What a scaled-back bill might look like

WHAT A SCALED-BACK BILL MIGHT LOOK LIKE…. The entire health care reform debate could end with a successful resolution if the House were to pass the Senate bill. But the House doesn’t want to, at least not yet.

But all of the relevant players still want to avoid complete failure, so competing options continue to be mulled over. The easiest, most direct, and most effective approach — the House passes the Senate bill, then approves improvements through reconciliation — is still struggling, for reasons that defy comprehension. Some House Dems want to break reform into parts and pace it piecemeal, which still doesn’t make sense.

And then there’s the possibility of a smaller, “scaled-back” reform plan that would bring health coverage to maybe 12 million to 15 million people, instead of the 30 million in the bills already approved by the House and Senate. What would the pared-back approach look like? The NYT report offered the most details:

Lawmakers, Congressional aides and health policy experts said the package might plausibly include these elements:

* Insurers could not deny coverage to children under the age of 19 on account of pre-existing medical conditions.

* Insurers would have to offer policyholders an opportunity to continue coverage for children through age 25 or 26.

* The federal government would offer financial incentives to states to expand Medicaid to cover childless adults and parents.

* The federal government would offer grants to states to establish regulated markets known as insurance exchanges, where consumers and small businesses could buy coverage.

* The federal government would offer tax credits to small businesses to help them defray the cost of providing health benefits to workers.

* If a health plan provided care through a network of doctors and hospitals, it could not charge patients more for going outside the network in an emergency. Co-payments for emergency care would have to be the same, regardless of whether a hospital was in the insurer’s network of preferred providers.

There are at least three obvious reasons why this is a bad idea. First, the scaled-back plan is considerably worse than the Senate bill, and would help far fewer Americans. This may seem like a radical concept, but if House Dems have a choice between two approaches, and one is superior to the other, they should probably support the better one.

Second, working on the scaled-back plan — in effect, writing a whole new, weaker bill — would take quite a bit of time. Indeed, it could add months to the process. Nothing is to be gained from dragging this out even further.

And third, if the House passed a weaker bill, it would then go to the Senate, where no one wants to even think about health care reform anymore, and where it would almost certainly be blocked by Republican obstructionism anyway.

As for the bigger picture, health care reform isn’t quite dead. It’s hanging by a thread — a weak, tattered, struggling thread — but there’s still a chance. Jonathan Cohn noted that “the key players — congressional leadership, labor leaders, and so on — keep leaving open the option of the Senate bill plus amendments via reconciliation, which remains the most viable path forward. Interest groups are starting to rally, too. The American Cancer Society Action Network, for example, just put out a statement urging Congress to move forward.”

Pass. The. Damn. Bill.

Pass. The. Damn. Bill.

Pass. The. Damn. Bill.