Wednesday, December 16, 2009

Health Care Reform Staggers Toward The Finish

If, as President Obama predicts, health care reform legislation is approaching the finish line in the Senate, then it has been staggering fitfully across the last stretch of the track. Senators are supposed to vote on this 2,000 plus page bill before Christmas, yet none of them have yet seen the actual text of the legislation. Managers of the bill will not release the final version until CBO has completed its scoring of the measure, and of course CBO is shooting at a moving target as the compromise negotiations stutter along on the two most controversial and stubbornly difficult aspects of reform: abortion funding and the public option.

Senator Joe Lieberman says he won’t vote for a bill with a public option in it, and Senator Roland Burris says he won’t vote for a bill without a public option in it. Either way, Democrats come up one vote short of the 60 needed for passage. No matter what the resolution of the public option problem, abortion coverage is an independent and equally contentious hurdle. Women’s rights advocates insist every American woman should have an avenue to purchase health coverage including the possibility of abortion services, and right to life advocates are equally insistent that not a penny of federal taxpayer dollars should go to fund the purchase of abortion insurance, either through premium subsidies or Medicare and Medicaid coverage.

Of course, passage in the Senate, whether before or after Christmas, does not assure that health care reform becomes reality. The only thing now clear about the Senate version of the legislation is that it won’t be identical to the bill already passed by the House. That means that whatever the Senate does pass will go to a conference committee, where these two seemingly impossible issues will rise again, along with the differences in approach between House and Senate tax impositions to pay for the enormous cost of expanding health coverage for those who can’t or won’t buy it on their own. Super Bowl Sunday may come and go before American citizens know what conclusion Congress reaches regarding health care reform legislation.
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