Meeks' Message From Capitol Hill
November has been quite a month for health care reform. Three Satur days ago the House of Repre - sentatives adopted the America's Affordable Health care Act (HR 3962). Last Satur day, the Senate took a gigantic stride in that direction when it passed a motion to proceed with the debate on the Patient Protection and Affordable Care Act, crafted by Senate Majority Leader Harry Reid.
A simple majority is all that is needed to pass legislation in the House. Senate rules allow for a filibuster (delaying or blocking legislative action by prolonging debate). It takes a three-fifths majority (60 Senators) to pass a motion to proceed or invoke cloture to actually consider legislation.
Last Saturday's passage of a motion to proceed enabled the process of refor ming health care to proceed. Failure to block a filibuster might have been a fatal setback.
Confusion and controversy swirls around the meaning of what has happened so far and what may happen as both houses of Congress and President Obama try to accomplish what no Con gress or president have accomplished despite nearly 100 years of trying.
The House passed its version (HR 3962 America's Affordable Health Care Act of 2009) 220 to 215 (218 votes are needed to adopt legislation in the House). While 39 of 258 Democrats voted no, only one Republican voted yes. Not a single Senate Republican voted for the motion to invoke cloture. The 60 votes came from the 58 Demo crats and 2 independents.
The Senate is now set to do what the House has already done - pass health reform legislation. Debate is likely to last several weeks, maybe several months. If the Reid bill is adopted, it will have provisions that are similar and dissimilar to the House bill. A House-Senate conference committee will be set up to reconcile the differences between the two measures. The conference committee's reconciliation report will be sent back to both houses for a final vote. If both houses adopt it, Congress will send the legislation to President Obama to be signed into law.
It is important to keep a few things in mind. First, although we have come a long way there is still a long way go. Second, to borrow from Langston Hughes, supporters of reform must 'keep their hands on the plow' by keeping their focus on the overall objective. Third, contrary to what critics allege, the final configuration of health care reform will be well worth the journey.
This is why all the talk about Democrats caving-in, divisions among Democ rats, Democrats abandon ing their principles, the House and Senate bills not being worth the effort, an inadequate public option, a so-called government take over of health care, and on and on, is dismaying, diver ting, and certainly disarming precisely at a moment when it is more necessary than ever to focus the energy and actions of tens of millions of Americans who desperately seek health care reform, health care coverage, and lo wer health care costs, on accomplishing what is possible under today's circumstances. Our constitutional system requires negotiation and compromise. The un ity of a party as socially, racially, ideologically, and geographically diverse as the Democratic Party necessitates negotiation and compromise. But if one looks at the wide areas of commonality between the bill passed by the House and the bill under consideration in the Senate, one can see the broad contours of the final bill:
• All insurance plans will be required to offer a minimum package of benefits; insurers will be prohibited from denying coverage or charging higher premiums because of a person's medical history or condition.
• Somewhere between 94 percent and 96 percent of Americans or 31 million to 36 million more Americans will be covered.
• Everyone with incomes are less than 150 percent of the poverty level will be covered by Medicaid; health plans will required to cover children of policyholders up to 25 or 26 years old.
• A health exchange will be established where individuals, families, and employers can shop for a health insurance plan that meets their needs and finances; a government-financed public health insurance plan of some sort will be created as part of this exchange to compete with private insurers.
• Most Americans will be required to have a minimum level of health insurance; tax credits and subsidies will be provided to help low- and middleincome Americans purchase insurance through the health exchange.
• Most employers will be required to contribute to the cost of covering their employees; tax credits will be provided to small businesses that want to offer coverage; employer plans that cover early retires ages 55 to 64 will receive subsidies. If the conference report splits the difference between the cost of the House bill and the cost of the Senate bill, as scored by the nonpartisan Congressio nal Budget Office, the final legislation will meet President Obama's target of $900 billion in cost over the first 10 years. Based on CBO estimates, the final bill will reduce deficits by $130 billion to $139 billion over the same period. The CBO says twice that amount will be saved in the second 10 years. By any objective measure, the process unfolding before us is yielding significant progress. Despite compromises made to keeping the process going, I am confident that supporters of health care reform on Capitol Hill and throughout the country will not have yielded their core principles to pass health reform.