No place to hide on health bill

“My goals for health care remain the same as when we started this discussion last year. We need to fundamentally change the system to bring costs down for our families and small businesses, hold insurance companies accountable, and increase access to quality health care. When we have a bill to vote on, I will determine whether it goes far enough to fix the incentives in our health care system and if it is going to help the people of the 20th District.”

–Rep. Scott Murphy (D-20th)

THE QUOTE ABOVE comes directly and in its entirety from Rep. Murphy’s Washington office. His press spokesman provided it in response to the question of whether the congressman, whose district includes all of Columbia County, has decided how he will vote on what’s called “reconciliation” of the Senate health insurance reform bill. A Yes vote supports health insurance reform. He voted No when the House adopted its version of a healthcare overhaul bill last year, but the bill narrowly passed anyway. He said he opposed aspects of that bill. Now the Senate has adopted a very different bill, more conservative in many ways and greased with pork for the states of a handful of senators whose votes were required for passage. Democrats in the Senate no longer have the 60 votes to stop a Republican filibuster, and the only way to get a bill passed is to use the reconciliation procedure. In this case, that means the House must adopt the Senate’s version of reform and make changes to it once the bill becomes law.

Is this a local issue? If you’ve got a permanent job with health insurance, probably not. If you’re over 65, you already have government insurance called Medicare, so it’s not your problem, either. If you’re really poor or disabled, the government covers you through Medicaid. But if you’re one of the 2,600 or so unemployed folks in Columbia County, it might interest you.

The county’s unemployment rate jumped nearly a full percentage point from December 2009 to January 2010, according to the state Department of Labor. And most experts agree the official number of unemployed misses lots of people who have given up looking for work or who don’t earn enough at their jobs make a living–the underemployed. What’s more, these statistics never reveal how many people have full-time jobs that don’t offer health care or whose jobs pay too little for them to afford health insurance even when their employers pick up part of the cost.

How expensive is health insurance right now? The state insurance department says that in this county it currently costs between $857 and $2,000 a month for an individual health insurance plan providing HMO coverage. Do the math and figure out how much salary you’d need if you had to pay that much for health insurance in addition to food and rent. Then see how many jobs here pay that much. But before you even attempt the calculation, consider the other key factor: You must be young and healthy enough to convince an insurer to cover you no matter what you can pay.

The vote on the health insurance reform reconciliation bill in the House will be very close, possibly much closer than the vote on the original bill. Rep. Murphy’s vote could prove decisive, which brings us back to his response to the question about his stand on reconciliation. He says he will decide on a bill when he sees one, but as we understand it, he and his colleagues must vote first on the Senate bill. In that case, he already knows what he’ll vote on. He’s dodging the question.

Mr. Murphy announced with pride last month that a Washington magazine dubbed him one of the most “centrist” members of the House. That may help if he runs for reelection this fall. But assuming a reconciliation vote comes up in the House during the next few weeks, there really isn’t a centrist place to hide.

If he votes for reconciliation, he can help extend health insurance coverage to millions of Americans and prevent insurance companies from denying care to those who need it. Most Americans believe those are worthwhile goals. And while Mr. Murphy certainly should consider how this bill would affect his district, he has a higher duty to act now to prevent needless pain and suffering and even the hastened deaths of people who lack insurance. It might be a politically astute to oppose this flawed health insurance reform bill, but it would be irresponsible and morally corrupt to vote No.

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