Health Care Reform

When Obama campaigned for president, he promised health care reform. Well, last night, after a year of struggling through Congress, the reform bill finally passed. So, what does this mean for you? The New York Times has an article and a interactive guide, The Los Angeles Times has this guide, and the Washington Post has this timeline. Basically, the uninsured are the people who will see benefits from this legislation almost immediately.

There are a lot of good things in this bill. And many are saying that this is just the beginning of reform- we still have a long way to go. It's not perfect, and I didn't expect it to be. But I can't help but feeling a bit disappointed. The Stupak amendment has a lot to do with it. Some say it's just upholding the Hyde Amendment, which I think should be repealed anyway (and so did Obama when he was campaigning), but it's more than that. If a woman buys insurance on the exchange, she has to write two checks, one for regular insurance, and one for "abortion" insurance. Even though abortion is a legal medical procedure. The Daily Beast:

Because only about 13 percent of abortions are billed directly to insurers, it is sometimes assumed that abortion is a relatively inelastic good—that women who really want one will get one, come hell or high water. But that assumption is false. A 1999 study of poor women in North Carolina found that about one-third of them had carried pregnancies to term only because Medicaid funding for abortions was unavailable during certain parts of the year. An abortion can cost between $350 and $1,000—equal to several months of rent or groceries—so the price can be prohibitive. The result of unaffordable abortion is another mouth a working-class mother cannot afford to feed, house, or educate during a time of record unemployment.

So, women's reproductive rights were used as the bargaining chip to get this bill passed. And it's not just poor women that will be affected. It could lead to the elimination of all insurance coverage for abortion services.

Besides that, the bill has a few other shortcomings:

A year ago, Pelosi swore there would be a public option. There is none. There is no cap on what insurance companies can charge people with so-called pre-existing conditions, including being a victim of domestic violence or sexual assault — insurance companies just can't refuse to cover you, but they can charge what they like and, worse yet, you'll be required to buy it or pay a fine. Obama's mandates that employers provide their workers with insurance turned into a mandate that individuals buy their own insurance if employers don't. Conservative Ben Nelson's abortion-related provisions - which require companies participating in the health insurance exchange to send patients two bills (one for regular insurance and one for "abortion" insurance) in order to highlight for Americans that women sometimes have abortions, and they hope, reduce Americans' support for it — remain part of the legislation despite the outcry from the pro-choice community.

Although the new 31 million people that will be covered by insurance is an impressive number, there is still a lot of room for improvement. Let's hope that this is the first step toward a more comprehensive and inclusive health care reform.

UPDATE: Here is a more comprehensive explanation of what Obama's executive order means.