As the House and Senate informally negotiate their respective health care bills, a broad coalition of religious figures, advocacy organizations and local and state elected officials is pushing for higher levels of subsidies for insurance.
More than 750 groups and individuals signed a letter on Wednesday urging the White House and congressional negotiators to adopt portions of the House's health care legislation as it pertains to affordability.
"The House of Representatives has passed health reform legislation that would cover 36 million people, 96 percent of all legal residents," the letter reads. "The House covers five million more people than the Senate. We urge you to support the coverage provisions in the House bill, so that millions of Americans are not left uninsured after the passage of comprehensive health reform."
"On the critical question of making coverage affordable, the House legislation sets premiums and out-of-pocket costs at levels that are likely to be affordable to lower-income working families. The House does a much better job in protecting lower-income people. The Senate approach provides somewhat better protections for middle-income workers, but would require lower-wage workers to buy insurance that costs many thousands of dollars more than the House legislation. We urge you to take the best elements of both approaches to create legislation that would protect all families from costs they cannot afford."
Signed by officials in 45 different states, as well as Washington D.C., the letter reflects just how defined the fault lines have become in the nearly-completed health care debate. Progressive groups have ceded a lot of policy turf already (with the dropping of a public option for insurance coverage). And they seem likely to have even more concessions forced upon them (the president reportedly told legislators that he prefers a tax on high-cost health care plans, which affect many labor unions, rather than a tax on the very wealthy).
The one area that seems non-negotiable is greater affordability, which the White House seems to recognize is smart politics. Those close to the health care negotiations say they expect much of the House's language on this matter to be adopted in the final go-round -- though, at this stage, nothing is set in stone.
As for the differences between the House and Senate legislation, here is how Consumer Reports breaks it down:
"The House bill generally makes health insurance more affordable for lower-income Americans. It makes Medicaid available to everyone earning up to 150 percent of the poverty level, as opposed to 133 percent in the Senate bill. It also provides more tax credits to those under 250 percent of the poverty level, whereas the Senate is more generous between 250 and 400 percent of the poverty level. Combining the House provisions at the lower end of this spectrum, and the Senate's at the higher end would help more Americans afford health insurance converge."