Tuesday, July 14, 2009

Waxman On, Waxman Off (Again)

The House Democrats finally unveiled their version of Obamacare today, but House Energy and Commerce chair Henry Waxman gave a headscratcher of a presser, saying that he expects the legislation done by the end of the year, but also strongly hinting that the House and Senate should work through the August recess until the bill is done.



So, um, which one is it Henry? Because honestly yesterday I went through all the myrad reasons why "end of the year" means "never" for Obamacare. Not going to happen if it doesn't happen by Labor Day.

Of course, that may be the point. What's Waxman getting at? Surely he's not buying into my warning theory...right?

Still, the legislation itself (It's called the America's Affordable Health Choices Act for a reason) is significant. TNR's Jon Cohn has the details:

The three House committees writing health care legislation have just released the full text of their bill. And my immediate, admittedly tentative reaction is strongly positive. Once fully implemented, this reform plan will accomplish most of the goals on my mental checklist:

  • Generous subisides, available to people making up to 400 percent of the poverty line
  • Expansion of Medicaid to cover people making less than 133 percent of the poverty line
  • Guarantees of solid benefits for everybody, with limits on out-of-pocket spending
  • Strong regulation of insurers, including requirements that insurers provide insurance to people with pre-existing conditions without higher rates
  • An individual mandate, so that everybody (or what passes for everybody in these discussions) gets into the system and assumes some financial responsibility
  • A public plan, one that appears to be strong, although I'll reserve judgment on that until I hear from the experts
  • Choice of public and private plan, at first just for individuals and small businesses, but later for larger businesses and--possibly--eventually for everybody
  • Efforts at payment reform, if not necessarily as strong as they could be
  • Investment in primary care and prevention, which is not sexy but potentially important for general health.

The Congressional Budget Office score? Their initial estimates have it covering 94 percent of people living here and 97 percent of legal immigrants, for net outlays of just over $1 trillion over ten years. That figure includes the offsetting effect of the employer mandate, which--at a healthy 8 percent of payroll for larger companies that don't insure workers--would generate $30 billion a year by the end of the decade-long planning window. (Smaller businesses would be exempt.)

It's a good bill so far. And now the fight really begins for America to make it law.

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