Delegate Donna Christensen joined Congressional leadership in front of the Capitol in Washington, D.C., earlier this week as House Speaker Nancy Pelosi rolled out the House version of health care reform, dubbed the Affordable Health Care for America Act.
The bill blends and updates the three versions of previous bills passed by House committees of jurisdiction in July. A vote in the House is expected Nov. 11. Meanwhile, in the Senate, House Majority Leader Harry Reid is merging three committee bills to form the final Senate bill. The House version contains a public option and Reid has said the Senate bill will too.
Unlike in the House, where majority vote rules, in the Senate, it takes 60 of 100 votes to close off debate and force a vote if there is a filibuster in opposition to a bill. With exactly 60 senators caucusing with the Democrats, and one, Sen. Joe Lieberman (I-Conn.) saying he will join a Republican filibuster, the final form and prospects for the Senate bill are up in the air. Whatever bill the Senate passes will then join the House bill for reconciliation into a single bill by a conference committee composed of members of both the House and Senate, which will then go before both houses for a final up or down vote.
A second Senate filibuster is possible, but may be avoided if the Senate leadership invokes certain budget bill rules that force a vote. So ultimately, filibuster or no, Democrats have the power to include whatever they choose in the final bill as long as committee heads and 50 senators are on board.
Christensen’s office said Thursday the House bill is in keeping with President Barack Obama’s guidelines for health reform in that it slows the growth of health costs, includes a public option which will keep it affordable, protects people’s choices of doctors and health plans, and assures access to care for all Americans.
Important to the U.S. Virgin Islands and other territories, the bill includes a $10.35 billion increase in Medicaid over the next nine years and inclusion in a health care exchange with subsidies for low-income patients. The exchange would be an insurance marketplace through which individuals and families with incomes less than 150 percent of the federal poverty level could receive federal subsidies to substantially reduce the cost of purchasing private insurance. This could benefit a substantial portion of Virgin Islands residents and reduce uncompensated care costs to Virgin Islands hospitals, clinics and doctors, potentially saving the V.I. Government tens of millions of dollars in annual health care subsidies. While insurance payments would be subsidized by the federal government, people would also be required to purchase insurance unless they qualify for the public option or already have private insurance through work.
“Inclusion in the exchange will ensure that territorial residents have a wide range of insurance options, to include the public option,” Christensen said in a statement from her office. “This will represent a significant increase in public health care funding as well as more affordable coverage.”
Pelosi and other leaders in the Democratic Caucus said that the House proposal will reduce the deficit by $30 billion over the first 10 years, cover young people on their parents plans up to age 27, exempt small businesses with payrolls below $500,000 from employer mandate, and begin to close the Medicare Part D "donut hole." The donut hole is a gap in prescription drug coverage under Medicare Part D. As is, it covers up to $2,700 per year in prescription drug payments, then stops. Coverage does not begin again until the recipient’s drug costs exceed $6,100 annually, thus leaving the recipient responsible for paying all drug costs between $2,700 and $6,100, creating a hardship for some recipients once they need to take several thousand dollars worth of prescription medicines annually.
The bill would also give immediate help for the uninsured until the exchange is available, ban limits on coverage, fund community health care centers and increase the number of primary care doctors.
But Karen Ignagni, president of the health insurance lobbying group America’s Health Insurance Plans (AHIP), released a statement Thursday critical of the bill, saying it would increase health care costs and threaten people’s private plans.
"The promise of health care reform has been that if you like your current coverage, you can keep it," Ignagni wrote. "We are concerned that this proposal will break this promise by increasing health care costs for families and employers across the country and significantly disrupting the quality coverage on which millions of Americans rely today."
Ignani also said federal subsidies to a private health insurance program called Medicare Advantage would be cut, suggesting this would be unpopular with seniors who prefer this private program to Medicare itself.
Thursday evening, after the bill’s rollout, Christensen and 11 of her colleagues in the Black, Hispanic, Asian and Progressive Caucuses met with Obama to give their input and concerns on health care reform and the proposals moving through Congress.
“We met for more than an hour and he listened to our concerns,” Christensen said in a statement from her office after the meeting. “There was agreement on some issues and not on others, but he pledged to work with us throughout the process. He called on us to be unified in our efforts as real health care reform becomes a reality,” she said.
Christensen said she told the White House meaningful health care reform must be available for all Americans including the nearly 5 million people living in the U.S. territories. The group also insisted that health care reform include strong health disparity elimination provisions, she said.
Obama greeted news of the rollout of the House bill with praise.
“The House legislation includes critical reforms to the insurance industry, so that Americans will no longer have to worry that they will be denied coverage, or that their coverage will be dropped or watered down when they need it most," Obama said in a White House statement.
According to the Congressional Budget Office’s analysis, the House bill would cost $894 billion over 10 years and extend insurance coverage to 36 million currently uninsured Americans, covering 96 percent of Americans. Adjustments in Medicare, requiring individuals to purchase insurance and other provisions offset that cost, and the CBO confirms the House bill would ultimately cut the projected federal budget deficit by $30 billion in the first 10 years.