Health Care Reform Passes - A Moment to Relfect

Last night, the House of Representatives voted to approve the bill previously passed by the Senate on December 24th. A sidecar bill was also passed which effectively included some amendments to the Health Care Reform bill. After President Obama signs HCR into law (probably on Tuesday), the Senate will take up the sidecar bill. If all items pass muster as being directly related to financial issues, the Senate can pass it with a simple majority of votes as a filibuster is not allowed for bills presented under Reconciliation.

Although Presidents for decades have attempted to reform Health Care, it hasn't happened until now. That has changed this President and this Congress from being referred to (incorrectly) as 'Do Nothing' to having 'Done Something Never Done Before'.

The merits of the Health Care Reform bill can be debated with valid points on both side, however, there really should not be any debate about the following items which will go into effect immediately:

Over 32 Million current un-insured legal citizens of the US will now be able to obtain Health Care and not be refused for pre-existing conditions.

Children can be carried on their parents' insurance plans until they are 26. This helps recent grads and those who find themselves in between jobs or working for companies that do not offer insurance.

Insurance companies can not put a cap on the maximum amount they will reimburse over the course of your lifetime. This impacts those with high-cost ailments like cancer.

The Medicare Part D 'donut hole' will be partially covered with a rebate of $250 for seniors who fell into the gap due to their income level.


This is not the end, it is rather the beginning. There are many issues still to resolve as well as some new ones that will probably be created by adding so many people to the rolls of the insured. A society that cares for all of its members is not without the pains to do so. Future blog posts will cover the remaining 500 pound elephant of insurance costs as well as how do we deal with people living longer now that they have access to better health care.

But for now, lets appreciate the good that has happened. The US has joined the ranks of all other developed nations and now provides health insurance coverage for all of its citizens. We are one step closer to being a Great Society.

On the Edge of Health Care Reform

I was initially going to title this post something along the lines of why I thought Health Care Reform would pass. Well, today, Congressman Dennis Kucinich changed his long-standing opposition to the bill from the Left and announced that he will vote for the Senate Health Care bill. That makes this article less of a call the outcome than state the impending obvious...that the House will approve the bill crafted and approved by the Senate. Kucinich is the first of several previously undecided or opposed Congressmen who will use press conferences in the next few days to say they have decided to vote in favor of HCR. The White House has put on a substantial full-court-press the past few days and the impact is being felt.

It will probably happen this weekend. As for procedural matters, it appears they will also subsequently pass a bill making changes to the bill (remove the Cornhusker kickback, etc.) and the Senate can pass that under reconciliation as all the items are budgetary in nature, and they would then need just a simple majority of 50 votes rather than a super-majority of 60 to prevent a filibuster. (I know 50 isn't a majority of the 100 member senate, but in the event of a tie, Vice-President Biden votes as well and that is the surest vote on HCR President Obama has ever had.)

I was also going to write that as the Democrats seemed about 50-50 to pass the bill, I gave the edge to Nancy Pelosi to find a way to twist enough arms to get the 216 votes needed to pass HCR at this time (due to a death and 3 resignations, the 50% plus 1 mark dropped from the standard 218 to 216). I am betting she gets 217-218, with 1 or 2 votes to spare, just in case there was a last minute defection.

Say what you want about Nancy Pelosi, but she will go down as one of the most successful and effective House Speakers in history. My money is on Nancy to bring in the herd at 216 or above.

We have been in the midst of this battle so long and have heard so much from both sides on the positives and negatives of HCR, that few have spent time thinking about the gravitas of the event if/when this bill passes. If/when this HCR bill passes, people will realize the historic nature of this social legislation. (No, it is not a socialist takeover of 16% of the economy - you may have heard or read that - but it is another building block in our society). Presidents for decades have tried and failed to pass health care reform...and Barack Obama will have accomplished it. The United States will join the ranks of every other developed nation in the world in providing health care coverage to ALL of its citizens. (No, HCR does not provide health insurance for illegal aliens, but yes as a member of a responsible society we should all feel it is appropriate to provide health care to illegals in need of medical attention)

Also in the news today is the Senate passing the Jobs Bill...with 11 Republicans on-board. The bill is ready to be signed by President Obama. That would be 2 significant accomplishments inside of a week. (The jobs bill pares in comparison to HCR in its impact, but it will have disproportionate good PR effects) We may very well be at the high point of projections for 2010 Republican gains in the House and Senate.

Also, HCR will not be static. Unfortunately, everyone wanted 'their stuff' in the first pass. There are still so many more things that can and will happen. Tort Reform, inter-state competition, end-of-life choice empowerment (previously referred to as 'Death Squads' by those opposed) and many other items that if handled individually, will probably garner some bi-partisan support. HCR will be a continuously evolving concept, but the ball had to start somewhere and the biggest hole was the uninsured and pre-existing condition exclusions.

The entire view of the Obama Presidency is about to change.

Is Scott Brown a Bridge Over a Troubled Senate?

When Scott Brown won the special election to take over the Massachusetts Senate seat previously held by the late Ted Kennedy, it seemed like the beginning of the end for any highly contested bills to even get to a vote in the Senate.

However, Senator Brown has shown that he isn't a rank and file Republican. As highlighted in this CNN story, Brown has twice voted for cloture hence stopping a filibuster. Although opposed to both the $15billion jobs bill and the $150billion bill to extend unemployment benefits, Senator Brown decided to "keep the process moving".

It appears that Brown is more moderate than his Conservative and Tea Party supporters had originally believed/hoped. In fact, he is acting more like a true independent. One who wants the business of Congress to proceed rather than be blocked by a majority. He also is acting like a Republican who wants to be re-elected to office by the very liberal Commonwealth of Massachusetts.

Regardless of his motives, he ceases to be the 41st vote to allow a filibuster to proceed. His highly visible presence in the middle might make it safer ground for other Republican moderates to go against their party on a cloture vote, providing them with an oasis.

A bigger question is whether he will also vote for cloture if/when a vote comes in the Senate for a revised health care bill even if he is against it. My guess is he won't get the chance as anything in the Senate will go through reconciliation which is not subject to a filibuster.

In any event, things might get more interesting as Senator Brown decides he likes being a moderate Republican senator from a liberal state.

Summary of the Health Care Summit

You mean you didn't have 7 hours last Thursday to dedicate to watching the Health Care Summit on TV or on your office computer? Well, here is all you need to know.

It was a noble effort. Unfortunately, the wrong people were invited. The members of the House and Senate.

Here is 7 hours of Senators and Congressmen rolled into 1 line:

Start Over...here's my patient story...Socialist Takeover...The Party of No...

Some have complained that President Obama spoke for roughly one-third of the 5 hours that were in session. Thank God. Any minute given over to almost any Democratic or Republican in the room would have made my eyes flip back inside my head.

There were a few notable exceptions. On the Republican side, hats off to Sen. Tom Coburn, R-Okla. He made cogent and meaty suggestions, if overselling the potential impact of tort reform on the total cost of Health Care. Expect to see some of the things he spoke of in the final bill put forward by President Obama. Being rational does have its benefits.

On the Democratic side, well, one member trumped pretty much everyone else in the room. Senator Dick Durbin, D-Illinois, spoke for a few minutes, but you only need to see this one minute clip to realize that almost everyone else in the room was out of their league.


With that, Senator Durbin boiled the entire health care debate down to a simple statement that wasn't even an attempt at a sound-bite (OK, well, the line about giving up your Govt Health Care if you think it is Socialist was a pretty good one). He stood out from everyone else and renewed my belief that there might indeed be intelligent life inside the Beltway.

We'll find out more tomorrow, but expect the following:

a few more snippets of Republican ideas added to the bill as well as existing Republican ideas already in the bill highlighted

The approach will be to get the House to approve the Senate bill as is and then have the changes/additions from the bill Obama presents produced as part of Reconcilliation Bill that will have just an up or down vote. No filibuster.

One final note - is it a requirement the senior leadership of both parties in the House and Senate sound and act ludicrous in the presence of everyone? I don't know who was worse. Yes I do, it was a tie. Nancy, you are a great leader of the House, which means you are totally despised by the opposition party, but when you have nothing to say, don't waste our time for 5 minutes.

John (Boehner), you remind me so much of the old Saturday Night Live skit when Steve Martin plays a contestant on the show Family Feud. He is the head of the Romaine Lettuce Growers Association of El Camino Del Rey Mar Vista California and the only answer he can think of to any question is "Romaine Lettuce".


I wonder if he ever feels awkward continuing to say we need to start over? I think even those who agree with him are tired of hearing him say it.

Now I understand how party leaders can get unseated. It seems that in order to fulfill your responsibilities in today's Congress, you have to sound like an idiot.