Health care reform

What the House bill promises
This is an archived article that was published on in 2009, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

As Democrats prepare to bring their health care reform bill to the floor of the U.S. House of Representatives, it is time for Americans to decide whether they support it and why. We support it because it holds the promise of bringing health insurance to tens of millions of Americans who do not have it today.

This won't come cheap. It will cost about $1 trillion, which is still a lot of money, even in this year when trillion has become the new billion. Frankly, we worry about that cost, even though the Congressional Budget Office says the bill would be self-funding, meaning that it would not add to federal budget deficits. In the best of circumstances, financial forecasting is an inexact science, and when a complex piece of federal legislation has as many interlocking parts and assumptions as this one does, it's impossible. We realize that this bill is something of a leap of faith.

Still, we believe it is a leap worth taking, despite the added costs it will impose on businesses and individuals. Part of the problem with the bill is that it is hard to predict how its different parts will offset each other.

For example, everyone will be required to have insurance. That should result in less cost-shifting from those who do not have insurance to those who do. Obviously, costs will go up for people who have gone without insurance, unless they qualify for Medicaid, and should go down for people who have been paying for insurance that has subsidized care for the uninsured. But when you consider the system of penalties for people and businesses that fail to buy or provide insurance, and the new taxes to support subsidies to help previously uninsured middle class people buy insurance and to expand Medicaid eligibility, it is difficult to predict whether revenues and costs will balance.

Our biggest disappointment is that the bill does not do more to contain costs. While it includes experiments and incentives to help restrain the rapid inflation in medical spending, some good ideas have been stripped away. It is hard for us to see much promise on the cost-containment side, and the CBO echoed that sentiment.

But the bottom line is this. The CBO predicts the bill will raise the percentage of insured Americans from the current 83 percent to 96 or 97 percent.

The system of employer-based health insurance would be preserved, so most people with jobs won't be affected much. The insurance business itself will be reformed to eliminate denial of coverage for pre-existing conditions and higher premiums for sick people.

The biggest benefit? The bill should bring more Americans peace of mind. It's hard to put a price on that.