In Defense of the Baucus Health Care Bill


The running joke about Sen. Max Baucus, who released his $800 billion health care reform bill this week, is that he finally created the bipartisanship consensus he's craved by creating a bill that both Democrats and Republicans hated. I offered this rundown of groups he managed to peeve: Republicans and liberals, unions and libertarians, insurers and social welfare groups -- you know, most breathing organisms.

But now, as predictable as the undertow after the wave, it's the backlash to the backlash. Out: The Baucus bill stunk. In: The Baucus bill is actually pretty good!

Atlantic Media's Ron Brownstein, who's basically the Almanac of American Politics with legs, calls the Baucus bill "the most fiscally sustainable framework yet devised for expanding coverage. It progresses much further...

than any other Congressional bill toward solving two fundamental and inter-related problems: creating a revenue stream that rises as fast as health care costs, and reshaping the incentives in the medical system in ways that should help "bend the curve" on those long-term cost increases. Without those two elements any coverage expansion will prove unaffordable, and thus unsustainable, over time. "Whatever its other pros and cons," said one senior Obama administration official integral to the health care debate, "the [Baucus] mark provides proof of concept that you can significantly expand coverage in a fiscally responsible way."

On many fronts, it's likely that the final bill will be tilted more toward Democratic priorities and preferences because Baucus crafted his plan partially to attract bipartisan backing and it now appears that if any bill passes, it will do so without support from many, and perhaps any, Republicans. Most glaringly, Baucus devotes too little money to help uninsured middle-class families buy the health insurance they would be required to obtain under the individual mandates included in all major bills. He also asks too little of larger employers who don't provide insurance for their workers."

I think that's right, on all counts. One year ago, it would have been difficult to imagine a health care bill that would expand coverage to tens of millions of Americans; make insurance fairer, more transparent, and more comprehensive; provide for state consumer-run organizations (or co-ops) to compete with insurance companies to bring prices down; save the government money over ten years, and beyond; and Democrats would roundly hate on it. Of course the Baucus bill comes up short for reformists in key areas -- see here -- but the emotional outpouring over Baucuscare is a combination of serious, legitimate misgivings and the agony of high expectations when they collide with Washington reality.

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Derek Thompson is a senior editor at The Atlantic, where he writes about economics, labor markets, and the entertainment business.

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