Don’t make yourself crazy!
I generally don’t recommend health care activists follow the ins and outs of the legislative process in Washington. There is always a tug of war between progressives and conservatives and it changes as we move from one field of play to another, that is from one committee to another and then to the floor of each house of Congress. Bills get better and they get worse.
There is little that any of us can do to influence the details of legislation at each of these moments.
The fundamental thing we need to do is to shape the overall environment in which legislation is being considered by getting the word out about health care reform; building our movement; and keeping pressure on our members of Congress by means of letters, phone calls, emails. We especially need to focus on those who seem to be wavering in support of real healthcare reform.
HCAN PA will in the next day or two announce a series of August events that aim to build pressure for reform, including welcome home events for our members of Congress that start on Monday.
Of course, when there is something critical you can do at any moment, as we did with our phone banking in to Blue Dog districts this week, we will let you know.
Where we are right now.
As the members of the House of Representatives leave for a recess and return to their districts, I want to give you an update about where we are.
In the last week, as a result of opposition on the part of some Blue Dogs to elements of it, HR 3200—the bill put forward by the chairs of the Ways and Means, Education and Labor, and Energy and Commerce committees—was modified a bit in ways we opposed. And then, today, after progressives in the House complained, it tilted a bit back in our direction.
So, even though it is not exactly what we want, we are in the strong position of having a good bill, HR 3200, ready to move to the floor of the House of Representative when our members return in September. And that is our message for the month: support HR 3200. It contains:
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Regulations that radically change the business model of private health insurance and stop them from denying people coverage or raising their rates if they have pre-existing conditions, are older, or are women of child bearing years.
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A public health insurance plan that, while it may start out small, will grow and still provide competition for private insurers, create pressure for its own expansion over time and re-legitimate government in the US.
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Subsidies for private and public health insurance up to 400% of the federal poverty line (FPL), which is $88,000 for a family of 4. The insurance premiums at 400% of FPL under this bill will be limited to 9680 which is about $2300 less than the average cost of premiums for health insurance for a family today.
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A healthcare exchange in which initially individuals and small businesses and eventually everyone can purchase insurance from private insurers or the public health insurance plan. A limited number of plans that all provide comprehensive insurance will be offered. This will increase competition and dramatically reduce administrative costs.
The Blue Dogs initially pushed to reduce subsidies to purchase health insurance. And then they raised the limit on the percentage of family income that people have to pay for health insurance from 11% to 12%. We are pleased that this was knocked back down to 11% in the Energy and Commerce bill.
The Blue Dogs have been successful in raising the reimbursement rates in the public health insurance bill form Medicare plus 5% to a negotiated rate between that level and the average level for private insurance in the region. We are not sure how this will affect the public health insurance plan. It might it more expensive and slow its growth. On the other hand, doctors and hospitals largely accept Medicare rates now and are likely to continue to do so under the public health insurance plan. Moreover, doctors and hospitals always had the right opt-out of the public health insurance plan so the potential for negotiation was always there.
Further changes that move the legislation in a more progressive direction, are likely to be made as the bills passed by the three committees are put together and amended on the floor of the House.