The following column was written before the release of President Obama’s proposed changes to the Senate health-reform bill. Those changes, to be made through the budget-reconciliation process, should reduce objections from House Democrats on several points. In particular, the president proposes to raise the threshold for the excise tax on high-cost health plans to $27,500 and to postpone it to 2018. A compromise on these lines should help ease the transition to a new system of coverage with better incentives to control costs.
Sen. Ben Nelson and Joseph Lieberman. (AP Photo/Lauren Victoria Burke)
If Congress can complete work on health-care legislation and send it to the president (as of mid-January, the final bill is still under negotiation), it will be a stunning historical achievement and the most important liberal reform since the 1960s. It may also be the most underappreciated social legislation in recent history. Never in my experience has such a big reform been treated as so small. Never have Democratic members of Congress who are putting their careers on the line for something they believe in been so vilified as sellouts by influential progressives. And never have those progressives been so grudging in their endorsement of landmark legislation or so willing to see it defeated.
As Barack Obama ends his first year in office, there is much talk about disillusionment with the president among progressives. The litany of complaints is obvious: unemployment still at 10 percent, economic policies unduly favorable to Wall Street, the surge in Afghanistan, compromises on health care, the failure to close down Guantánamo, and a general inability to bring about the transformative change that Obama spoke of during his campaign.
Senate Finance Committee Chairman Sen. Max Baucus, Monday, Dec. 14, 2009, in Washington. (AP Photo/Haraz N. Ghanbari)
The moment of decision on health-care reform is arriving for progressives in Congress. Some of them have insisted they will refuse to vote for any bill without a public option, and that is now the only bill that has any chance of passing. If they hold to their position, the most significant social reform on behalf of low-income Americans in 40 years will go down to defeat.
A Senate staffer passes out paperwork prior to a health care news conference. (AP Photo/Harry Hamburg)
No provision of the health-care reforms being debated in Congress is as likely to generate a popular backlash as is the individual mandate -- the requirement that individuals purchase health insurance if they are not otherwise covered. But there is an alternative to the mandate as it is currently structured that can accomplish the same purpose without raising as much opposition.