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In The Public Interest: Health Care Reform - A Down Payment, Not "Broken Promises"

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In Washington and in state capitols around America, there's a story that health reform opponents can't stop telling. The new health care law, they say, is a great big promise that will never be met. But reader beware - this story of "broken promises" might make a nice fable, but it's simply not true.

In fact, health reform opponents are hoping their tale will be a self-fulfilling prophecy. They want to spook policy-makers into backing down from implementing the new law and thereby delivering to American health care consumers the new rights and options they deserve. And then they hope to take advantage of that "failure" - that they create - at the polls.

Take the reaction to the federal Pre-existing Condition Insurance Program, announced yesterday. This program was derived from Senator John McCain's presidential campaign proposal to create so-called high-risk purchasing pools to provide some basic coverage options to those whose pre-existing conditions.

The concept of these high-risk pools was not without critics, including from within the Obama campaign. But last year, as a concession to bipartisanship, the administration welcomed the concept's inclusion in the new health care law. It was styled as a stopgap measure between now and 2014, when a total ban on pre-existing condition exclusions will go into effect.

But despite its bipartisan pedigree, reform opponents in Congress have been nothing if not skeptical of the program. They have carped that the administration pushed the roll-out of the new program nine days, from June 21 to July 1, to conform to the beginning of the fiscal year. And they have criticized the initial $5 billion appropriation for the program as inadequate.

These attacks continue, even though nothing prevents Congress from investing more in the program except these opponents' own knee-jerk opposition to anything related to new health care law.

If these critics were driven by real policy concerns, they might try to come up with more money, a step most reform supporters would welcome. Instead, they seem bent on pushing the broken-promises narrative, in the hope that a disillusioned public will reward them at the ballot box.

The new federal program is only a temporary and partial solution, until exclusion due to pre-existing conditions are fully banned in 2014. But the opening of enrollment in the Pre-existing Condition Insurance Program yesterday in 21 states, and its roll-out in the 29 others in coming weeks, are steps forward. For hundreds of thousands of Americans currently shut out of our health care marketplace, the new program will finally provide them a way in.

So, let's get this straight.

What Americans are seeing is not a case of broken promises, but an immediate, if modest, down payment on the thoroughgoing change that our health system needs.

Just like the extension of coverage to dependent children until age 26, the ban on pre-existing condition exclusions for kids, or the elimination of copays and deductibles for preventive care in Medicare and new private plans, the new Pre-existing Condition Insurance Program is less a consummation of reform that under-delivers than a early hint of the new choices the reform will offer when fully implemented.

Instead of peddling their broken-promises story in the hopes of gaining political advantage, Senators and Congressmen in Washington ought to be working together to ensure the new law's implementation actually does succeed in delivering health reform that is truly in the public interest because it brings down costs and protects consumers.

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