On Tuesday, President Barack Obama signed into law the first major reform of the United States health care system since the creation of Medicare and Medicaid 45 years earlier.
The Patient Protection and Affordable Care Act survived months of tea party protests, town hall demonstrations and legislative wrangling before Obama’s signing ceremony.
“We didn’t give in to mistrust or to cynicism or to fear,” Obama said at the signing. “Instead, we proved that we are still a people capable of doing big things.”
The bill, which passed a House of Representatives vote on Sunday night, is projected to extend health care coverage to more than 30 million people and Medicaid to an additional 16 million.
According to a Congressional Budget Office report, the estimated cost will total $940 billion over the next 10 years in subsidies for coverage of lower-income Americans. It is also projected to reduce the federal deficit by $130 billion.
The new legislation outlaws insurance companies’ denial of coverage to people with pre-existing conditions, and children will be allowed to stay on their parents’ coverage plans until the age of 26.
The bill does not mandate that businesses offer coverage to employees, but businesses with more than 50 employees would be fined for each individual not covered. A similar method will be used for individuals, forcing nearly all adult Americans to have health insurance or pay a fine.
As it had during the entirety of its debate, the bill’s passage drew harsh language from politicians on both sides of the issue.
Gov. Tim Pawlenty, appearing on Good Morning America on Tuesday morning, said this legislation was the wrong solution to the country’s health care problem.
“The nation faces big challenges, and we do need to fix our health care system,” Pawlenty said. “But [the Democrats have] taken it to this big, federalized, bureaucratic, government-run, kind of nanny-nation approach, and there were better ways to do it. They should’ve worked with us on those better ways.”
Rep. Keith Ellison, D-Minn., had hoped the legislation would include a single-payer system or “at least” a public option, but he said the bill was the best result given the situation.
“We could’ve done a lot more; we could’ve done a lot better,” Ellison said. “But you know, given everything, it still is an amazing accomplishment.”
Sen. Amy Klobuchar, D-Minn., said she spent much of the legislative process worrying about the “somewhat boring but important, incredibly important” issue of cost reform, seeking to reward the quality of care a hospital provides, rather than the number of tests billed to its patients.
Though the bill passed the House vote without a single Republican supporter, Klobuchar said its final form was shaped by early negotiations with Republicans.
“There are still a lot of bipartisan ideas in this bill, even though it’s not passed with bipartisan support,” Klobuchar said.
Like Ellison, Klobuchar felt that in some respects, the bill did not go far enough.
“I really see this as a beginning and not an end,” Klobuchar said. “The bill is not perfect. There will have to be changes in the future.”
Pawlenty sent a letter to Attorney General Lori Swanson, urging her to review what he called an “unprecedented federal mandate.”
“It appears Congress may be overstepping its bounds by forcing individuals or businesses to buy insurance,” Pawlenty wrote.
Ben Wogsland, a spokesman for Swanson, noted in an e-mail that most of the individual mandates would not go into effect until 2014 and said the attorney general’s office would now begin reviewing the 2,400-page bill.
Pawlenty was joined in questioning the reform’s constitutionality by 13 conservative state attorneys general, who filed suit in a Florida court before the ink on Obama’s signature was dry.
Amy Monahan, a University of Minnesota law professor and expert on health law, said these legal challenges would come down to a states’ rights issue.
Monahan said the Supreme Court had ruled that health insurance implicates interstate commerce and is therefore subject to federal regulation.
“Most experts agree that it isn’t an issue, that the federal government does have this power,” Monahan said. “They’re not actually forcing you to buy insurance; they’re giving you a choice. You can either buy insurance or you can pay a penalty, so essentially it’s a tax.”
Ellison was confident that Pawlenty’s appeal to Swanson would fall short.
“Tell [Pawlenty] lots of luck with Lori Swanson over there,” Ellison said. “Lori knows the abuses of insurance; Lori knows the pain Minnesotans go through. I’ve just got a feeling that [Pawlenty’s challenge] is just sour grapes. They lost, and they should’ve lost, and it’s good that they lost, and thank goodness that they lost.”
Humphrey Institute of Public Affairs professor and policy expert Larry Jacobs traced the Democrats’ success in passing health care back to the party’s election victories in the last two elective cycles.
“In 2006 and 2008 there was a remarkable shift in the balance of power,” Jacobs said. “We’ve really had this kind of almost tidal shift in Congress.”
Jacobs said the Obama administration, which includes veterans of President Bill Clinton’s failed attempt at health care reform in the mid-’90s, learned from Clinton’s failure. By putting health care reform on the table early in Obama’s term, Jacobs said the Democrats avoided a potential clash with the 2010 elections.
Even so, Jacobs said that as the debate process dragged on for months, some elements of the Obama administration considered abandoning the issue. Jacobs said the enthusiasm of Speaker of the House Nancy Pelosi, D-Calif., was vital in the final stages of the bill’s passage.
“I think Pelosi stands as kind of the hero, or the villain, depending on how you want to look at it,” Jacobs said.
Klobuchar said a number of complicating issues — from historic snowfalls in the nation’s capital during the critical voting period in December to the surprise election of Massachusetts Republican Scott Brown to the Senate seat once held by Ted Kennedy — put the entire bill in jeopardy.
“It was somewhat of a harder thing to get done than people think,” Klobuchar said.
Ellison said that a few weeks ago, health care reform became a personal issue for him. He got a letter in the mail from BlueCross BlueShield telling him that his son, who turned 22 on March 13, would be removed from Ellison’s coverage after a 30-day grace period. With the passage of health care, Ellison said his son would soon be back on his plan.
Ellison observed that not only would his son be covered under the plan, but so would the children of those who had protested the bill’s passage.
“All those tea partiers, if they have a child who’s 21 years old, about to be 22, will be able to keep their child on their health insurance, which will be remarkably important to their family,” Ellison said.
UMN students have traveled to Florida colleges to collaborate with students on various projects.
When UMN students plan for a vacation, having trip cancellation travel insurance is a worthwhile commodity to check out.
Minneapolis Used Cars
Give back to the Minnesota community with a boat donation at boat4causes.org.
If you have been involved in a car accident call a Philadelphia Car Accident Lawyer for a free consultation.