Evaluating The House Health Care Bill

Speaker Pelosi says the bill could be voted on by Saturday, but is it any good?

The House of Representatives could vote on comprehensive health care reform this Saturday, a crucial step in the long and difficult journey toward health care legislation. Speaker Nancy Pelosi predicts Democrats will successfully secure votes for passing the bill, which has been endorsed by AARP and includes the much-debated public option. If it passes, the Senate will still have to pass a bill and the two will then have to be merged.

• The Best Plan  The New Republic's Jonathan Cohn argues the House bill is the best version produced by Congress. "Like the bills that passed three House committees in the summer, this one will cover more people--and provide them with more protection--than the emerging counterpart in the Senate," he writes. "House lawmakers managed to assemble their proposals in a way that should, by CBO's estimation, reduce deficits (albeit quite modestly) over the long term. In terms of cost, that should really be the takeaway point: That it pays for itself and, in the long run, actually starts to reduce federal deficits."

• Senior-Friendly, Good Politics  The Washington Post's Harold Meyerson praises the bill's provisions to reduce costs for seniors. "The House bill is not only better public policy than the Senate's, it is also better Democratic politics. Seniors always constitute a disproportionate share of midterm electorates, and Democrats concerned about next year's congressional contests would do themselves a major favor by passing a bill that reduced the costs of seniors' medications," he writes. "When the two bills go to conference, the conferees should note that the House version not only bends the nation's cost curve downward but tilts the Democrats' electoral prospects upward."

• Needs Cadillac Tax  Ezra Klein insists the Senate bill's funding mechanism, which would focus on taxing so-called "Cadillac plans," is still better. "The Senate pays for health-care reform by slapping a surtax on high-value plans offered by employers. Economists almost universally believe that such a tax will do quite a bit to control costs and increase wages, both of which are overriding priorities," he writes. "That said, the Senate's excise tax is too small to fund health-care reform, and it's likely to get smaller. So I'd like to see some of the House funding mechanisms blended into the bill to increase the total subsidies."

• Tough on Big PhRMA  Jonathan Cohn cheers the House for not joining a deal between the Senate reformers and the pharmaceutical industry. "PhRMA vowed to endorse reform and advertise on its behalf. Baucus and the administration, in turn, promised not to extract more than about $80 billion in savings from changes that would affect pharmaceutical makers. It was nothing short of a shakedown," he writes. "The House, though, was not party to this deal. And so it's decided to ask a little more--about twice as much, in fact."

• But Great for Medical Device Lobby  The New Republic's Suzy Khimm reports on an unusual concession. "The House bill cuts the $40 billion tax on the device industry that’s in the Senate Finance Committee down to $20 million," she writes. "The tax reduction is an unequivocal victory for the device industry’s intensive lobbying campaign, which led a legion of prominent Democratic legislators to protest the tax for putting a damper on the industry in their home states."

• Ten Reasons To Love It  Health care blogger Anthony Wright lists ten reasons he loves the House bill. These include, "The biggest expansion of Medicaid since its creation 40 years ago, completing an unfulfilled commitment for millions in and near poverty," and, "New consumer protections: New rules & oversight on insurers that include the abolition of underwriting and 'pre-existing conditions,' minimum benefit standards, limits on age-based rates and on premiums dollars going to administration and profit." Wright beams, "But we should look at this bill in its totality, and appreciate how signficant it is, and how much help it would provide if it passes."

• Rush May Preclude Amendments  The Washington Independent's Mike Lillis points out the rush to secure a vote could mean Pelosi wouldn't allow the bill to be amended. "It remains unclear whether Democratic leaders will allow lawmakers to offer amendments on the chamber floor. Speaker Nancy Pelosi (D-Calif.) told reporters Thursday morning that she hasn’t reached any conclusions. 'We may not have any amendments,' she said. 'That decision has not been made.' She’s running out of time."