Democrats Win  Historic Health Insurance Law;
Tough Hurdles  to Universal  Coverage Remain

By Harry Kelber

Democrats in Congress secured passage of a landmark health insurance law on March 21 by a vote of 219-212   with not a single Republican voting for it and 34 Democrats joining the opposition. When President Obama signs the legislation, it will not go into effect until 2014.

After more than a year of  intense public discussion of health insurance in the media and in Congress, misconceptions about the actual provisions of the law remain. In the ensuing months before the November elections, Democrats will emphasize the advantages of the law, while Republicans will call attention  to its defects.

One thing is clear: this is not the universal health care bill we all hoped for.  It would extend insurance coverage to 31 million people, but what about the other 16.5 million who do not have insurance coverage and the  tens of thousands who are being forced to give it up because they can’t afford it?

Starting in 2014, this law will mandate that millions of people who are currently uninsured must buy insurance from private companies or the U.S. Internal Revenue Service will collect 2 percent  of their annual income in penalties. Poor people will be given subsidies to help them purchase insurance.

Under this law, Americans cannot be denied insurance because of a “pre-existing condition” or dropped  from coverage when they get sick. But critics claim that without an enforcement mechanism, there is little to hold the insurance companies from getting around the law.

Employers with 50 or more workers will pay a $750-per worker penalty if they do not offer coverage, and their workers get subsidies for private insurance.  Employers will have to cover   at least 60 percent of the cost of benefits. Out-of-pocket payments will be capped at $11,900 a year for a family.
The Obama administration claims that it can pay for insuring 31 million people and  reduce deficits by about $140 billion in this decade and by more than a trillion dollars in the following decade. It is counting on eliminating $500 billion from Medicare and gaining billions in revenue from tax increases.

Will  Health Insurance Become Affordable for the Middle Class?

AFL-CIO President Richard Trumka says: “We continue to think the excise tax is the wrong way to control costs. But the changes included in the corrections bill cut the tax  back deeply, so that it now eliminates 85 percent of the tax for working families.” The bill also cuts brand name drug prices for Medicare beneficiaries by 50 percent in 2011 and closes the Medicare prescription drug “donut hole” completely by 2020.

The Democrats used a three-stage power play to avoid the Republican filibuster threat. The first phase was to have the House approve a Senate health reform bill passed by the Senate last November. The vote was fairly close: 219-212. with all Republicans and more than two dozen Democrats opposed.

Then the House passed a series of “fixes” in the Senate bill under a procedure known as  “reconciliation.” The final step will be to adopt the Senate bill with the House additions by a  traditional  majority of 51 votes.

The final bill, including President Obama’s executive order, contains a provision that is the most blatant attack on a woman’s right to decide, in consultation with her doctor, whether  or not she wants to have an abortion.

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On a lighter note, I received the following e-mail letter from President Richard Trumka, which surprised me  Here is a part of what he said:

       “Dear Harry.

       What a historic moment! And it’s thanks to you.

       When  I was at the Capitol last night lobbying House members to vote for the health care reform legislation, I took with me your strength and that of millions of union members and health care activists like you.

        Winning the historic health care vote in the House simply could not have happened without you.”

Over the years, Trumka has never responded to me on my suggestions for improving union organizing or labor education.  So what am I to make of this gushing letter?

--Harry Kelber.