bill and a package intended to resolve differences between the House and Senate bills.
President Obama is expected to sign the health care bill Tuesday at the earliest. The Senate will plan this week to begin debating a second measure added by the House to the health care legislation. This measure, which makes small changes to the original bill, also passed the House Sunday, 220 to 211.
It may be a bumpy road for the Senate to sign off on those changes.
Senate Republicans have voiced they will use any and all legislative tactics in order to slow or stop the reconciliation bill from passing.
Reconciliation rules require there must be 20 hours of debate and according to Senate rules, members are allowed to offer unlimited amendments and challenges to the reconciled bill.
Thus with Republicans allowed to offer unlimited amendments, all which must be ruled on by the Senate parliamentarian, the time could stretch much further.
Senate Democrats option is to overrule the parliamentarian’s decision; but they would need Republican votes to reach the necessary three-quarters majority required to do that, which looks unlikely in the highly polarized Senate.
All the Democrats need is a simple majority of 51 votes. If needed, Vice President Joe Biden, who serves as president of the Senate, could cast a tie-breaking vote.
If a provision in the reconciled package is struck down, the bill will have to go back to the House for another vote.
For more information on the health care legistlation, watch ATVN live at 6 p.m. on Trojan Vision 8 or catch the live stream on http://www.trojanvision.com.
