The Treatment

Baucus Answers The "not Now" Crowd

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Max Baucus just gave a speech on health reform at the Center for American Progress. And it served as a clear rejoinder to those who say health care reform must wait, because of the economic crisis:

The picture is bleak.  Deficits are higher and continue longer than we had expected.  The economic conditions facing our country are severe.  Unemployment is rising.  Families are struggling to make ends meet.  Many are losing their homes. But this economic uncertainty does not dampen the urgency of health care reform. Indeed, the economic downturn contributes to the urgency for health care reform.  More than three out of five people believe that it’s now more important than ever to take on health reform. And to those who think that we cannot afford to address health reform, I say: We cannot afford to wait.  Why? Because health care reform is not just a moral imperative. It is also an economic imperative. The consequences of not enacting comprehensive health care would be dire. The costs would be unsustainable for individuals, families, employers, and state and Federal governments alike. The costs of not acting are high. 

Of course, you've heard that from other champions of reform. But, as Karen Tumulty's new article in Time reminds us, Baucus is among the most influential figures in the debate. And he's not merely making vague promises to act swiftly. He has also set a specific timetable:

We must act this year. And that means that we have to act fast. To meet that deadline, the House and Senate need to pass legislation before the August recess.  If we do not act this year, then we won’t have another opportunity for another decade. Next year, we’ll be in the midst of Congressional elections. The following year, we’ll be in a Presidential cycle. We have to act now.

Baucus also used the occasion to make clear the necessity of an individual mandate--that is, a requirement that everybody obtain insurance. He'd signaled as much before, most memorably in his white paper on reform. But I don't recall him making as explicit a statement as the one he just did:

Even the insurance industry has accepted that “business as usual” is no longer acceptable. They recently sent a letter supporting the changes that I’m proposing, if done with an individual obligation to purchase insurance. And once coverage is accessible, affordable, and meaningful, people should have a responsibility to get insurance. An individual obligation to get health coverage is essential for several reasons. It is the only way to stop the cost-shifting related to uncompensated care. Today, the costs of care for 46 million Americans without health insurance are largely borne by those with insurance. Getting all Americans covered will also make insurance markets function properly. Insurance works because policyholders pay into their plans when they are healthy. And they get their medical bills paid when they are sick. 

(It's possible Baucus has been this clear before; if that turns out to be the case, I'll update.)

One note in there will definitely give fans of reform pause: Baucus came out pretty strongly against using the reconciliation process to enact reform:

I am doing everything that I can to keep pushing, along with my good friend and partner Ted Kennedy. Together, we have sketched out a path to get a bill through the Senate. That path necessarily involves bipartisan support. Why? Because in the end, in the Senate, a bill needs 60 votes. Attempts to circumvent this requirement using reconciliation would also require trade-offs.

More on that issue later...

--Jonathan Cohn 

Photo courtesy of Getty Images

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