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Morning Read: House (finally) passes health reform (again)

House Democrats got the votes they needed to pass the latest iteration of the health reform bill, a signal that the end of the long and winding road to health reform is in sight. The final tally was 219-212, with all 178 Republicans and 34 Democrats opposing the measure. House Speaker Nancy Pelosi rounded up the votes in her chamber thanks to a deal on abortion reached with conservative Democrats. The details of the deal really aren’t all that important, since abortion rights supporters say the deal merely affirms what’s already in the bill. Regardless of what President Obama does for the next three (or seven) years, this is the accomplishment–or to his opponents, the miserable failure–that is likely to define his legacy.

Highlights of the important and the interesting from the world of health care:

Finally: House Democrats got the votes they needed to pass the latest iteration of the health reform bill, a signal that the end of the long and winding road to health reform is in sight. The final tally was 219-212, with all 178 Republicans and 34 Democrats opposing the measure. House Speaker Nancy Pelosi rounded up the votes in her chamber thanks to a deal on abortion reached with conservative Democrats. The details of the deal really aren’t all that important, since abortion rights supporters say the deal merely affirms what’s already in the bill. Regardless of what President Obama does for the next three (or seven) years, this is the accomplishment–or to his opponents, the miserable failure–that is likely to define his legacy.

Next, the measure moves to the Senate, where it should easily have the 51 votes needed to pass, though Republicans will almost certainly try to throw  up some procedural roadblocks. Then it’s on to President Obama for his signature, and then the most significant healthcare legislation in nearly a half-century will be in the books.

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Democratic Incumbent Protection Plan… is another word for the “early deliverables” in this bill that will take effect in the first year it’s enacted. Kaiser Health News says those items included that dependent children could remain on their parents’ health insurance plans until age 26, senior citizens would get more help paying for drugs in Medicare and people with health problems that left them uninsurable could qualify for coverage through a federal program. “If we can’t market them well, then we will have deserved to fail,” Democratic consultant Chris Jennings told KHN.

Six reactions to reform (or two). It’s less than 12 hours passed, but there’s plenty of reaction to go around. The See First Blog has six immediate takes, of which I like the following two.

4.  It’s Not a Left-Right Thing. It’s not.  Sure, the existing infrastructure of the culture war has grabbed hold of reform and is riding it.  But Republicans opposing the plan should learn from Massachusetts.  Don’t confuse the fact that you are saying things people like for a shift in support for your culture war causes.  There is a glimpse of this in the last minute wrangling over abortion.  While that’s an important issue for a lot of people, it’s not what public anxiety over reform is about.  So if, for example, Republicans decide to make abortion a big part of their strategy going forward, they shouldn’t be surprised when they find there aren’t as many people behind them as they expect.


5.  Health insurance regulation is now federal territory. Little-noticed (well, except by me) is the fact that Congress has repealed the anti-trust exemption for health insurance and that the reform plan sets up the basics of a federal infrastructure for insurance regulation.  The federal government doesn’t just drop by and visit, they move in.  Memo to state insurance regulators: the feds are outside, and they have a HUGE moving van.

One day we’ll all be able to tell our kids we lived in a quaint time when we used to regulate health insurance in the states.  Our kids will laugh.  Actually, strike that.  They’ll wonder why we thought it was interesting to tell them that.

What didn’t make it into the reform package: Most of us know the much-celebrated public  option never made its way into the final health-reform legislation. But a few other things were left out along the way, as NPR points out. Remember the insurance rate commission that was going to review big premium hikes? Didn’t make it. Beefing up the Federal Trade Commission’s powers to clamp down on deals between generic and brand-name drugmakers that keep generics off the market? Relegated to the dustbin of history, for now at least.

Fox News on health reform: GoozNews lists some sarcastic suggestions for news leads after the House vote that would make Fox News proud. A sample: “In a move that will bankrupt the federal government, the House on Sunday passed a sweeping health care reform bill that will cut the federal budget deficit by more than $100 billion over the next decade.”

100 years of health reform: If you’ve got a few hours to devote to reading about health care (and who doesn’t?) the New York Times’ 100-year timeline of reform efforts in the U.S. is where to spend it. From the numerous twists and turns of the legislative process since the current bills were introduced in the summer of 2009 (seems like so long ago), to Teddy Roosevelt campaigning in 1912 for national health insurance, the retrospective is an informative look at how the issue of health care has taken shape over the last century. Who knew that a 1929 partnership between a teaching  union and Dallas’ Baylor Hospital was the first example of “modern” health insurance in the U.S.?

A number of the entries contain corresponding articles from the Times’ archives that can make for fascinating reading. I was struck by this lengthy 2002 article, written as health insurance premiums were trending up after a brief respite during the 1990s. Sure, eight years isn’t that long of a time when viewing things from a larger perspective, but virtually all the problems present in 2002 are still with us today–only worse. I enjoyed one quote from an analyst that illustrates how “the-more-care-is-better-care” mentality is something that we’ve still barely begun to grapple with, despite having known for years the dangerous path it’s leading us down.

”As a society, sooner or later we will have to determine whether there are some benefits that are just too small to justify the cost,” said the analyst. Americans, he said, ”have an enormous tendency to use treatments if we think they work or if we hope they work, even if there is no evidence that they do work.”

– Dependent children could remain on their parents’ health insurance plans until age 26.

–  Senior citizens would get more help paying for drugs in Medicare.

–  People with health problems that left them uninsurable could qualify for coverage through a federal program.

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