This article originally appeared on The Media Consortium.
The Senate passed its healthcare bill in the early morning hours of Christmas Eve. Senate Majority Leader Harry Reid had to make major compromises to secure the votes of fence-sitters like senators Ben Nelson and Joe Lieberman. Reid sacrificed the public option to keep Lieberman on board and tightened the bill’s abortion restrictions to placate Nelson.
Next, representatives from the House and the Senate will merge their respective bills in a conference committee, creating a single piece of legislation that both houses will vote on. If the conference report passes both houses, it will proceed to the president’s desk to be signed into law. Conference will start after the winter recess. The whole process could be complete by late January.
Despite the Senate compromises, there’s still plenty for progressives to like in the new bill. Kevin Drum lists some of the bill’s positive attributes in Mother Jones:
Insurers have to take all comers: They can’t turn you down for a preexisting condition or cut you off after you get sick.
Community rating: Within a few broad classes, everyone gets charged the same amount for insurance.
Individual mandate, which would require everyone to have health insurance. (Remember how we all argued that this was a progressive feature back when John Edwards and Hillary Clinton were championing it during the primaries?) On the progressive upside, a mandate would bring down costs and share risk more equitably. However, progressives realize that without a public option, it means forcing people to buy the insurance companies’ crappy product.
A significant expansion of Medicaid.
Subsidies for low and middle income workers that keeps premium costs under 10 percent of income.
Limits on ER charges to low-income, uninsured emergency patients.
Caps on out-of-pocket expenses
A broad range of cost-containment measures
A dedicated revenue stream to support all this.
The House version of the healthcare bill has a public option. In theory, the public option could be added back in in conference, but even the most optimistic progressives have given up hope on that score. If the public option rose from the ashes, Lieberman could filibuster the conference report, and no one doubts he’d do it. So no matter how tough and savvy House Speaker Nancy Pelosi is, she won’t have much leverage in conference. One way or another, Pelosi can probably pass just about anything that comes out of conference. Reid still has the Sword of Damocles hanging over his head.
That doesn’t mean that everything is set in stone, though. J. Lester Feder of The Nation discusses what’s left to be worked out in conference. Feder says the big three areas up for discussion are affordability, enforceability and financing. Compared to the House bill, Senate version offers larger insurance subsidies, but also weaker protections against high out-of-pocket costs.