Echoes of the FDR Era: Health Care Passes the US House

This is the difference; that the House comes out pretty strong on a fundamental shift. There's TONS of crap that this bill bans. The fact that the public option is in and strong-ish is amazing; were this Clinton (Bill) we'd be talking about how it's good they only get to do SOME preexisting conditions; or as it turned out, how their bill failed.

Hooray.

Looking forward to some commentary on the Honduran situation. I know to take my reporting with a grain of salt; there's a couple comment/analysis stories out of Al Jazeera that say Mel blew it with this last accord; selling out the consulta? I've been pretty happy with how things have gone until this point.

All the volunteers who have spent months organizing and working their tails off. And to Nancy Pelosi and the House leadership who managed 220 egos and steered the bill through to passage.

Onward to the Senate!

I really do not understand liberals and progressives crying out in outrage over the health care bill. Do they not get it? Are they always going to scream about something that might not be perfect, which can later be changed if they organize about it and that pragmatic concessions, no matter how unpalatable to them, were the only way this bill was going to pass?

Does incremental, step-by-step and persistent organization beyond thier comprehensions? And even when real change happens and is written into Law, do they forget how long it takes to actually implement those laws and for the public to finally see results? Do they forget thier history of how many women and men died for thier causes and think that an easy wand will magicaly make everything A-Ok as long as thier is a Democratic President?

It is no wonder they are always divided and get nothing done.They are already dooming next years seat elections and how the Dems are going to lose the majority. They should be ashamed of their whining when an actual health care bill has finally passed the House for the first time in decades and how much the actual organizers have accomplished.

They can complain about Congress and thier ways and be frustrated, that's all fine dandy..but they seem to forget how long these people have been in power and how long it will take them to let loose of that power. Do they really expect that in one year Obama can just fix all those years of corruption and greed?

WAKE UP and get real and join the people that actually made this health care reform a one small step miracle in getting it in the Senate.

I for one am shocked it even passed. SO Kudos to all who made this possible and keep your fight going to the senate no matter how Unperfect it may turn out to be. The first bill is always the hardest to pass into law.

Needed to vent because some people really pissed me off.

Keep up your good work Al!

i hope we don't get to look forward to increasingly shrill, irrlevant, and quixodic behavior.

After all the angst and put-down of President Obama's approach to this bill, I appreciated reading Booman's commentary just because it states what most savvy administration folks knew from the gitgo. The legislators of this country are so far behind the populace in terms of understanding what is going on and needed, it's a miracle anything passed the house or will pass the Senate. I wonder if and when we will elect representatives with intelligence, compassion, and a real world grasp of what needs to be done to save this nation and the globe. Their ignorance is embarrassing.

 I am happy we passed a bill, but sick of my rights being infringed on. I believe the bill would have gone down in flames without the Stupid Stupak amendment, but why are woman always the ones to get the shaft?

The silver lining to the closeness of the vote - and seeing the disgusting sausage-making process up close - is that perhaps people will stop blaming Obama forr not using his magic wand to force a better bill.

It should be obvious now how steep the odds have always been against any progressive legislation.  People should focus on the positive developments, rather than lament what is missing.  This legislation will continue to be fixed in the years and decades to come.  But the first step was always going to be the hardest.

And by the way, Obama is being credited in some papers today with "closing" the deal" with several recalcitrant lawmakers.

@Christi

I agree completely. Logically I understand the provision can be modified/stripped if we organize around it (and we will) but my initial reaction was from the gut, and it took my breath away. The non-logical reaction was immediate and painful, and exactly like you described: women get shafted. It felt like we were discarded, told to "take one for the team." And it hurt even more to find that 26 Dems voted for the anti-choice amendment but then didn't even vote for the health care bill!

On the plus side, I think the GOP and the Blue Dogs may have overplayed their hand and the reaction and organizing around the final bill will be much stronger and vocal. People who might not have gotten involved will just to make sure that piece is removed and they'll have impact on other aspects as well. I was active and organized before, but it was mostly a positive energy. Now I'm really angry on top of it. I doubt I'm alone in this.

From what I hear on the news, this sounds like a terrible bill--because it takes one of the fundamental flaws of the US health care system and amplifies it.

Instead of disconnecting health care from employment, this makes it stronger by requiring more employers to buy insurance. It's incremental, but in the wrong direction.

I'm not sure what to do about it--my feeling from early in the year is reinforced: Obama really had nothing to offer here, so I never had any desire to help.

(And I think I've asked for this before--links to well written analysis of the state of this debate would be great--I know this blog is not much interested in it, but someone out there must be. My opinion above may be totally wrong, as it's based on limited information.)

@Matt

That's not the case at all. They're mandated to provide coverage, yes, but you pick it out and get it and keep it if you get laid-off. You pruchase it from health insurance exchanges so you can compare plans and kind of "shop around". That's my understanding.

I'll tell you exactly why the "progressive" left is up in arms about it: if they can't get to their destination in one step, they don't even want to leave their couches. The extent to which they're self-righteous (wo)man-children is shocking and depressing. This attitude is why the right has enjoyed such far-reaching(and destructive) success over the past 30 years in terms of weakening social programs. To them, doing nothing is better than compromising on anything.

 I would also like to note that all 26 Dem's who voted Yea on the amendment and No on the bill are ALL men. Pricks that's what I say-every last one of them.

I don't really know how good the final bill will be, but I can tell you that if the men Democrats in this country don't want the women Democrats in this country to revolt they better fix it.  I for one will abandon the party if this law goes into effect. A bunch of old white men on Viagra telling women what they can and can't do with their own bodies in unacceptable to me.

I'm with Christi.

Damn.  Leonard Cohen, in Anthem, says it for me (special thanks to Booman, I want him in my Foxhole)

"Ring the bells that still can ring. Forget your perfect offering.  Everything has a crack in it.  It's how the light gets in."

But, damn, damn, damn.  Why is it always a woman's rights getting trampled.

IT. IS. MY. BODY.  DAMN!

 Long time no talk to lady. Hope your doing well. email me

Because of the Hyde Rule, federal money has not been allowed to be used to pay for abortions since 1976. In a situation where people are receiving federal subsidies for health insurance or are on a federally-funded health plan (the public option), it was never going to be possible to have abortions covered by this money. Pelosi tried to come up with a way around this, and that is what was removed by the Stupak amendemnt. In other words, the Stupak amendment returned us to the status quo under the Hyde Rule.

I felt it like a kick in the gut when I first read it too, but then after some comments I read I did some reading up on the Hyde Rule and realized that there is already a sucky situation because of this. The Stupak amendment does not actually make things any worse than they already are.

I think your understanding of the Stupak amendment is incorrect.  All it states is that the federal public option can not offer abortions to women ie pay for women to have abortions.

Women can still have one, but they must pay for it themselves.  Its the same way today with private insurance as not all private insurance covers it either.

The cost of an abortion is nominal financially between $500 and $900.

The amendment DOES not take away a woman's right to choose.  It only takes away the public plan from paying for it.  What is wrong with that Christi Demuth?  I see no problem with it.

I am really happy this passed even when I am always left with the feeling I could have done more on the ground. I hope this inspires everyone here to go out there and work the phones and the canvasing with OFA, the big battle is yet to come and I look forward to pressuring that idiot Lieberman into a bend. He needs to know his stupidity will no longer be tolerated and that he either leaves the pretense of democratic values and goes to the GOP once for all, or he falls in line. Otherwise we must get this goon out of office.

I find this discussion quite fascinating.

The passage of the bill is badly needed good news, after the string of killings in Iraq, Afghanistan, Pakistan and the US, and after the recent gubernatorial elections in NJ and VA. Obama's team surely has a great science of timing, as was also demonstrated during the campaign.

Now, I'd be very interested to hear how much of a momentum is now building in Obama's favor, to allow him to push forward some of his other priorities. E.g. any really good news cooking in Honduras?

And also, how much does the House passage of the Health care reform bill mean in view of the Senate debates?

@Laura & Stephanie,  I am going to read it myself before I come to any more conclusions. I listened to Donna Brazile this morning and was upset.

The problem with it, Stephanie, is I thought we FINALLY had a President and Democratic majority in Congress to stand up for HUMAN RIGHTS for all, oh, btw, that includes women.  So Clinton didn't have the guts to change anything, didn't expect much from him or the DLC, but after how hard millions worked to elect THIS President - yes, I thought we were finally, FINALLY, going to allow ALL women, regardless of their income, to have the same rights men have, control of ones body.

As this stands, if you are able to afford it, you have the right to control your own body.

Most insurance companies do actually provide for abortions, and the bill would not allow insurance companies participating in the newly created insurance exchange (of which the public option is one). It's also worth pointing out that $500-$900 is actually a lot of money for those who are most likely to get an abortion (I'm talking poor, young women who may or may not have any support from the would-be father), this is something that disproportionately hurts poor women, and there is absolutely no saving grace about it outside of the fact that it might move the health-care debate along.

@Suzy Shore

With all that being said, I don't think it's fair to put the blame for it on Obama, nor should anyone here think this is the end of things, after all, this still has to go through conference, and it's entirely possible that this god-awful amendment gets stripped in the House-Senate meetings which will follow.

Thanks, Elliot, you're right.  I don't "blame" Obama.  I know how HUGE his election was -  the work now feels so painfully incremental. Let's HOPE the final product is one we can support with all our hearts!    Just watching so many Democrats vote against it in the House was painful.  Really is much worse than sausage making.

Here's to the Senate having more courage

Having read a great deal about this issue over the past few days, I have come to the following conclusions:

a) It will remain (maybe with a little tampering) in the final Bill that goes through the Senate because there is no other way to get it through

b) It could be challenged afterwards in the High Court & the challenge might be successful if Justice Kennedy can be persuaded

c) There is already a major organization that funds abortions for the needy &, at least temporarily, more funds to assist it might be forthcoming in some form of omnibus budget bill.

Yes, women have been shafted by old white men on viagra (payed for by their health insurance), but this is temporary set-back for a greater good. This doesn't mean stop griping about it, but just gripe until the Bill gets through the Senate, please!

As master organizer, Al, what would your organizing advice be for those of us who very currently want to ensure women keep the rights they've earned the past 30-40 years in regard to having dominion over their own bodies, and secondarily, though just as importantly, to expand their now-limited economic rights?

Specifically, what could be done to drop the Stupak amendment, and then beyond that what would be a good strategy for reversing the gradual de facto revocation of women's rights?

Thank you.

Larry - That's a great question. I'm working on some other things right now but I will get to it. If I haven't gotten to it in, say, a week from now, somebody please remind me!

(This is the week we are poring over completed applications for the 2010 School of Authentic Journalism and it involves a lot of reading and interviewing of applicants as well as other time-intensive tasks. I'm also writing an update about Honduras at present.)

I love the question and will give it the attention it deserves.

When you do address strategy for organizing against the Stupak amendment, I'd be interested to hear your take on a poll in a recent recced dkos diary:

Organize an effort to pressure President Obama to fire Rahm	97 votes - 6 %
Organize an effort to pressure Obama/Pelosi/Reid to drop Stupak Amendment	742 votes - 53 %
Organize an effort to pressure Pelosi/Reid to appoint pro-choice Democrats to Conference	324 votes - 23 %
Organize an effort to kill the health care bill	51 votes - 3 %
Pie	177 votes - 12 %

Other factors aside, there seemed to me to be a big difference between pushing to have the amendment dropped and pushing for pro-choice democrats to be appointed to conference. I can see the former allowing the sausage-makers room to maneuver/choose the means by which the ends are achieved, but the latter might achieve the same ends and result in a more progressive group at the center of power.

Basically, is it more effective to organize around  the ideal itself (women's rights), a group known to support the ideal (pro-choice congresspeople), or the specific instance of less-than-ideal legislation (the stupak amendment)?

Part of my concern is that the plan extends beyond not using federal money for abortions. As I understand it, the amendment will not allow women who are receiving subsidies to even enroll in a plan that offers to cover abortion. In other words, they cannot even join the plan, even if they would never have an abortion. This places a lot of pressure on the plans to not offer abortion coverage at all to increase their customer base, so it's less  available to women who are not subsidized as well.

Doesn't Planned Parenthood already provide services to woman who are indigent?  The ones who can't afford to pay the 500-900 dollars? Also, the free clinic provides for free birth control and the morning after pill to woman who are indigent as well and nominally for others thru donations folks who use their services give them for the product/s they receive.

I don't see how the Stupak amendment infringes upon a woman's right to choose? The choice is still there- it seems your argument lies with who should be paying for it, ones self, the gov't option, or private health insurance?  Currently, doesn't the govt provide for and pay for abortions thru its somewhat funding of planned parenthood?  If so, then why do they need to provide for it again thru insurance covg too, public or private?

I think the bigger issue here is that we passed healthcare in the House to stop corp insurance companies from dropping people, denying them covg for pre-exisiting conditions, for giving them poor cvg, setting maximum lifetime benefits and procedural limits, etc....this is the LEAST of the countries problems.

Its not like the right to choose has been taken away.

Women need to look at the entire picture of what this legislation means for ALL Americans and get behind something that hasn't been able to be realized since Teddy Roosevelt tried in the 1800's!

In the near future if the amendment is not restructured, amended, etc. then work on changing it or take it to the supreme court.  We can't be myopic in our views regarding such historic legislation being passed because its not perfect. NOW if it took away a woman's right to choose all together than I would agree with you all because that is a fundamental right being taken away HOWEVER it is not the case.  I don't see how funding an abortion thru 3rd parties is a fundamental right women should or currently have and I don't think ROE v WADE delineates any differently.

Logic and the greater good of society needs to prevail over visceral and emotional responses that some woman are giving to this amendment.

 My understanding is it pretty much takes away private insurance for abortions. Currently 85% of insurers offer this as a coverage. I will follow up with the rest with my conclusions tomorrow. If this is not the case please show me where it says otherwise.

New York Times has some useful information on the Stupak amendment and the issues involved.

Edited to add: The text of the Stupak amendment can be found under the header "Section 256" here (you may need to scroll).

My first rule of organizing: know the facts and what will be possible under the law. The Stupak amendment can no doubt be improved but still needs to conform to the Hyde Rule, which is going to be a very difficult needle to thread.

While I agree the Stupak amendment needs to be stripped all of your assumptions of it are incorrect.  I'd highly suggest reading it for yourself its only two pages.

First, I think its important to point out, that while private insurers may offer abortion coverage, the average co-pay for an elective abortion is $200+ (it varies by state).  That is roughly the same amount it cost to get an abortion at a clinic (again it varies by state.  But that is the going rate in Maryland).

Secondly, the amendment only prohibits those women who seek insurance through the exchange from having access to plans with abortion coverage.  It does not, and explicitly states in the amendment, affect insurance plans in the private market.

I am not advocating for this amendment, but there seems to be a lot of misunderstanding about (1) what is offered in private plans when it comes to abortion coverage (ITS NOT FREE) and (2) how the amendment affects private insurance plans (IT DOES NOT).

As a pro-choicer, I have decided not to let it distract me from the overall goal because I'm pretty confident it will be stripped in conference.  And two, I know from personal experience that elective abortions with or without insurance have roughly the same out-of-pocket expense.

Here is a copy of the amendment for you to read yourself.

http://www.docstoc.com/docs/15284081/Stupak-Amendment-to-HR-3962-Rev-108

I am not a lawyer, but my reading of the amendment is as follows:

* Health insurance plans on the Exchange CAN cover abortions, except for federal plans

* Health insurance providers that offer plans on the Exchange that cover abortion must also offer plans on the Exchange that do not cover abortion and these plans MUST be identical to the abortion-covering plans except for the abortion part

* Health insurance providers can offer supplemental plans on the Exchange that cover just abortion, except for federal providers

* If you are a consumer on the Exchange who receives a federal subsidy you are not allowed to purchase a health insurance plan that covers abortions, even if you will never use that part

* HOWEVER, you can purchase the non-abortion equivalent plan plus a supplement for abortion. You can use any source other than federal funds to purchase the abortion supplement. This should be identical to the abortion-covering plan but avoids the possibility that your federal subsidy is used towards abortion coverage, something that is prohibited under the Hyde Rule

The New York Times article notes the following facts:

* Only 13% of abortions are even reported to insurance companies

* Only half of employer-provided health insurance plans cover abortions at all

* 33 states do not allow Medicaid to cover abortions. The other 17 states do allow it, but only if only state funds are used (not federal funds, which is prohibited by the Hyde Rule)

* The government employees health plan does not cover abortions (so the public plan would be the same as this)

* 5 states prohibit all private insurance companies from covering elective abortions. You are unlucky if you live in Idaho, Kentucky, Missouri, North Dakota, or Oklahoma

Hopefully the discussion over how best to proceed will be informed by these facts.

to Jake Tapper regarding abortion language in bill.

Health care reform must happen and if that means the Stupak amendment along with it then it's the bitter pill I will swallow. Do I agree with it? No. Some say it closed a loophole in the Hyde Rule, others say it goes beyond that. No matter, it still takes health care and adds another restriction on womens choices.  Obama is right, this a health reform bill not a abortion bill. I didn't spend hours of many days callings reps and Obama voters asking them to call their reps to see health care reform fail all because of abortion. I must say being a progressive pro-choicer these days has become somewhat disappointing especially the part where supposed liberal woman are telling me to sit down shut up and take the slap once again.

Post Edit: This morning the NY Times weighs in.

Here's an interesting piece about the cost of fielding democratic candidates that can win in Red States in order to gain control of the House and Senate. I can't help but agree. Very interesting point about the ugliness of the party that passed the majority of the important legislation during the "golden years" of Democratic legislative dominance. Get ready to swallow more bitter pills and turn the other cheek after another slap. That's how the big bills get done, n'est ce pas?

Doesn't this bill contain mandates?  Wasn't this blog against mandates back around election time?

Yes, Scats - I loathe the concept of mandates (forcing people to get health insurance even if we don't want it). That said, the bill has some exemptions (i.e. Americans living abroad) in it. And its mandates also seem unenforceable (much like the Massachusetts "health care" plan).

The bill has a lot of junk I don't like. But the big trick here is getting it through the door. Once its in, then more changes can be made. The hard part is getting something to happen, since its opponents know that once it's law, the US will never be able to go back to the situation of today. It will become political suicide for any politician to call on repealing health care (much like it would be for any that today might call for repealing medicare or social security).

As Al said, lots of junk in the bill.  Many Americans have been banging on this "door of reform" for too long.

If you want the change we seek in health care in the US, are you making calls to Senators and Representatives?  If you were involved in getting President Obama elected, are you involved now?  The OFA Site has made calling Obama supporters in other states, from the comfort of your home, an easy option.  Encouraging like minded Americans to call their Senators and Reps. is not difficult.  How much time could you give in this endevor?  http://www.barackobama.com/index.php

A comment by Dianne on the OFA Blog this morning is perfect.  I have reprinted it here because I could not say it any better than this.  Thanks, Dianne.

I really have to wonder what the Republican/Conservative Grand Obstructionist Party has against women?

First, it was Senator KYL stating he doesn't think Maternity Care should NOT be included in health insurance plans because he doesn't need it & it makes his health care more expensive, to which Senator Stabenow retorted: I bet your "mother" did. Next came the threats of"
the government's "going to throw Granny off the train". What about Gramps? Then, their assult on a woman's reproductive choice & now mammography. What's next?

Introducing the "furore" over Mammography at this point in time was NO coincidence, it was intentional.

The Republican/Conservative Grand Obstructionist Party knew it was coming & latched on to their "mantra" that's "government panels for ya".

It appears this was an OLD recommendation from this panel from 1997, that at the time caused an uproar:

"The debate over mammography is not new. Similar recommendations were made in 1997 by a committee of federal medical experts. The uproar was so loud that Congress convened hearings and overrode the findings."

AND,

"Daniel Kopans, a radiology professor at Harvard Medical School and breast cancer expert, told CNN that the panel that made the ruling included no oncologists or nationally-known radiologists. The panel was appointed under former president George W Bush's administration, Sebelius pointed out."

U.S. Health Chief, Kathleen Sebelius' statement:
NO CHANGE in MAMMOGRAPHY POLICY:

Link

For more information on the U.S. Preventative Services Task Force here's some background:

Panel Members & US Preventative Services Task Force Web Site:

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