The deliverables

The White House posted a nice memo that clearly lays out how Americans will benefit from the health care reform now (or at least in the very near future).  Kevin Drum highlights some of the key points:

  • This year, children with pre-existing conditions can no longer
    be denied health insurance coverage. Once the new health insurance
    exchanges begin in the coming years, pre-existing condition
    discrimination will become a thing of the past for everyone.
  • This year, health care plans will allow young people to remain
    on their parents' insurance policy up until their 26th birthday.
  • This year, insurance companies will be banned from dropping
    people from coverage when they get sick, and they will be banned from
    implementing lifetime caps on coverage. This year, restrictive annual
    limits on coverage will be banned for certain plans. Under health
    insurance reform, Americans will be ensured access to the care they
    need.
  • This year, adults who are uninsured because of pre-existing
    conditions will have access to affordable insurance through a temporary
    subsidized high-risk pool.
  • In the next fiscal year, the bill increases funding for
    community health centers, so they can treat nearly double the number of
    patients over the next five years.
  • This year, this bill creates a new, independent appeals process
    that ensures consumers in new private plans have access to an effective
    process to appeal decisions made by their insurer.
  • This year, discrimination based on salary will be outlawed. New
    group health plans will be prohibited from establishing any eligibility
    rules for health care coverage that discriminate in favor of higher-wage
    employees.
  • Starting January 1, 2011, insurers in the individual and small
    group market will be required to spend 80 percent of their premium
    dollars on medical services. Insurers in the large group market will be
    required to spend 85 percent of their premium dollars on medical
    services. Any insurers who don't meet those thresholds will be required
    to provide rebates to their policyholders.
  • Starting in 2011, this bill helps states require insurance
    companies to submit justification for requested premium increases. Any
    company with excessive or unjustified premium increases may not be able
    to participate in the new health insurance exchanges.
  • This year, small businesses that choose to offer coverage will
    begin to receive tax credits of up to 35 percent of premiums to help
    make employee coverage more affordable.
  • This year, new private plans will be required to provide free
    preventive care: no co-payments and no deductibles for preventive
    services. And beginning January 1, 2011, Medicare will do the same.
  • This year, this bill will provide help for early retirees by
    creating a temporary re-insurance program to help offset the costs of
    expensive premiums for employers and retirees age 55-64.
  • This year, this bill starts to close the Medicare Part D 'donut
    hole' by providing a $250 rebate to Medicare beneficiaries who hit the
    gap in prescription drug coverage. And beginning in 2011, the bill
    institutes a 50% discount on prescription drugs in the 'donut hole.'

 That's a lot of good stuff that will make a real difference in many people's lives.

 

Why November will be good for Republicans

It's most definitely not health care.  Democrats saved themselves from electoral disaster by passing the bill.  No, it's just the basics of elections.  Democrats are over-extended after two really good election cycles.  They hold a ton of seats that are in areas that actually lean Republican.  Without Barack Obama at the time of the ticket (or George W. Bush to enrage them, as in 2006), many of these Democratic voters who put these Democratic Congress members in office simply will not be voting this November.  Thus, Republicans should be expected to reclaim a lot of these seats.  This is a classic pattern of voting trends in American politics that we political scientists even have a name for: surge and decline.  2008 was the surge, 2010 is inevitably the decline– especially with a bad economy.  Check out this cool chart based on the Cook Partisan Voting index (scroll down).  There's a ton of seats that are red in the left column (i.e., leaning Republican) but blue in the right column (i.e., held by a Democrat).  Almost all of these are inherently vulnerable.  In contrast, there's only two of 435 seats that represent the converse.  When Republicans pick up a bunch of seats in the Fall, this is 90% of your explanation.  When the time comes and various media sources tell you it was all about health care or some other short-term factor, you'll know they don't have a clue.

 

A little more on repeal

There's a reason the Ezra Klein is an awesome widely-read blogger and I am not.  Here he explains exactly why repeal is a complete non-starter much more clearly and succinctly than my attempt:

Cornyn and his colleagues repeatedly said that they wanted to ban
discrimination on preexisting conditions during the debate and that
their argument was with all the other stuff. But all the other stuff,
Ponnuru says, flows from the ban on preexisting conditions. If you're
going to change the insurance market such that the sick can't be left
out, you have to make sure that the risk pool doesn't become so sick and
expensive that the healthy flee. That's why you do the mandate. And if
there's a mandate, there needs to be subsidies to make sure people can
afford what they're being asked to buy. And then of course, we need to
define what they're being asked to buy, and so you get minimum benefit
regulations.

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