By Earl Ofari Hutchinson, New America Media
President Obama, House Speaker Nancy Pelosi, Senate Majority Leader
Harry Reid, key House and Senate Democrats and Republicans, and most
importantly the major pharmaceuticals and private insurers know one
thing, and they've known it from the start of the health care debate:
The Senate, not the House, will decide what, if any, health care reform
plan is finally approved.
The pharmaceuticals and private insurers have repeatedly and forcefully
made it clear that they flatly reject a true public option, any
enforced restrictions on their right to charge whatever the freight
will carry for health care, or dump or summarily exclude anyone who's
too sick, poor, or too old from coverage. They also made it abundantly
clear that they'll only accept a bill that requires millions to be
covered by them at government (taxpayers) expense and that slaps
penalties on those who refuse to go along with it.
The full enactment of the main provisions of whatever health care bill
is passed won't take place for nearly another decade, and that gives
private insurers time to hike prices to cover any added costs in policy
and coverage changes they must make under reform. They've fielded an
army of lobbyists, health insurer flacks, held secret deal-cutting
meetings at the White House, stuffed millions in the campaign coffers
of leading Democratic senators (including one time senator Obama), and
poured more millions into ads and planted articles to get their way.
The Senate, and even more specifically, the Senate Finance Committee,
has been the target of the insurers' relentless, prolonged, and
well-oiled campaign to get the most generous industry health care plan
possible, or no plan at all. Their time, effort and money has been
well-spent. The finance committee quickly killed the public option,
slapped penalties on non-buyers, and imposed no tough regulations to
compel the private insurers to keep their bargain to insure everyone.
It did not impose tight cost-containment measures to insure that
private insurers keep their prices down.
Senate leaders did not raise a peep at the crude, naked blackmail
threat by America's Health Insurance Plans, the private health
insurance industry group. It publicly waved around a study it
commissioned that claimed that private insurers would have to sharply
increase the prices families would pay if the House version of the
health care reform plan passed.
The actual House vote is far from the great victory that Pelosi and
Democratic leaders declared. The Democrats had a crushing majority, had
poll after poll that showed the public wants a real public option and
full affordable health coverage for all, and no cuts in Medicare
services (the cuts are in the House and Senate bills). Yet, the House
bill still barely squeaked through and then only after Pelosi and other
House liberals shamefully back pedaled and excised abortion coverage
from the bill. This all guaranteed that the resistance to the most
liberal provisions of the House bill will be even more ferocious in the
Even if none of these factors came into play in the Senate, the Senate
still more often than not has been the graveyard for House passed
legislation that the Senate considers too liberal, too pro labor, too
expansive, too costly, and too non-industry friendly. In the past
couple of years, the Senate has killed House bills to toughen energy
standards, to scale back contributions to the IMF, increase education
spending, and decrease war spending in Iraq and Afghanistan. Ditto
immigration and major banking reforms. It also bottled up for years the
House's expanded hate crimes bill.
Industry groups dead set against the House bill have one more trump
card, and that's the conference committees. The Senate can amend,
change the language, or red pencil out anything in a House bill. It
then tosses it back to the House to amend, change the language or
excise things that the Senate wants tossed out. The conference
committee negotiations on controversial legislation are long, tedious
and drawn out. When or even if agreement is ever reached, it then goes
back to both the full body of the House and Senate for a vote. There's
no time frame for completion for any of this. Nor is there any
requirement the Senate take a final vote. This was the case with other
pieces of "landmark" bills the House passed.
The House vote on health care reform was historic only in that one body
of Congress took the hotly contested first big step toward reform. The
Senate hasn't spoken. And it, not the House, is the name of the game on
health care reform.
Earl Ofari Hutchinson is an author and political analyst. His
forthcoming book, How Obama Governed: The Year of Crisis and Challenge
(Middle Passage Press) will be released in January 2010.