By a vote of 219 to 212 the U.S. House of Representatives entered the anals of history by passing H.R. 3490, the Patient Protection and Affordable Care Act — the first federal legislative victory on behalf of health care reform after nearly 100 years of trying. The House also passed H.R. 4872, the Health Care and Education Affordability Reconciliation Act, by a vote of 220 to 33, which amends the H.R. 3490, the Senate version of the health care bill and reconciles differences between the House and Senate bills. Despite rancor, name-calling, and diversionary tactics, the Democratic majority was able to win the fight to end some of the unfair practices that can leave even those with health insurance financially debilitated when they become ill. Rep. John Lewis, D-Ga., outlines the biggest myths regarding the Health Care Reform bill and highlights the next steps.
Biggest Misconceptions
- Nothing in the bill reduces Medicare benefits for seniors. Rather than undermining Medicare, this bill strengthens it. It is estimated that up to 20 percent of Medicare spending, as well as private health care spending, goes to waste, inefficiency, fraud, and unnecessary procedures. It is this spending that is targeted for elimination in this bill. The Medicare savings in the bill is simply a 5 percent reduction overall in what Medicare is expected to spend over the next 10 years. Much of the cost savings achieved are reinvested into Medicare – improving benefits and extending the life of the Medicare Trust Fund by nine years. This bill strengthens and helps to stabilize Medicare.
- This legislation expands private health insurance in America, and is based on increasing choice and competition and providing for new marketplaces where the uninsured, small business employees, and the self-employed will be able to choose from a variety of private insurance plans. Many will receive tax credits to help them afford the health plan they choose. It is not a government takeover of the health care system.
- There is nothing in the bill that enables federal dollars to be utilized for abortions. Once anti-abortion proponents had the opportunity to closely examine the bill, they realized that pro-choice rhetoric related to abortion was unfounded. The bill has been endorsed by the Catholic Health Association, Association of Jesuit Colleges and Universities, Faithful America, Evangelicals for Social Action, and 360 other organizations. The author of the Stupak Amendment voted for the passage of the bill.
- The bill does not create more expenses for small businesses, but it helps to relieve the burden of health care costs for those businesses.
The status quo is unsustainable for the small business community. Sixty percent of America’s uninsured — or 28 million people — are small business owners, workers, and their families. Insurance costs for small businesses have increased 129 percent since 2000.
The bill provides $40 billion in tax credits for small businesses to help them offer coverage to their employees and exempts 96 percent of all businesses from the shared responsibility requirement.
- The shared responsibility requirement in the health reform legislation is designed to be fair to all Americans.
Under the House health reform bill, the shared responsibility requirement is: only for those who do not already have health insurance but can afford it. The vast majority of Americans, more than 85 percent, already have health insurance, and therefore would not be affected by this requirement. Secondly, the bill is designed to ensure that the shared responsibility requirement is never imposed on those who cannot afford to purchase health insurance.
- This bill does not violate the Supremacy Clause of the Constitution. Once Congress enacts an individual mandate in the form of a fee on persons who can afford to buy health insurance but refuse to do so, no state law can override that mandate.
Next Steps:
The Reconciliation bill will now go to the Senate where it is to be debated for 20 hours. However the process often takes much longer, as motions and amendments may be offered and considered without debate after the 20 hours has expired. Since this bill cannot be filibustered, the minority’s only way to influence the outcome of the bill is to offer amendment after amendment in a process that has become known as “vote-a-rama.” After the bill is passed by the Senate, it must be signed into law by the President.
