December 2, 2009

Settling in for a Long Debate

This report was written by John K. Iglehart, national correspondent, New England Journal of Medicine, He writes that with virtually all Republicans in opposition and public opinion sharply divided, the Senate opened debate on a democratic health care reform bill that would greatly expand insurance coverage and reverse the erosion of the party's standing in the electorate's eyes. Prospects seem dim that the Democrats will be able to enact their proposal without scaling down its scope to accommodate the more conservative Democrats. Nevertheless, Majority Leader Harry Reid (D-NV) opened floor debate by saying that "the next weekends, we will be working" on the reform bill, because there is "not an issue more important than finishing this legislation." Along with Reid, President Barack Obama and his staff members will be active dealmakers. The issues that divide the parties, and provoke rancor even within them, are formidable and include whether to create a public insurance option, vastly expand Medicaid, cover abortion services through private health plans that are partially paid for with public subsidies, and allow undocumented immigrants to purchase coverage with their own money through an insurance exchange. The total cost of the reform bill, estimated at $848 billion by the Congressional Budget Office, will come under scrutiny.