Thoughts for the Day on Texas Politics of Health Reform

The press has made much of the fact that House Republican Health Reform proposals laid out on Tuesday do not prohibit denying delaying or excluding health insurance for pre-existing g conditions, even though many Republican officials to this point have identified that as a reform goal. 

In my opinion, the biggest thing missing from this House Republican party proposal and the stated positions of  Republican officials on health reform in the current debate is that covering all Americans, or even making coverage affordable for all Americans, is never mentioned as goal.  All that is mentioned is reducing the cost of coverage (or the rate of cost increases).  This can’t get America anywhere near coverage for all, because the $12,000 a year average cost of family premiums (not even counting other out-of-pocket costs) is simply too big a share of total income for too many low-income full-time working families.   Also missing from the House Republican bill are other hallmarks of insurance market reform, such as ending wild unregulated premium variations based on age, gender, health status, and occupation.

I hear daily from a wide range of national groups, from wonky analysts to pro-reform organizers.  In recent days, calls are coming in from all quarter for continued pressure on Texas Congressmen Henry Cuellar (our one avowed Blue Dog), Chet Edwards, Solomon Ortiz, and Ciro Rodriguez to get on board with the House bill.  I can’t begin to explain to you whether or why they are either genuinely wavering or widely perceived to be so, but we want to make sure the word is out on that topic.

TVHR was happy to assemble 21 organizations to sign a letter supporting affordability priorities in health reform; Texas AFL-CIO also submitted a separate but coordinated letter.  It is hard to get everyone in the room, on the phone, or reading their email when you need to coordinate a consensus draft, and ultimately there were 3 major statewide groups who only bowed out because of one provision in the letter.  Guess which one?  You got it—the public option.  The letter pitched that option as a key cost-saving measure, noting that the lower the cost, the more low-income uninsured folks can be helped from the same limited pot of money.  How many of us would have predicted a year ago that this would be the lightening rod issue is has become? 

I continue to believe that the biggest lift of all is establishing in law the goal of making decent coverage affordable for all.  I remain hopeful that we are about to make the biggest step in U.S. history toward that goal.