In the last week, the public health insurance option Majority Leader Reid put into his merged bill was stripped out, and a “compromise” allowing people over the age of 55 to buy into Medicare if they chose was added and then also stripped to appease Senators Joe Lieberman.^1,2 The leadership and the White House accepted these changes in order to move forward, and they have introduced a bill in the Senate that reflects this.^3,4

The compromise, which took away the best way to truly hold the insurance companies accountable, provoked an angry reaction from health reform supporters.⁵ Frankly, we’re angry, too. The new bill released today does include a number of new, tougher insurance reforms, including a patients’ bill of rights, restrictions on how much insurers can spend on administration and profit, and an attempt to hold down insurance premium increases.

Right now, the Senate bill looks like it will pass the Senate next week and move into conference with the House, which has a much better bill that it passed last month.⁶

What needs to be fixed?

The Senate bill, as it stands now, has major problems that need to be fixed. We need to make sure that the final bill that goes to President Obama’s desk provides good, affordable coverage and holds insurance companies accountable.

Here’s what must be fixed:

1. Make health care affordable
The Senate bill does not make health care affordable at work, and would encourage employers to hire part-time workers and offer bare-bones benefits. We need the final legislation to do what the House bill does – require all but the smallest employers to contribute a fair amount to good coverage for their workers.

And for those people who are self-employed or in between jobs, both bills need improvement on affordability. The Senate bill doesn’t do enough to make coverage affordable for low-and-moderate income families and the House falls short for middle-income families. The final bill should combine the best of both.

2. Hold insurance companies accountable
The final bill must include strong consumer protections and insurance regulations for all consumers, and give the federal government responsibility for running the new insurance marketplaces. Generally, the House bill is better, but we need Congress to pick the strongest provisions from both bills to be sure that everyone with insurance benefits from strong consumer protections.

The final bill should also give us the choice of a national public health insurance option that’s available on day one.

3. Fairly finance health care reform
The Senate bill taxes the health care benefits of millions of workers to pay for health reform. There’s a better way to pay for health reform that won’t raise premiums and out of pocket costs. By contrast, the House bill asks those who can most afford to pay their fair share to finance reform, as President Obama promised during his campaign.

The final bill should ask the richest to pay their fair share for reform, instead of taxing our health care benefits.

What’s next?

The reason that conservative Democrats like Ben Nelson and Independent Joe Lieberman have been able to hold the bill hostage to their demands is that Republicans have insisted on filibustering the bill every step of the way, requiring all 60 Senators who are part of the Democratic caucus to agree. That will continue this week, with the next 60-vote motion happening on Monday and perhaps two more 60-votes motions occurring during the week.

After the Senate passes their health care bill, it will head into “conference” with the House bill. There, leaders from each branch of Congress, as well as the White House, will work to resolve the differences between the two bills and come up with something that can pass and be sent to the President’s desk.

Conference is an opportunity to stand up for the three priorities listed above, and make sure the final bill guarantees us quality, affordable health care, with the choice of a public health insurance option. The legislation that comes out of the conference will be sent to both houses of Congress for a final vote, and will require a majority in the House and 60 votes one more time in the Senate.

What can be done?

In the coming days, we’ll be asking you to let your Senators, member of Congress and President Obama hear from you. We’ll be rolling out with a campaign to stand up for the fixes we must see to get the best bill possible to the President’s desk. We’ll be asking you to take part, raise your voice, and help us fight for what we believe in.

It’s been a tough week for health care reformers, there’s no question. But we need to get ready, because it’s not over yet.

As President Teddy Roosevelt once said, “Nothing in the world is worth having or worth doing unless it means effort, pain, and difficulty.” This last week has been painful and difficult, and there’s a lot of effort ahead. We’ll all be taking this time over the holidays to recharge for the coming fight.

As long as you’re fighting with us, we’ve got a chance to win this thing and finish reform right.

Thank you, happy holidays, and onwards!“

To your health,