The ACP Advocate Blog
by Bob Doherty
Friday, October 2, 2009
Will health reform help a Missouri bartender?
Early this morning, the Senate Finance Committee finished its work on amending the bill drafted by Chairman Max Baucus (D-MT). A final vote within the committee is expected next week. Baucus says he has the votes to get it out of committee although it remains unclear if Senator Olympia Snowe (R-ME) will vote in the affirmative, in which case she would be the sole Republican, Senate or House, to vote for the health reform overhaul. Assuming approval by the SFC, Majority Leader Harry Reid (D-NV) will work on melding the SFC bill with the version approved by the Health, Education, Labor and Pensions Committee, with a floor debate and vote in mid-October.
As the Washington Post reports, approval by the SFC and HELP committee and the three committees of jurisdiction in the House of Representatives, will take health reform farther along the road to enactment than any other time in American history. It is looking more and more likely that there is a consensus among Democrats to get a bill sent to President Obama for his signature. Nothing is assured, though, until the final votes are cast.
Although all of the attention is on Washington, I am reminded of a recent conversation with a woman in Missouri that reminds me of what health care reform is all about. I was in Missouri attending the ACP chapter meeting. Over several beers at the hotel bar, Dave Fleming, the ACP Missouri chapter governor, and I were debating whether health care is a right, privilege or societal responsibility. Our bartender overheard our conversation and asked if health care reform would help her and her family.
She said she has some serious health problems that require expensive medications, which are only partly covered by the health insurance plan offered by her employer. Her company plan also covers her 19 year old dependent daughter with a serious mental health condition. Her husband, an independent contractor who can't find coverage on his own, also relies on his wife's plan for coverage. She said that even with the insurance, her premiums and out-of-pocket health care bills are so high that "I don't know how we'll make it". She was planning to take a day off from work to plead with state Medicaid office to cover her daughter, even though she had already been advised over the phone that her daughter wouldn't qualify.
Dr. Fleming and I explained that health care reform might make her daughter eligible for Medicaid, because the pending bills would require the program to cover anyone up to 133% of the poverty level (we didn't ask her how much she and her husband earned). We also told her that she might be able to get subsidized coverage through a health exchange, and that insurers wouldn't be allowed to turn down her daughter or charge higher premiums because of her pre-existing mental health condition. She wistfully responded, "I hope so" but sounded unconvinced that the politicians in Washington would do these things for her.
As the politicians continue to debate the intricacies of such things as excise taxes, budget offsets, health exchanges, subsidies, mandates, and public options, I hope we don't lose sight of this Missouri bartender, and the millions of working American families, who can't afford health care and are looking to Washington for help. None of the bills making their way through Congress are perfect - far from it. But I believe the litmus test of whether the results are worth it is whether our Missouri bartender and her family can get good coverage at a price that they can afford.
Today's question: Do you have confidence that the politicians in Washington are going to produce a bill that provides help to this Missouri family and the millions like her?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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