The high hurdle of health care reform

Brian Darling Liberty Government Affairs
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Last year the House of Representatives and the Senate passed different versions of health care “reform.” But both houses need to pass identical bills before a measure can become law. The easiest way to accomplish that would be for the House to simply pass the Senate bill as is.

But for fans of ObamaCare, there’s a problem. Many House members oppose crucial elements in the Senate bill, including federal funding for abortion.

One group, in fact, has come to be known as the “Stupak dozen.” Named for Rep. Bart Stupak, (D-Mich.), these lawmakers have said they will change their vote to no if federal funding for abortion is in the final bill.

Administration and Democratic leaders are asking members to, in effect, “just pass it; we will ask the Senate later to fix the parts you object to.” Except that this latter part is unlikely ever to happen. If ObamaCare becomes the law of the land, there would be no incentive for senators to pass something they dislike.

That’s why all the talk of “reconciliation” is meaningless. It’s unlikely this arcane legislative maneuver that allows for circumventing the traditional rules of the Senate would ever be used.

Equally meaningless are President Obama’s campaign-style events in traditional swing states. Obama has lost the battle for public opinion, and ginning up votes in one or two states won’t help him at this point.

So let’s review some of the most controversial components within the House and Senate versions.

  • The treatment of taxpayer-funded abortions. The House bill contains the Stupak-Pitts amendment, which would build a genuine firewall between federal funding and abortion coverage. The Senate bill, however, specifically allows federal taxpayer funding for abortion.
    The fact is that a House vote for the Senate bill would enshrine the Senate abortion language in federal law, while any revisions would require 60 votes in the Senate and a majority in the House. This appears unlikely given reports that the White House and Congressional Democrats will move forward with or without the support of the pro-life members of their caucus.
  • Government-run health care no matter what. The bills also differ in whether or not to offer a “public option” to “compete” with private insurers. The Senate bill eliminated provisions to establish an explicit public plan. Instead, it would set up multi-state private health plans sponsored by the U.S. Office of Personnel Management to compete against private health plans in the state-based exchanges the Senate bill mandates.
    The House bill, meanwhile, includes an explicit government-run health plan. And House liberals have already compromised, watering down the public plan they wanted in order to get a bill passed. So those liberals would need to really back down to agree to the Senate bill.
  • Employer mandates that kill jobs. Another problem, shared by both the House and Senate bills, is the mandate that employers provide insurance coverage.
    The Senate bill would fine any company that employs 50 or more $750 per worker unless the company provides “federally qualified coverage.” If a worker uses federal subsidies to buy coverage through the health insurance exchange the federal government plans to set up, the employer would pay an annual penalty of $3,000 for each worker who obtains a subsidy.
    Talk about a job-killer. Small companies would have a reason to stay small, and employers would have little incentive to hire new workers. The House version, meanwhile, goes right to taxation. It would force employers to offer federally qualified health-care coverage to their employees and pay a specified percentage for single and family premiums or pay a payroll tax of up to 8 percent.
  • Tax penalties for the non-insured. Both bills would also require individuals to either buy federally approved health insurance or pay a tax penalty. The Senate bill would impose its penalties starting in 2014, and the annual penalty would be at least $750 in the years ahead.
    Beginning in 2013, the House bill would require individuals to pay 2.5 percent of their income if they don’t obtain federally “acceptable” health care coverage. Those with health insurance that doesn’t meet the federal standards would still pay the tax penalty. Individual citizens would be punished in either case.

The best way to figure out a trick is to keep your eye on the magician, and ignore the distractions. Poll after poll shows that a growing majority opposes ObamaCare. It’s going to take more than a talented illusionist to pull off this legislative sleight of hand.

Brian Darling is Director of Senate Relations at The Heritage Foundation.