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The bill is the most sweeping piece of federal legislation since Medicare was passed in 1965. It aims to smooth out one of the roughest edges in American society — the inability of many people to afford medical care after they lose a job or get sick. And it would do so in large measure by taxing the rich.
A big chunk of the money to pay for the bill comes from lifting payroll taxes on households making more than $250,000. On average, the annual tax bill for households making more than $1 million a year will rise by $46,000 in 2013, according to the Tax Policy Center, a Washington research group. Another major piece of financing would cut Medicare subsidies for private insurers, ultimately affecting their executives and shareholders.
The benefits, meanwhile, flow mostly to households making less than four times the poverty level — $88,200 for a family of four people. Those without insurance in this group will become eligible to receive subsidies or to join Medicaid. (Many of the poor are already covered by Medicaid.) Insurance costs are also likely to drop for higher-income workers at small companies.
The Democrats passed a huge, complex piece of legislation that provides the greatest benefit to our sickest and poorest citizens. That just does not happen in the Amerioca I grew up in! (I was born in 1971.)
The main features of the bill are:
1. People can no longer be denied insurance coverage because of a pre-existing health conditions.
2. People can no longer be charged a higher health insurance premium because of pre-existing conditions.
3. Millions of additional families will be eligible for Medicaid.
4. Millions of middle class families will receive billions of dollars in subsidies to purchase health insurance.
5. Everyone will be required to have health insurance.
Of course, as addressed in recent Economist article, featured in a rec-listed diary, there are a ton of reasons why Democrats are not seeing much political upside from the law yet.
First, the main provisions do not take effect until 2014.
Second, people who are already satisfied with their insurance situation will not feel much of a benefit.
Third, many people who will benefit tremendously from the bill do not realize that the will benefit tremendously from the bill and won't realize it until they get sick or lose their job.
Fourth, it is a big and complex bill that is hard to summarize in four words.
It was a hard bill to pass, especially in the middle of the worst economic and financial crisis of most of our life times. But it was the right thing to do.
The main problem with our country's political system is that politicians are afraid to take on big complex problems because, electorally, the risks outweigh the rewards. But the Democrats did it this time. And of course they are being punished for it in the polls and by the media.
On March 21, 2010, ocngressional Democrats, under attack from the right and left, stood tall and courageously took a vote that they knew might hurt them politically this year. I was never more proud to be a Democrat.
And now somebody who sums up my feelings more eloquently than I could ever hope to:
Now, I can't guarantee that this is good politics. Every one of you know your districts better than I do. You talk to folks. You're under enormous pressure. You're getting robocalls. You're getting e-mails that are tying up the communications system. I know the pressure you're under. I get a few comments made about me. I don't know if you've noticed. I've been in your shoes. I know what it's like to take a tough vote.
But what did Lincoln say? "I am not bound to win, but I am bound to be true." Two generations ago, folks who were sitting in your position, they made a decision -- we are going to make sure that seniors and the poor have health care coverage that they can count on. And they did the right thing.
And I'm sure at the time they were making that vote, they weren't sure how the politics were either, any more than the people who made the decision to make sure that Social Security was in place knew how the politics would play out, or folks who passed the civil rights acts knew how the politics were going to play out. They were not bound to win, but they were bound to be true.
And now we've got middle class Americans, don't have Medicare, don't have Medicaid, watching the employer-based system fray along the edges or being caught in terrible situations. And the question is, are we going to be true to them?
Sometimes I think about how I got involved in politics. I didn't think of myself as a potential politician when I get out of college. I went to work in neighborhoods, working with Catholic churches in poor neighborhoods in Chicago, trying to figure out how people could get a little bit of help. And I was skeptical about politics and politicians, just like a lot of Americans are skeptical about politics and politicians are right now. Because my working assumption was when push comes to shove, all too often folks in elected office, they're looking for themselves and not looking out for the folks who put them there; that there are too many compromises; that the special interests have too much power; they just got too much clout; there's too much big money washing around.
And I decided finally to get involved because I realized if I wasn't willing to step up and be true to the things I believe in, then the system wouldn't change. Every single one of you had that same kind of moment at the beginning of your careers. Maybe it was just listening to stories in your neighborhood about what was happening to people who'd been laid off of work. Maybe it was your own family experience, somebody got sick and didn't have health care and you said something should change.
Something inspired you to get involved, and something inspired you to be a Democrat instead of running as a Republican. Because somewhere deep in your heart you said to yourself, I believe in an America in which we don't just look out for ourselves, that we don't just tell people you're on your own, that we are proud of our individualism, we are proud of our liberty, but we also have a sense of neighborliness and a sense of community -- (applause) -- and we are willing to look out for one another and help people who are vulnerable and help people who are down on their luck and give them a pathway to success and give them a ladder into the middle class. That's why you decided to run. (Applause.)
And now a lot of us have been here a while and everybody here has taken their lumps and their bruises. And it turns out people have had to make compromises, and you've been away from families for a long time and you've missed special events for your kids sometimes. And maybe there have been times where you asked yourself, why did I ever get involved in politics in the first place? And maybe things can't change after all. And when you do something courageous, it turns out sometimes you may be attacked. And sometimes the very people you thought you were trying to help may be angry at you and shout at you. And you say to yourself, maybe that thing that I started with has been lost.
But you know what? Every once in a while, every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises that you made in all those town meetings and all those constituency breakfasts and all that traveling through the district, all those people who you looked in the eye and you said, you know what, you're right, the system is not working for you and I'm going to make it a little bit better.
And this is one of those moments. This is one of those times where you can honestly say to yourself, doggone it, this is exactly why I came here. This is why I got into politics. This is why I got into public service. This is why I've made those sacrifices. Because I believe so deeply in this country and I believe so deeply in this democracy and I'm willing to stand up even when it's hard, even when it's tough.
Every single one of you have made that promise not just to your constituents but to yourself. And this is the time to make true on that promise. We are not bound to win, but we are bound to be true. We are not bound to succeed, but we are bound to let whatever light we have shine. We have been debating health care for decades. It has now been debated for a year. It is in your hands. It is time to pass health care reform for America, and I am confident that you are going to do it tomorrow.
-Barack Obama, rallying Democrats to stand up for the American people, March 20, 2010.
The People's View
Proud to be American. Proud to be enemies of Donald J. Trump.
A pragmatic, progressive site dedicated to public policy, in-depth analysis that puts the lives of real people above ideological dogmatism.