Health Care Reform: Easier Than It Looks
Monday, January 11, 2010
By E.J. Dionne
Truthdig
Reaching agreement on a health care bill is harder in theory than it will be in practice.
Between now and the day the measure goes to President Barack Obama’s desk, there will be many crisis points, much posturing and dire warnings of impending failure. There are real differences between the bills passed by the House and the Senate. The last few votes are always the most difficult to get.
But more than negotiators can afford to acknowledge openly, there is broad agreement on the kinds of concessions the Senate can make to the House and still preserve the 60 votes needed for passage. Indeed, some of those concessions will be eagerly sought by progressive Democratic senators.
Over the last week, I’ve been talking with key figures in the House, Senate and White House, and the outlines of a deal are becoming reasonably clear. The public option is, alas, dead. But the idea of setting up a national insurance exchange—alongside state exchanges—where the uninsured can purchase coverage is very much alive. The House is demanding this as the price for giving up on the public plan, and a national exchange would provide for much more consumer-friendly regulation of health insurance policies.
Almost everyone in both houses wants to find ways of making insurance more affordable. Steps in this direction would include more generous subsidies for the purchase of insurance than those in the Senate bill, and expanding on its Medicaid provisions. The bill’s overall price tag will grow from the Senate’s $871 billion over a decade, probably to somewhere in the range of $930 billion to $950 billion....(Remainder.)
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