Policy Specialists Urge House Leaders to Adopt Senate Healthcare Bill

For nearly three-quarters of a century, Presidents and Congressional leaders have tried to enact legislation that would make health care accessible to Americans. Although pieces of this dream have been realized -- health care for the elderly, the disabled, and children in low-income families -- universal coverage itself has proved beyond reach.

We are now on the cusp of realizing this goal. Both houses of Congress have adopted legislation that would provide health coverage to tens of millions of Americans, begin to control health care costs that seriously threaten our economy, and improve the quality of health care for every American. These bills are imperfect. Yet they represent a huge step forward in creating a more humane, effective, and sustainable health care system for every American.

We have come further than we have ever come before. Only two steps remain. The House must adopt the Senate bill, and the President must sign it.

While the House and Senate bills differ on specific points, they are built on the same framework and common elements -- eliminating health status underwriting and insurance abuses, creating functioning insurance markets, offering affordability credits to those who cannot afford health insurance, requiring that all Americans act responsibly and purchase health insurance if they are able to do so, expanding Medicaid to cover all poor Americans, reforming Medicare payment to encourage quality and control costs, strengthening the primary care workforce, and encouraging prevention and wellness.

Some differences between the bills, such as the scope of the tax on high-cost plans and the allocation of premium subsidies, should be repaired through the reconciliation process. Key elements of this repair enjoy broad support in both houses. Other limitations of the Senate bill can be addressed through other means.

The Senate bill accomplishes most of what both houses of Congress set out to do; it would largely realize the goals many Americans across the political spectrum espouse in achieving near universal coverage and real delivery reform.

With the loss of Edward Kennedy's Senate seat, Democrats no longer enjoy a filibuster-proof Senate majority, though they still enjoy the largest Senate majority any party has achieved in the past generation. The loss of this one vote does not require Congress or the President to abandon Senator Kennedy's life work of health care reform. A year of political infighting, misleading debates about death panels and socialized medicine, and sheer inaction has left Americans exhausted, confused, and disgruntled. Americans are also bearing the severe consequences of deep recession and unemployment. Still, a majority of Americans support the elements of the Senate bill.

The House of Representatives faces a stark choice. It can enact the Senate bill, and realize the century-old dream of health care reform. By doing so, it can achieve a historic milestone while freeing itself to address other national problems such as joblessness and mortgage foreclosure that affect millions of Americans. Differences between the House and Senate bill can be negotiated through the reconciliation process.

Alternatively, Congress can abandon this effort at this critical moment, leaving millions more Americans to become uninsured in the coming years as health care becomes ever less affordable. Abandoning health care reform -- the signature political issue of this administration -- would send a message that Democrats are incapable of governing and lead to massive losses in the 2010 election, possibly even in 2012. Such a retreat would also abandon the chance to achieve reforms that millions of Americans across the political spectrum desperately need in these difficult times. Now is the moment for calm and resolute leadership, pressing on toward the goal now within sight.

Some have proposed dividing the bill or starting anew with negotiations to produce a less comprehensive bill. From the perspective of both politics and policy, we do not believe this is a feasible option. We doubt that the American public would welcome more months of partisan wrangling and debate. We doubt that the final product would match what has already been achieved. Indeed we doubt that any bill would reach the President's desk should congressional leaders pursue this misguided course.

We, the signatories of this letter, come from a variety of different perspectives. Some of us are long-standing advocates of progressive causes. Some of us are nonpartisan or identify as political moderates.

From these differing perspectives, we agree on one thing: the current choice is clear. Pass the Senate bill, and improve it through reconciliation.

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