The Senate is currently involved in a heated debate regarding healthcare reform. Democrats are seeking to expand the availability of affordable health insurance to millions of more Americans. However, their bill has been plagued with infighting, as a result of several disagreements over policy. President Barack Obama, a proponent of comprehensive health insurance reform, visited the Senate on Sunday in order to encourage cooperation among liberal, moderate, and conservative party members.
Obama's appearance served to give moral support to legislators working over the weekend to finalize the details of reform. Their main sticking point is whether or not a public option should be included. Such a provision would create a government-run health insurance plan--similar to Medicare--which would compete with private insurers in an exchange market. Supporters believe that doing so would increase competition, leading to more affordable health insurance. Those who oppose the public option, however, feel that it will be too costly, inefficient, and result in bigger federal government. In his speech, the president urged a caucus of prominent Democratic senators to put their differences aside and focus on the opportunity to back historical legislation. In the past, some liberals have likened the current push for healthcare reform to Great Society domestic programs enacted by President Lyndon B. Johnson in the 1960s; among them were Medicare (for senior citizens) and Medicaid (for the poor).
Despite Obama's encouragement to enact reforms, skeptics remain unconvinced that potential upheaval of the entire health insurance industry is ideal. The public option that has been presented to Congress is not a true single-payer health care system, unlike the plans in Canada and western Europe. In fact, states will be allowed to opt out of the national coverage. Still, that provision is unsatisfactory to conservative Democrats such as Nebraska's Ben Nelson, or Democratic caucus member and independent Senator Joe Lieberman. Both, along with two unnamed senators, have pledged to block the passage of healthcare reform if any form of a public option is involved whatsoever. On the other hand, liberals believe a public option is necessary in order for affordable health insurance to become a reality for more of the uninsured population in this country.
Abortion is another controversial topic in the healthcare reform talks. It is generally accepted that federal money is not directly used to pay for elective abortions; the only exceptions are when there is danger to the mother's life, incest, or rape. However, some senators want to go farther than others to ensure that is the case. Conservative Democrats want to prohibit the use of subsidies to buy a health insurance plan that includes coverage for abortion. These subsidies would be given to low- and moderate-income individuals and families to acquire health insurance in a regulated insurance exchange. A similar measure passed in the House of Representatives, but looks unlikely to pass in the Senate. Pro-choice Democrats are against the provision, since it effectively prevents women from buying
affordable health insurance with abortion coverage if they so choose; but Nelson and other right-leaning Democrats say they will oppose any bill that doesn't forbid the practice, as they do not believe federal funds can be sufficiently separated from a person's own money.
Healthcare reform is clearly a priority for the Democratic Congress; they took the unusual step of meeting on weekends to hammer it out. Senate Majority Leader Harry Reid, as well as Obama and others, have expressed their desire for healthcare reform legislation to pass before the Senate adjourns for its holiday break. While it appears unlikely that the Senate will beat that deadline, there is no doubt that they are making progress. Several amendments to the main bill were voted on last week. Will
affordable health insurance reform happen? Its prospects appear mixed, but things are finally moving along in the Senate.
