Important change does not come easily. But it marched forward in Washington on Sunday. The vote in the House of Representatives in favor of health care reform was a historic step towards protecting health insurance for those who have it and providing coverage for 32 million now uninsured. The 221 Representatives who supported health reform in two key House votes acted in the interest of the American people. They stood up to an unceasing stream of fear-mongering, distortions, and untruths in the media, in public forums, and even in the House chamber. Those who voted yes deserve our gratitude; opponents should hear our dismay. (It's easy to register thanks or disappointment through the Coalition on Human Needs website.)
More than thanks, proponents in Congress need our help. So do the millions among us whose health care depends on the full enactment and implementation of the law
That's because the people who are fighting change are not going to stop now. They will keep slinging their talking points about bureaucrats getting between you and your health care. Someone has to point out that there are bureaucrats making health care decisions and denials, and they work for insurance companies. Opponents will try to scuttle the next steps in the Senate, and have vowed to seek repeal and obstruction. Someone has to remind the nation that lives are at stake. We must remember the 294,000 adults Families USA reported had died prematurely for lack of health coverage since 1995, the last time health care reform was debated in Congress - and warn that 275,000 more people will die if we let another decade go by without acting. Someone must speak of all the others who did not die but suffer needless losses - the former teacher who lost his sight for lack of $3,000 to pay for an operation, the baby born prematurely because the mother had little prenatal care, the family in bankruptcy because of medical bills.
The President and Members of Congress are expected to make a concerted effort to communicate the benefits of the legislation that just passed the House. But the public, hearing all the misinformation, is bound to be skeptical. Independent advocates must speak out too, forcefully and repeatedly.
I have my doubts that people with an open mind are persuaded by opponents trotting out taunts of "socialized medicine." Still, we don't want to forget to point out that the same labels were used against Medicare before it passed in 1965. I'd like to think that the racial and homophobic epithets hurled at Members of Congress by anti-health reform demonstrators hurt their cause.
We should seriously answer the accusations that the legislation is too expensive. It does cost a lot of money. But let's face it: health care is costing us a lot of money now, and we are at the mercy of punishing increases year after year. This legislation will rein in those exorbitant hikes, making savings over time that independent analysts say will reduce the federal deficit.
We must make sure that people around the country understand that soon after the law's enactment, people will see real benefits. Families will be sure their children can remain in their insurance plan up to age 26. New insurance plans will be barred from denying coverage to children based on pre-existing conditions. There will be temporary help for adults with pre-existing conditions until they receive full protection in 2014. New and existing plans will not be able to place lifetime dollar limits on benefits; some restrictions will take effect on insurers' annual limits on benefits. Older Americans will get $250 in relief from prescription drug costs when they enter the "donut hole" in 2010, with the donut hole phased out over time.
We must let people know that, starting in 2014, insurance meeting basic standards of comprehensiveness will be available to small businesses and individuals without coverage. If the legislation were fully in effect today, a family of four with an income of less than $88,200 would be eligible for help paying premiums. If their income were less than $55,125, the family would be able to get help with co-payments and deductibles too. These income levels will rise as living costs rise. Out-of-pocket expenses will be limited. People with incomes up to a little over the poverty line will be able to qualify for Medicaid.
Yes - the bill requires most people to purchase health insurance, starting in 2014. For some, that will be an unacceptable infringement on personal liberty. But for most, it is a reasonable compact, joining personal responsibility with protections from uncontrollable health care costs and unfair denials by insurance companies.
It isn't perfect. But the President, supporters in the House, and advocates for health care reform can be proud they are taking a giant step towards change that will make our lives better and make our economy stronger. The Senate needs to do its part this week. We have worked a long time for this victory. We can't let up now.
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