Where Health Reform Stands: Senate vs. House

Last month, history was made. The House of Representatives passed a health care bill that gave the American people what they want.

In poll [1] after poll [2], people wanted most of all to have the choice of a public health insurance option, to keep their health care benefits untaxed, and to have affordable health care both at work and out of it. The House bill came incredibly close to those goals. It was truly history-making.

Early this morning [3], the Senate took its first step towards passing a health care bill. While the Senate bill includes significant reforms, it looks small in comparison with the House. And progressives are, as Richard Kirsch, our National Campaign Director said [4], "Very, very angry and disappointed."

Shortly, the two bills will head into conference. In the next few days, we'll elaborate on what exactly needs to be fixed in the Senate bill and how it's better in the House bill, but for now, the key differences can can be broken down into two areas:

1. Make health care affordable

Low and middle income families must be able to afford health insurance if they do not get it through work, and employers must be asked to provide good health coverage for their employees so health care is affordable at work.

The House bill asks employers to pitch in, and is much more affordable for lower-income people who don't get coverage through work. The Senate bill lets employers off the hook, increasing the cost to employees for health coverage, though it is more affordable for middle-income people who don't get coverage through work.

Also, the House bill finances reform with a surtax on the richest families - those making over $1 million per year. The Senate bill finances reform by taxing middle-class health care benefits, which will only increase cost or decrease coverage for millions [5].

The final bill should ask employers to pitch in and share responsibility for full and part-time workers, and should make health care affordable for all incomes. And t he final bill should get rid of this tax on health benefits, something President Obama ran against. Instead, the wealthiest in society who can afford to help should be asked to pitch in their fair share to pay for reform.

2. Hold insurance companies accountable

Insurance companies must be held accountable with strong regulations and consumer protections, and we must be given the choice of a national public health insurance option available on day one. The House bill gives us that choice.

One area we've seen the Senate bill improve upon since dropping the public option is improved insurance regulations such as the Patient's Bill of Rights. But the House bill is still stronger in many aspects. The final bill needs tough regulations and real choices, to give the American people what they want and need.

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In all of these areas (except some aspects of affordability, to be elaborated upon in the next few days), the House bill does a better job than the Senate bill of standing up for what the American people want and need. Speaker Pelosi has a document on the differences between the bills [6] that's worth checking out, which lays things out along similar lines.

This process isn't over, not by a long shot. This what we'll be fighting for in conference. (And yes, there will be a conference [7].)

Over the last few weeks, progressives have been shocked and demoralized by the way the debate in Washington has played out. But we can't stop fighting, and we can't stop pressuring our leaders in Congress and the White House to do what's right.

A good bill, like the House bill, that does right by Americans can still be delivered to the Oval Office. Congress and the President have a choice: They can give us that good bill, or they can leave us disappointed and angry. A message to them: Choose wisely.