Op-Ed: Stop Bill Pascrell from Killing Health Care Reform

Red alert: Bill Pascrell, Congressional representative of much of South Orange and Maplewood, is leading an effort to kill comprehensive health care reform. Voters should let Mr. Pascrell know—now—that he should cease and desist from an effort that will disembowel effective reform, leave tens of millions uninsured for the foreseeable future, disempower the Democrats for several election cycles, and very likely destroy the Obama presidency.

The Democrats' sudden loss of their filibuster-proof majority in the Senate interrupted House-Senate negotiations that were forging constructive compromises to incorporate some features of the more liberal House bill. In the wake of Scott Brown's upset victory in Massachusetts, Democratic leaders know that there is one viable path to saving comprehensive reform efforts: have the House pass the Senate bill, which has already passed the Senate, while negotiating to accommodate some House goals through a process known as reconciliation, which allows budget-related legislation to pass the Senate with a bare majority. Likely fixes include limiting the excise tax on expensive health plans and improving subsidies for middle class buyers of insurance.

Pascrell is leading a faction that wants to scale back the bill and pass some pieces of it. As the President made clear in an interview last week, this is an incoherent and unworkable prescription:

"If you ask the American people about health care, one of the things that drives them crazy is insurance companies denying people coverage because of preexisting conditions. Well, it turns out that if you don't—if you don't make sure that everybody has health insurance, then you can't eliminate insurance companies—you can't stop insurance companies from discriminating against people because of preexisting conditions. Well, if you're going to give everybody health insurance, you've got to make sure it's affordable. So it turns out that a lot of these things are interconnected."

There is no doubt that Democrats have dawdled too long over the health reform effort. In so doing, they let Republicans mislead the American public about its key provisions and core architecture (far from a "government takeover" of health care delivery, it leaves the private health insurance industry intact and affects about 4 percent of U.S. spending on health care). In the face of Republican stonewalling, they have been forced to forego the public option and cut a couple of unseemly deals to keep their most conservative members in line.

But the basic architecture of the bills that have passed the House and Senate—which overlap about 90 percent—remains strong. Together, they promise to provide health insurance to 30 million Americans who currently lack it; to end the most egregious practices of the health insurance industry, such as pricing out people with preexisting conditions, imposing annual and lifetime benefit caps and rescinding policies on thin pretexts; to put Medicare on a more sustainable path; and to do it all while reducing the federal deficits.

Many progressives have damned the bill with faint enthusiasm—or condemned it outright, for failing to squeeze the insurance industry hard enough or provide generous enough subsidies to middle-income Americans. But most health care experts recognize that the bill will not only vastly bolster economic security and improve the health of tens of millions, but that it is a foundation that can be built upon to transform health insurance and health delivery. Atul Gawande, surgeon and peerless writer on health care and medical issues for The New Yorker, has argued persuasively that the bill's provisions for dozens of pilot programs and demonstration projects designed to improve outcomes and change providers' incentives have the potential to transform healthcare, just as the Dept. of Agriculture's cornucopia of analogous projects transformed agriculture in the first third of the 20th century. Fifty-one of the nation's leading health care experts across the ideological spectrum have signed a letter to House Democrats urging them to pass the Senate bill and work to improve it through reconciliation. Jacob Hacker, father of the public option, also expressed his support for the Senate bill. See also Steve Benen's powerful appeal to Democratic lawmakers. 

In contrast, Bill Pascrell told Politico that he is "tired" of the health care reform process. The "clear message" that he's taken from voters in Massachusetts, New Jersey and Virginia is that Democrats ought to retreat in terror before Republican demagoguery and rejectionism—rather than stop dithering, make their full-throated case to voters and abide their verdict. He told Hardball that it is "arrogant" to "not accept the dictates of those couple of elections"—meaning New Jersey and Virginia. Well, voters need to let Mr. Pascrell know that it's cowardly to retreat from an effort that's worthy on the merits because you've failed to make your case for it.

If Rep. Pascrell is too "tired" to pass meaningful health care reform, voters should prepare to retire him. Since his core belief is in heeding voters' "clear messages," please send him one at http://pascrell.house.gov or 202-225-5751.

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Andrew Sprung is a South Orange resident and author of the blog xpostfactoid.