05/02/2009 05:12 am ET | Updated May 25, 2011

No Recovery in Sight -- Unless We Pass Health Reform

A new study came out today from the UC Berkeley Center for Labor Research and Education called "No Recovery in Sight: Health Coverage for Working-Age Adults in the United States and California". The report claims that half a million people in California have lost their health insurance coverage during the recession:

As the economy sheds jobs during the current economic crisis, health coverage for working-age
adults is declining precipitously. Since the start of the recession an estimated 3.7 million working-age
adults have lost coverage in the United States, and 500,000 have lost coverage in California. In the
absence of health-care reform,
even if the economy fully recovers, the coverage rates for working-age
adults will not return to pre-recession levels, and the number of those without coverage will
continue to grow even beyond the current recession-induced increases.

The key term here is "In the absence of health reform" -- Californians are suffering from the recession already, and this report shows that things will only get worse in terms of health coverage if we do NOT pass health reform SOON. I have family members, and I'm sure you do too, who are one illness away from bankruptcy. Even people who have insurance are paying exorbitant monthly premiums but have such high deductibles that they can't even afford to use what they have.

The president and the Democratic leaders in Congress agree that it's an urgent problem. Intense efforts are underway in the House and the Senate right now to write a health reform bill that can be signed by the president before the end of the Summer. The urgency is there for a variety of obvious reasons -- for the reasons outlined in this new study, but also because once Congress returns from its August recess, half of the House start running for re-election in 2010. In past years, that phenomenon has caused good pieces of legislation to languish and even die in the latter part of the year.

The Democrats will do their best, but there are a few controversial issues that will need to be resolved before a bill can be passed. Here is my best effort at explaining what these are in plain English:

1. Will everyone be required to buy health insurance? If so, that's called an "individual mandate". During the campaign, then candidate Obama objected to the idea of requiring all adults to get health insurance saying that he thought people would want to buy it if it was affordable but you wouldn't have to force them to do it. The California health reform effort last year failed in part because of concerns people had about an individual mandate -- but Massachusetts has one and so far it has worked pretty well.

2. How much will we have to pay to get coverage if a bill is passed? Will it be affordable? What is affordable anyway? For many families, $500 a month for a family premium breaks the bank and keeps food off the table. No one knows the answers to these questions right now.

3. Can we reform the health insurance industry so that they can't refuse coverage if you've ever been sick? That is called "medical underwriting" and "pre-existing conditions". Last week, America's Health Insurance Plans (AHIP) and the BlueCross BlueShield Association (BCBSA) wrote a letter to the president offering to drop those practices if everyone was required to have insurance. It's a start. They certainly didn't offer to do that back in 1993 when the Clintons were trying to reform health care.

4. A lot of people think that if we offer health plans to people who don't get insurance through their employers, that there ought to be a choice between a private insurance plan and some sort of publicly administered plan. That "public plan option" is being fiercely debated in Congress right now. The private insurance plans worry that they can't compete successfully with a public plan for a whole lot of reasons I won't go into here, so they are opposing it. Look for this to be huge source of debate in the next few months. But do yourself a favor -- do your homework about it and don't believe everything you hear, like it would be socialism or government telling your doctors what to do. Read about the public plan idea and see if it makes sense to you.

5. Should our health care benefits be taxed? Or should the portion our employers pay be taxed? This is a hot potato for sure. The problem with this idea is that there is a LOT of money to be collected by taxing the benefits of people who have insurance to help pay for those who do not. Very tricky.

These are just a few of the issues that will need to be resolved before we get health coverage for everyone. Despite the fact that this is complicated, all you need to do to answer your own questions is look around you -- do you know someone who has insurance but still can't get the care they need? People who are a paycheck away from losing what they have? People who have to rely on the emergency room because they have no other way to get care? If you do, then you understand the meaning of "No recovery in sight" UNLESS we pass health reform.