Health Reform Rises from the Dead

For those of us who questioned how hard the White House and its congressional allies would fight for health care reform, the answer is here. The devil remains in the details, of course, but in the last couple of days Barack Obama has put Republicans and conservative Democrats alike "on notice": Get on board or get left behind.

This week’s big news is that Sen. Ted Kennedy’s Health, Education, Labor and Pensions Committee passed its version of a reform bill—including the president’s public plan—on a party line vote. They shrugged and accepted several GOP amendments (I haven’t yet read anything that considers the amendments consequential) and called it a bipartisan effort.

Kennedy’s HELP has been the counterpoint to Sen. Max Baucus’ stalled Finance Committee, where Baucus has thus far failed to convince Republicans and moderate Dems to support some form of a public option to compete against existing private plans. The HELP bill now stands as a tangible threat—if Baucus doesn’t move something soon, this becomes the primary Senate bill.

The bill requires every American be covered—through an employer, through Medicaid/Medicare or by purchasing as an individual. It then provides subsidies to make buying insurance affordable and introduces a public plan as one option inside a regulated marketplace, what’s been called a health insurance exchange. Subsidies go to families making less than four times the poverty level—about $88,000 for a family of four—according to AP. Adds the WASHINGTON POST:

Under the legislation, most businesses would be required to offer insurance to workers or pay a $750 annual fee per full-time employee. Companies with fewer than 25 employees would be exempt from the mandate.

Politically, just as important as the HELP bill is a DNC ad campaign launched today. According to CNN, the 30-second spot will urge viewers in eight states with key senators in both parties to call Capitol Hill. The ad doesn’t name names, but the message is pretty damn clear. (The eight states are Arkansas, Indiana, Florida, Louisiana, Maine, North Dakota, Nebraska and Ohio.) Moreover, both David Axelrod and Rahm Emanuel have said plainly in the last couple of days that the White House is perfectly content with a party line vote. Here’s the TV ad:

Meanwhile, three House committees released a bill yesterday that they’ve drafted in concert. As Ezra Klein points out, this is huge news politically for a couple of reasons. First, the confusing cacophony of proposals that came out of various committees during the 1994 reform effort helped doom it; no such dissention on the House side this time. Second, the committees’ unity greatly strengthens the House’s negotiating hand when it comes time to reconcile its bill with whatever the Senate passes, which will almost certainly be less ambitious.

Already, the House bill appears to take a bigger swing than even the Senate HELP version. Klein’s your best journalistic source for the House bill’s policy weeds (he hadn’t yet posted on the Senate bill’s details at this writing, but look for it). But Igor Volsky in Think Progress’ WONK ROOM also makes an important point.  He notes that the House version is less shy about using Medicare’s negotiating advantage with providers than the Senate HELP bill, and it’s thus more likely to truly bring down costs.

—KAI WRIGHT