It took what, 60 years to get here? But the Congress has passed an historic piece of legislation that slightly nudges the health insurance situation in the United States to something closer to universal coverage.
Let's be clear: What was passed last night--the Senate bill will become law on Tuesday, when President Obama signs it--is a modest and disappointing bill. The bill to be passed later this week--reconciliation, which passed the House last night but needs to be passed yet by the Senate--makes the reform infinitesimally better.
However, there are some significant immediate benefits that will begin on Tuesday when the bill becomes the law of the land. Closing the odious Medicare Part D "donut hole" (something Republicans saddled seniors with after their dead-of-night antics passing that bill). Starting a new appeals process for those already covered by insurance, and making it harder for insurance companies to deny new coverage. Helping small businesses to afford to extend coverage to their workers. All of these are good things, and to be commended and celebrated.
And as time goes on, more elements of the reform will kick in, including cost controls and expanded access to basic and preventive care across the nation. These are also all good things, and to be commended and celebrated.
It's also worth celebrating that the Democrats seem to have held together (what was it Will Rogers said about us again?) and got something significant done. This is not something that has happened often in my lifetime. I think the last time may have been passing Bill Clinton's 1994 budget--you know, the one that led to a decade of unparalleled growth and record budget surpluses?--which, like health care, happened without a single Republican vote.
It is almost not at all surprising that Republicans held fast against it; after all, their leadership has been clear of late that that was their only strategy. (Some sensible Republicans have noted that this is a dumb strategy, not just for their party, but for the nation as a whole.) This is in contrast to previous decades when Republicans used to promote exactly the same kinds of reforms that are in the bill now.
I say almost, because in retrospect a couple of things are if not surprising, then at least disturbing. For example, apparently the process of how a bill becomes a law (everyone sing along, now) is "sleazy." Let's recap: Last spring and summer, the House and Senate held weeks of televised hearings on reform, released multiple full-text versions of reform bills, and debated all through the fall the best way to proceed. The House passed a bill in December. The Senate, overcoming a filibuster and days of Republican delaying tactics, also passed a bill. (I'm still looking for the sleazy part.) Last night, after hours of more delaying tactics by Republicans, the House passed the Senate version of the bill and it's now awaiting Obama's signature. That's the way Congress works, has worked, will continue to work. When both houses pass the same bill, it gets signed (usually) and becomes law. What's sleazy?
There is reconciliation. The House passed it last night, and the Senate has the votes to pass it as soon as they can overcome the inevitable delaying tactics by Republicans. But here's the second surprising-slash-disturbing thing: Republicans seem to remain unified against this part, as well. Which I literally do not understand, because the reconciliation bill does indeed make things better. It improves the Senate bill. It kills the "Cornhusker Kickback" and many of the other special deals that may have been the "sleazy" part and which have fueled a lot of the public and tea-party backlash against reform. It makes the bill cheaper, short-term and long-run. It fixes, by everyone's estimation, R or D, con or lib, many of the ugliest parts of the final bill being signed into law tomorrow. If Republicans were honest brokers instead of stubborn dolts, they would realize that the grand fight is over, and they lost, and they ought to be working and voting to make the winning bill more to their liking. Instead, they've continued to stonewall and delay and refuse to participate meaningfully in the governance of this nation.
Which is why, though I am only moderately proud to be a Democrat this morning, I would be utterly mortified and ashamed to be a Republican right now.