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Published: Tuesday, 3/23/2010

Health-care reform wins

THE health-care reform package that the House approved Sunday night does several hugely important things. Above all, it will provide coverage for an estimated 31 million uninsured Americans whose medical expenses now are subsidized by insured individuals and by businesses.

For all the tiresome scare rhetoric about a "government takeover of one-sixth of the American economy," the legislation will stimulate competition among private health insurers. At the same time, it will curb their worst abuses, such as denying coverage to people with pre-existing medical conditions, or making such coverage prohibitively expensive.

It helps small businesses by providing tax credits for insuring their employees. Its mandate that most Americans buy health insurance or pay a penalty is accompanied by subsidies for struggling low-income, working-class, and middle-class households. It fairly taxes high-cost "Cadillac" health insurance plans.

It will start to limit increases in health-care costs, without widening the federal deficit. And it will do all these things without essentially disrupting the coverage of Americans who get health insurance from their employers or from Medicare.

President Obama deserves credit for perseverance on his chief domestic issue, through 14 months of discord and partisan obstructionism. Special recognition goes to those House Democrats in swing districts who voted for the bill despite threats that they could lose their jobs in November.

It's mildly disconcerting that Rep. Marcy Kaptur (D., Toledo) waited until the last minute to sign onto legislation that will help so many of her constituents. Mr. Obama mollified Miss Kaptur and other anti-abortion Democrats by issuing an executive order prohibiting the use of public money to subsidize abortions - effectively restating current law. This issue should not have become the obstacle that it did, but Miss Kaptur's support was better late than never.

Not one Republican House member voted for the bill. Since GOP lawmakers call incessantly for reduced government spending, here's a suggestion: Let them stay home and phone in their "no" votes. Not only would that save a lot of money, but their self-imposed irrelevance to the political process would not be so conspicuous.

House Democratic leaders wisely chose not to invoke the "deem and pass" tactic that would have weakened the legitimacy of the reform package. Still, the process is not quite over.

Although the House sent to the President the Senate-approved health-care bill, senators must vote to accept the changes House members made to the bill. They will use a valid parliamentary procedure called reconciliation that will enable the Senate to enact the changes on a simple majority - thus preventing a filibuster by the GOP minority from killing the legislation.

Even then, the job will not be done. The bill does not do enough to curb health-care inflation, but its initiatives on Medicare cost control and private insurance exchanges are good starts.

Social Security and Medicare were highly controversial when they were enacted, but both programs have become basic protectors of elderly and sick Americans against destitution. In time, this health-care reform legislation likely will have the same effect.

But those critics who think Mr. Obama and Democratic lawmakers have moved too fast to ensure that America is no longer the only large industrialized nation that does not require near-universal health-care coverage might want to think again. Former Republican President Theodore Roosevelt called for national health insurance - in 1912.



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