Healthy morning: Persistence carries the day on insurance reform

Written by Susan Mannella on .

After all the lies and distortion, all the deceit and fear mongering, the House of Representatives cast a landmark vote Sunday night to extend health insurance to 32 million Americans. While other action is still needed, the vote was a watershed moment for President Barack Obama, the Democratic Party and the principle that basic health care is a fundamental right.

The tally was 219-212, after weeks of Democratic arm twisting to secure a partisan majority on what should have been a bipartisan achievement. In Western Pennsylvania, Reps. Mike Doyle, D-Forest Hills, and Kathy Dahlkemper, D-Erie, voted for the plan, while Reps. Jason Altmire, D-McCandless, and Tim Murphy, R-Upper St. Clair, couldnĀ¹t summon the courage to support the most forward-looking legislation in decades.

The measure, as historic as Social Security and Medicare, will cost $940 million over 10 years and, according to the nonpartisan Congressional Budget Office, reduce the federal deficit by $138 million over the next decade.

Once fully in effect, the package will require individuals to have or buy health insurance, or face a fine. It will enable the uninsured and self-employed to obtain coverage through state-based exchanges, with subsidies available to help people afford a policy. The plan will require employers with more than 50 workers to offer health insurance or be fined if any employee receives a federal subsidy to buy coverage. It will also create separate insurance exchanges to make it easier for small businesses to buy health plans for their workers.

The reform prohibits insurance companies from dropping customers due to pre-existing conditions and requires insurers to allow children to stay on their parents' plans through age 26. It will close Medicare's prescription drug "donut hole" and expand Medicaid. The cost of the plan will be covered by a Medicare payroll tax on the unearned income of well-to-do families, an excise tax on high-end insurance plans and a 10 percent tax on indoor tanning services.

That's change on a host of fronts and change for the better. Yet despite change being long overdue, the Republican Party dedicated itself to defending the insurance companies and keeping millions of Americans victimized by a cruel insurance market. Its leaders and foot soldiers tried to leverage this debate into a cynical, political end game to cripple a Democratic president's administration. They were not successful in the short run, and history will prove them wrong as well.

Now the House has passed the Senate's bill. Next the House will send to the Senate final changes that must then be reconciled. The battle is not won, but it is nearly over. If persistence carries the day, health care will be within reach for all. To paraphrase a Ronald Reagan theme, it will be a new morning in America.

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