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Amy Smoucha has worked on health care issues for Jobs with Justice for three years now. That’s dozens of months, hundreds of weeks, and thousands of hours. And that makes her expertise on the subject worth listening to. So I did. When the e-mail below arrived in my inbox, I paid attention–especially to her fourth point.

In fact, within a few days, I will write in more detail about the “national, non-profit, publicly accountable option for health insurance coverage” contained in the Senate bill. Suffice it for now to say that rather than fight the screaming mob about the public option, the Senate did an end run: it eliminated that program and substituted a plan that has the potential–minus the right wing hysteria–to achieve the same thing. An analysis of how useful (or less than) those two programs may turn out to be will be part of my upcoming posting.

But for now, see what Amy thinks of the progress Democrats have made so far:

An open letter to progressives:  ideology kills people

I have been amazed at the rancor and deceit that many politically “right wing” and conservative leaders have demonstrated during the long, heated struggle to pass health reform legislation.  I’m amazed that for political, partisan and ideological reasons, Republicans and Libertarians are willing to lie to their own voters.  I’m awestruck at the monumental steps people are taking to protect corporations, defend outrageous profits and protect a status quo that working people in any political party cannot afford much longer.

Of course, we expect that sort of vitriol and cynicism from the right wing and from conservative political operatives who have lost ground in the last election and are bitterly losing the health care fight.

I am having a much harder time understanding the fierce attack by some folks who are thoughtful, independently-minded and progressive.  Like any significant human and civil rights struggle, we are in a place where we’ve won a lot, we’ve lost some of our demands, and there’s more work to be done to get a final bill out of conference.  Both the House and Senate health care bills represent an incredible step toward real, affordable, quality health care for every person in our country.   Neither of them accomplish everything we need.

I hope we all evaluate the bills and what they accomplish based on the ambitious reforms they include and an understanding of the context in which the measures are proposed. The bils do many things for our communities–like funding clinics and doctors.   It’s important to consider the flaws in the bills alongside a balanced understanding of just a few examples of what we are gaining and winning:

1. The Senate bill delivers health coverage to 94% of Americans –31 million uninsured people will gain access to affordable health coverage.  (The House bill would cover 36 million-95%.)

2. The proposed expansion of Medicaid will provide a lifeline to 15 million low-income and disabled Americans.  Congress is about to enact a significant expansion of Medicaid for both individuals and families up to 133% of the federal poverty level.   Currently in Missouri a family of three is eligible for the state health insurance program if their income is less than $292 a month.  Both House and Senate bills lift the income rules for the whole country to about $2029 a month for that same family of three.  For the first time adults without dependent children will get this coverage.  These 15 million uninsured, low income individuals will gain insurance through a public health insurance program that is affordable and has very nominal out of pocket costs.  This provision will help laid-off workers and part-time workers.  This expansion will revolutionize life for people with disabilities and people living with mental illnesses.  For many of us, when disability strikes, we will no longer have to prove that we are “permanently and totally disabled” and unable to work just to have access to the public option of Medicaid.  We won’t have to stop working just to get health care.


3. Corporate abuses are curtailed and health Insurance companies have been significantly pushed back in both bills. The Senate bill went much farther than we imagined in reining in insurance company abuses.  What’s really in the Senate bill?  Insurance companies will not be able to turn us down or charge us more if we have pre-existing medical conditions. Insurers will be required to spend 85 cents out of every dollar they receive in premiums on health care rather than profits and administrative costs. If not, people would receive rebates from their insurance companies for the difference.  Insurance companies will be banned from issuing policies that have lifetime or annual limits on benefits.  Consumers gain the right to an independent appeal of any decision by an insurer to deny coverage.

4. Both the House and Senate bills bill create a national, non-profit, publicly accountable option for health insurance coverage.  The House bill contains a national public insurance option.  However, even in the Senate bill, people purchasing insurance in the Exchange will be able to choose from national plans, including at least one non-profit plan, supervised by the same department of the federal government that selects health insurance plans for federal employees.  Before the recent invention of a “public plan” demand, progressive health care activists were asking Congress to either open up Medicare for all or allow people to buy into the plans administered by the Office of Professional Management-the same plans that Congress and Federal employees have.  We just won a long-standing demand.

5. We cannot “start over” and get more progressive reform through Congress any time soon.  Getting landmark legislation passed is a treacherous, long chess game, especially when that legislation has powerful corporate enemies or extends significant civil and human rights.  Unprecedented political capital and economic capital have been spent-the years spent making health reform a key issue in the last election, the storybanks, the canvasses, the phone calling.  We all put our best game on the field.  It’s time for a final push to improve the legislation in conference committee and to plan on how we will take this momentum and build and expand on our victory.  Many leaders in the health reform movement predict that if health reform fails now, we will not have another meaningful effort for 15 to 20 years, if at all.  If health reform fails now, the insurance companies and for profit health care corporations will laugh (at us) all the way to the board room.

This fight has been long and vicious because Congress is creating federal rules that make insurance companies behave.  Insurance companies are going to be regulated, and they don’t like it.  So much is at stake.  It is very dangerous to forgo these incredible victories because they are not far enough, especially since losing means millions of struggling Americans will have to continue in the health care system as it is for many, many years.  I’ve spent the last three years talking to hard working people throughout Missouri who will get real, measurable, concrete help from these legislative changes.  For some of them, their lives literally hang in the balance.  We have a responsibility to stand beside and for the uninsured working people who will gain much from these bills.

As a few progressive groups send emails around to “kill the bill” (along with the tea party) or “a bad bill is worse than no bill,” insurance companies and right wing political operatives throw fuel on that fire. All of us should deeply consider the consequences of
squandering this opportunity to move our health care system several strides forward.  Kill the bill, and insurance companies win.   I believe we are better than that.