Since Congress returned from its recess this week, all eyes and attention have returned to health care reform. A framework for a potential bipartisan health care reform bill was made public this week. And President Barack Obama addressed a joint session of Congress, outlining his plan for health care reform, though Republicans generally remain wary of the potential costs and scope of government control.
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Baucus’ Senate Bill
This week Senator Max Baucus (D-Montana), who chairs the Senate Finance Committee, released a draft of the committee’s health care reform proposal. Baucus, along with five other senators (collectively referred to as the “Gang of Six”), are the last of five congressional committees to submit their health care reform proposal. This bill has been highly anticipated since it is the last chance for a bipartisan reform bill. (Three Democrats and three Republicans make up the “Gang of Six.”)
Baucus’ plan does not contain a public option, but does create exchanges on a state level to help the uninsured purchase insurance. Under the current draft, individuals will be required to purchase health insurance, but the committee’s plan doesn’t require all employers to offer insurance to employees (like some other reform proposals). Instead, the only type of employer mandate is directed at companies that have more than 50 full-time employees and whose employees receive federal subsidies to buy insurance. Those employers would be required to make a contribution to the government for the subsidies.
According to Baucus, he will present his bill to the committee the week of September 21, either with or without Republican support.
Obama’s Plan
Obama began his speech by emphasizing that he believes health care reform is central to the country’s future. He went on to outline his plan, which included three main goals: providing more security and stability to those who already have health insurance, providing insurance to Americans who don’t have it, and slowing the growing costs.
Before elaborating on the details of his proposed plan, Obama noted that everyone, including employers and individuals, must take responsibility for health care. He noted that even if health care reform provides affordable options, individuals and companies might still choose not to buy coverage for themselves or their employees. He chastised individuals who would rather take the risk than buy affordable insurance and businesses that would still fail to provide employees with health care coverage for engaging in “irresponsible behavior.” He noted that organizations that don’t provide health care coverage force others to pick up the tab and also gives them an unfair advantage over their competitors that do provide coverage.
Obama then revealed that his plan would create an insurance exchange or marketplace where consumers can go and shop around for coverage. Under his plan, individuals would be required to carry basic health insurance (similar to requirements for carrying car insurance). His plan also includes an employer mandate, and employers must either offer health care to their employees or chip in to cover the cost of insurance for their workers. He noted, however, that 95% of small businesses would be excluded from such a mandate “because of their size and narrow profit margin.”
Obama, who has continued to support a public, government-run insurance option, addressed this issue in his speech. Although he did not take the public option off the table and in fact made a case for it, he acknowledged that he was willing to consider other options. The public option has been such a key issue in debates over health care reform because many believe the U.S. House of Representatives will not pass a bill without a public option, and the U.S. Senate will not pass a bill with it.
The President also addressed medical malpractice reform, an issue that Republicans have championed. Although Obama noted that he didn’t believe malpractice reform was the “silver bullet” that would bring down health care costs, he knew “defensive medicine may be contributing to unnecessary costs.” Obama said he would immediately move forward with a Bush Administration plan to test malpractice issues such as putting patient safety first and allowing doctors to focus on practicing medicine.
On the subject of cost, Obama did draw one line in the sand in his speech: He said he won’t sign a bill that will add to the nation’s deficit, either now or in the future.
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