Thursday, January 20, 2011

Okay, NOW can we get down to business?

The House of Representatives just got through wasting time debating the repeal of last year's health care reform bill. To no great surprise, the repeal bill passed the GOP-controlled House, 245-189, with every Republican and three Democrats voting to repeal it.

The debate and vote were largely symbolic.

Democrats control the Senate. Even if they did not, President Barack Obama would veto any repeal of "Obamacare."

So Republicans were just engaging in political grandstanding and pandering, they knew they weren't actually accomplishing anything.

And that's okay, because very few people really want to repeal health care reform, including (shhh, keep this under your hat) the Republicans who just made such a show of trying to do so.

Polling on the issue has been shifting. A Gallup poll in early January found 46% in favor of repealing the law and 40% against. An Associated Press-GfK poll last week finds only 25% favoring repeal and only 30% against the health care reform law. Finally, an NBC-Wall Street Journal polls split the difference, with 39% opposing health care reform and 39% supporting it, and 46% opposing repeal while 45% favored it.

I don't doubt there are about  a third of the voters who are strongly for repealing health care reform. That's the hardcore Tea Party "we're-against-anything-Obama-does" crowd.

There's no question the GOP majority in the House owes them a debt. They turned out in disproportionate numbers in November's election and fueled a Republican landslide.

Hopefully. now that we've got the symbolic repeal out of the way, Congress can get down to doing the people's business.

Because, let's be honest here, everybody knows we need health care reform -- including Republicans.

That's why "Obamacare" bears a striking resemblence to "Romneycare," the state health insurance plan once-and-future Republican presidential candidate Mitt Romney signed into law as governor of Massachusetts. It's also pretty similar to proposals former Republican presidential candidate and Senate Majority Leader Bob Dole made back in the late '90s.

The individual mandate to buy health insurance that so inflamed the Tea Party and prompted Virginia Attorney General Ken Cuccinelli to sue the federal government? That was a Republican idea.

While I'm not a big fan of that individual mandate, it did get the insurance companies to sign on to the bill and agree to other concessions, like not denying coverage based on pre-existing conditions or canceling clients' insurance when they get sick.

Those and other provisions of the bill, like allowing children to remain covered under  their parents' policy until their mid twenties, are actually quite popular. Republicans will tamper with them at their own political peril.

Since there's no longer any need to slander the bill for political purposes by calling it a "government takeover of health care," maybe now Republicans can start to help to fix the bill.


Because it's not a government takeover -- unfortunately,, all health care and health care insurance remains private, any one who is happy with their present coverage can keep it. And it doesn't "cover illegal immigrants" -- who are specifically excluded from coverage in the bill. Nor does it contain "death panels" -- if you choose to consult with a doctor about end of life decisions for a loved one,  the bill requires the insurance company to pay the doctor's bill for that meeting,

There are improvements to be made. In another poll, 42% of respondents said they wished the health care reform law did more. And some of the ideas that Republicans have championed in the past could help make the law better.

For instance, the law says that people who are not insured through their employee will be able to join state insurance pools, hopefully to be able to buy coverage at lower rates than individual coverage is currently available at by spreading the risk over a larger number of people.

Republicans have proposed in the past to allow health insurance companies to operate across state lines. That's a great idea because it will increase competition for the business represented by the state insurance pools. And insurance companies would compete for that business, because those pools will represent huge amounts of  business.

Think how many car insurance commercials you see every evening from Geico and Progressive and State Farm and Nationwide and All State, all competing for your car insurance business and trying to get you to switch because they all say they've got the best price. They are allowed to compete nationwide and they do. That competition keeps car insurance rates down.

There are some wrinkles that would have to be worked out. Insurance regulations are largely the function of state governments. Would the insurers be bound by the regulations of the state they operate from or the buyer's state?

I'm pro-consumer, so I'd say make them bound by whichever set of regulations is most benificial to the customer. Some folks in Congress, on both sides of the aisle, who get a lot of money from insurance companies would likely disagree.

There are probably other Republican ideas that could improve the health care law. They should trot them out. Yelling "No!" at the top of your lungs may be a great way to gain political power. It's not the way to keep it. Neither is appealing to the 25%-30% of the country furthest to the right  -- or left.

Voters who chose change in 2008 and then change again in 2010, when it wasn't working out the way they thought it should, obviously don't have any deep-seated party loyalty. They may change their minds again in 2012.

Partisan gridlock and political gamesmanship isn't the kind of change anyone voted for in 2008, or last year. In fact, it isn't any kind of change at all.

If this Republican Congress is seen as obstructionist and more concerned with political games than governance, they'll find that they've made the same mistake that the class of 1994 made when they shut down the government to make a political point and insured Bill Clinton's re-election.

Cross posted to All Politics Is Local.

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