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Confronting Poverty
Confronting Poverty
July 30, 2009
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Public Option in Healthcare Reform
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Latest Healthcare Reform Update Signals the Need for More Advocacy on a Strong Public Option

The latest news on healthcare reform: Neither the House nor the Senate will vote on healthcare reform proposals before Congress breaks for August recess.

In the House, three committees have jurisdiction over healthcare reform, and each needs to mark-up a bill before the entire House takes a vote. The House Education & Labor Committee and the House Ways & Means Committee finished their mark-ups earlier this month. However, intraparty disputes in the House Energy & Commerce Committee delayed the mark-up until a deal was struck earlier this week between the Committee's chairman, Congressman Henry Waxman (D-CA) and a group of more fiscally conservative "Blue Dog" Democrats (Reps. Mike Ross of Arkansas, Bart Gordon of Tennessee, Baron Hill of Indiana, and Zack Space of Ohio), who were concerned about the cost of the bill.

Unfortunately, in order to reach a deal that would allow the mark-up of the bill to resume, Chairman Waxman had to trade one of the provisions of JCPA and UJC's common principles for healthcare reform: a robust public option. For more information on what a public option is and why it is so necessary, please click here. According to the latest CBS News/NYTimes poll (covering July 24-28), 2/3 of Americans (66%) support a public plan like Medicare to compete with private health insurers.

While the bill still nominally includes a public plan, it was significantly weakened by $100 billion in cuts to the House health reform proposal, the ability of states to create co-ops to compete for consumers in private and public plans, and a provision which de-links reimbursement rates under the public plan to those provided by Medicare.

These changes sparked an uprising from The Congressional Progressive Caucus in the House, whose 80+ members strongly favor a robust public option. Two months ago, these Representatives signed a pledge signaling that they would oppose any healthcare bill that did not include a strong public plan to compete with private insurers, and yesterday afternoon they flexed their muscles indicating the provisions in the compromise with the Blue Dog Democrats were unacceptable and compromised their support of the health insurance reform bill on the House floor. This development last night caused Chairman Waxman to move a scheduled mark-up of the compromise draft for later in the week.

Yesterday, the House leadership called a caucus meeting to answer Representative's questions about the bill. However, even if mark-up is completed before the House adjourns for recess this week, there will be no floor vote. This was a key demand of the Blue Dog Democrats who wanted the August recess to review the bill and answer constituent's questions.

In the Senate, the Finance Committee continues efforts to reach a bipartisan deal, with the key players being Chairman Max Baucus (D-MT), Ranking Member Chuck Grassley (R-Iowa), Democratic Sens. Kent Conrad (N.D.) and Jeff Bingaman (N.M.) and Republican Sen. Olympia Snowe (Maine). Earlier this week Senator Baucus indicated that the committee's initial proposal would cost under $900 billion over 10 years and would cover 95 percent of U.S. residents by 2015. However, in the process of these negotiations, the Senate Finance Committee not only weakened, but completely traded away the public option, and is now leaning towards the creation of state non-profit "co-ops."

The Finance bill is currently the bill to watch as any bipartisan support of that proposal could unravel if Finance provisions are compromised when combined with the more progressive version out of the Senate Health Education Labor and Pensions (HELP) Committee or the version that ultimately passes the House. For example, Senator Enzi (R-WY) signaled that his support of the bill is contingent upon the final version leaving the Finance compromises in there. However, it is not clear whether the bill passed out of the Finance committee could win the support of some of the more progressive members of Congress as it leaves out not only the public option, but also the employer mandate.  The Senate does not adjourn for recess until August 7th, but the Senate Finance Committee has not offered any guarantees that their mark-up will be complete by that point.

JCPA has not yet endorsed any of the draft bills, and we are continuing to work with our partners at UJC to analyze each of the proposals against the shared principles we laid out earlier this year.

ACTION:

During the August recess, contact all of your members of Congress, particularly Senators on the Finance Committee, Blue Dog Democrats, and members of the House Energy and Commerce Committee. Let them know that it is critical to keep a robust public option as part of health care reform. A strong public plan will not unfairly compete with private insurance. Rather it will:

  • Be available in the Health Insurance Exchange as an alternative to private health coverage;
  • Be required to meet the same benefit requirements, and comply with the same insurance market reforms as private plans;
  • Be required to be self-sustaining;
  • Promote primary care, encourage coordinated care and shared accountability;
  • Provide a benchmark to judge the performance of private insurers against.

Additionally, supporters believe that a public option would be more reliable and affordable than private insurance because administrative expenses would be lower and there would be no need to generate returns for shareholders.  A public option could exert pressure on the private insurance market, promoting competition and demonstrating to commercial insurers best practices in providing good coverage at a fair cost with transparency. 

If you have any questions, or would like additional information, please contact Melissa Boteach at mboteach@thejcpa.org.

 
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JCPA speaks to you each week in "Confronting Poverty", providing up-to-date information on policy developments, research and activism related to combating poverty in America. For three generations, JCPA has brought together diverse voices in the Jewish community to unite a strong Jewish public policy force that embodies the principle of "tzedek, tzedek tirdof", and promotes equal opportunity and social justice in American society.
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