The Pluses and Minuses of Pelosi’s Package

Nancy Pelosi’s health care reform bill has much to commend it, and much to condemn it.

On the plus side, there’s a public option, with no opt out.

The insurance companies won’t be able to deny coverage for preexisting conditions or rescind policies once someone gets sick.

And it greatly expands Medicaid.

Currently, Medicaid doesn’t cover all poor Americans. If you’re single and poor, you’re out of luck. And if you’re married and poor but don’t have young kids, you’re also out of luck.

But under Pelosi’s plan, every adult in America who is poor would qualify for Medicaid.

And her plan raises the qualifying definition of poor up to 150 percent of the poverty line—that means anyone earning under $16,200 would be eligible for Medicaid.

Another plus is on the funding side. Rather than tax generous health care plans that unions have won, as the Senate bill would, Pelosi’s would slap a 5.4 percent surtax on individuals making $500,000 or more, and families making $1 million or more.

The bill isn’t near perfect, though.

First, it doesn’t allow the government to set the reimbursement rates. Instead, the insurance companies would be empowered to negotiate those rates with the government.

Second, it appears that Pelosi’s public option would not be open to everybody. Like Obama’s plan, not many of us would be able to join it. And I wish it would have kept Rep. Dennis Kucinich’s amendment to allow states to experiment with universal coverage.

Kucinich himself denounced the compromise.

“Is this the best we can do? Government negotiates rates which will drive up insurance costs, but the government won’t negotiate with the pharmaceutical companies which will drive up pharmaceutical costs.

“Is this the best we can do? Only 3% of Americans will go to a new public plan, while currently 33% of Americans are either uninsured or underinsured?

“Is this the best we can do? Eliminating the state single payer option, while forcing most people to buy private insurance.

“If this is the best we can do, then our best isn’t good enough and we have to ask some hard questions about our political system: such as Health Care or Insurance Care? Government of the people or a government of the corporations.”

I also believe that true health care reform must include health care coverage for everybody in America, not just citizens. And this bill doesn’t provide that. Health care is a human right. It doesn’t matter whether you are here without proper documentation or not; you deserve health care. And, from an economic standpoint, it’s foolish to deny health care to the undocumented, since they will end up going to the emergency room for costly care when they could have been treated initially, at much less cost, if they had health care coverage.

Pelosi could have come forward with the strongest bill possible, knowing the Senate would water it down. She didn’t need to pre-dilute it.