Get ready for health care reform, whatever that will mean.
The nonpartisan Congressional Budget Office estimated last week that the Senate Finance Committee's $829 billion proposal would cover 29 million more Americans and lower the deficit $81 billion because of offsetting cost savings, industry fees and targeted tax increases.
The share of nonelderly Americans with health insurance would grow from 83 percent to 94 percent by 2019. An estimated 25 million — a third of whom would be illegal immigrants — would remain uninsured. The bill would require millions to buy insurance by 2013 or face an escalating penalty of up to $750 per family by 2017.
Moderate Democrats and a few Republicans said they were waiting for the CBO report before taking sides. For the bill's supporters, led by Sen. Max Baucus, D-Mont., the CBO scoring was a resounding victory. A committee vote will likely come next week and a Senate floor debate this month.
Opinion polls have consistently shown that a majority of Americans want expanded health care access for their uninsured fellow citizens, but they are concerned about whether they could pay for it. The CBO report answered that question.
Barring unforeseen developments, there is no longer a question of whether there will be reform. The question is what it will look like.
While committee passage appears inevitable, this is just the beginning. The Baucus-led effort is one of five bills winding their way through the federal legislative process. But this one, in its current form, hits all the important marks and will be the blueprint for reform.
President Barack Obama said he wanted a bill that would not add "one dime to the deficit." He also requested that it cost less than $900 billion. The chief goal of liberals was to expand insurance access significantly. Conservatives wanted to reduce the deficit and protect the private insurance system. The Senate Finance bill does all of that.
However, the bill will have to withstand a difficult legislative gantlet.
Health-industry lobbyists, who include some of the most powerful in Washington, will be jockeying to emerge in the best possible position. For example, the hospital industry originally pledged $155 billion in savings toward the reform effort, but a spokesman for the Federation of American Hospitals said the proposed legislation needs to cover 97 percent of Americans for the group to stick to its pledge.
House Speaker Nancy Pelosi, D-Calif., insists that the ultimate House version would contain a public insurance option, and that may be the biggest upcoming battle. The Senate Finance version creates nonprofit cooperatives in an attempt to bring about a competitive marketplace for buying health insurance. The CBO report shrugged off this effort as ineffective.
Republicans, who have chosen not to offer their own reform plan, will continue to play defense and allege that all the Democrat-generated proposals go too far.
We have previously predicted that Obama health care reform will be incremental, rather than transformational, because of uncertain economic conditions and political tradition. The current legislation falls in line with that prediction.
Those with employer-supplied health insurance and traditional Medicare coverage will be unaffected. Because reform is aimed at the uninsured and those seeking insurance on their own, the effects will go largely unnoticed by most Americans.
None of the competing legislation addresses the root causes of runaway health care inflation: overapplication of medical technology and reimbursement for quantity, rather than quality, of care. It merely expands access to a deeply flawed system.
The time for town hall and talk-show hysteria and conspiracy theories has passed. It is time to pay attention to the details. Strap on your seat belts because it will be a months-long bumpy ride. The health care legislative process has finally taken flight.
—Fort Worth Star-Telegram