In the twilight of 2009, the torch carriers of reform -- that is, the Democrats on Capitol Hill -- appeared to be just a few steps shy of finishing the marathon.
And then, suddenly, the finish line vanished. With the shocking January election of Republican U.S. Senate candidate Scott Brown to the empty chair of the late Ted Kennedy in Massachusetts, came the fog of uncertainty and inaction.
This is because with Brown's election, Senate Democrats lost their coveted 60-40 majority needed for easy passage.
So what now? The possibilities are many. The House could simply try to pass the Senate version sans any amendments, bypassing the need for another vote in the Senate. Or Congressional Democrats could choose to exercise the even more politically risky trump card of "reconciliation," which essentially allows them to pass legislation with a simple 51-vote majority. Or Democrats could comply with GOP demands to scrap both bills and start from scratch.
In any event, this much is certain: As Congress continues to prolong the debate, the cost of health care continues to set alarming new records.
In February, the U.S. Centers for Medicare and Medicaid Services released a report showing that 17.3 percent of the U.S. gross domestic product was spent on health care services in 2009, an increase from 16.2 percent in 2008. The figure not only represents an all-time high since such record-keeping began half a century ago, but also the biggest one-year jump in the health care sector's share of the American economy.
Meanwhile, Hispanics remain the population most beset by lack of coverage due to health insurance premiums that are financially out of reach, with one in three uninsured. (About six in 10 uninsured Hispanics are not U.S. citizens, according to the U.S. Department of Health and Human Services.)
So what is best for Hispanics? The answer depends on whom you ask.
"We have an opportunity here to hit the reset button and have it really be a bipartisan effort," Danny Vargas, recent past chair of the Republican National Hispanic Assembly and a frequent commentator on Fox News' Sean Hannity Show, told HispanicBusiness Magazine. "It needs to take into account private-sector reform, as opposed to being a massive federal undertaking."
Mr. Vargas would like to see more reform aimed at helping small businesses, such as tort reform, the ability for health insurers to compete across state lines and tax breaks for people who open up a health savings account.
Such measures, he says would rein in soaring costs, thereby allowing more businesses to offer insurance, and more individuals to purchase it.
On immigration, Mr. Vargas believes undocumented people should be able to purchase insurance on the exchange. (An exchange is a large pool of people that contracts with insurers to lower risk and therefore reduce the premiums of the customers.)
"They can buy it today," he said.
For the National Council of La Raza, the ultimate goal is to "support any process that creates more pathways to affordable health coverage for Latinos," both first and 2nd generation Hispanics. This could mean backing the reconciliation option, which would amount to an end run around Republicans.
Why? Simply put, in NCLR's view, the House's bill is preferable to the Senate's bill. Folding more of it into the Senate bill would require another Senate vote -- with Mr. Brown and his 40 GOP colleagues presumably poised to vote no.
NCLR prefers the House bill because it includes, for example, a more robust set of investments in prevention, as well as a more generous offering of subsidies for low- to moderate-income people, said Jennifer Ng'andu, deputy director of NCLR's health policy report.
Perhaps more controversially, the House bill, unlike the Senate's, allows illegal immigrants to purchase their own private insurance (with no government subsidies) on a newly created insurance exchange.
Although the prevailing view holds that making an end run around Republicans is politically risky for Democrats, Ms. Ng'andu submitted that in the long run, inaction poses an even greater political threat to the party.
"People are going to look at Democrats as being responsible for healthcare reform," she told HispanicBusiness Magazine. "NCLR believes good policy equals good politics in the long term."
Both Ms. Ng'andu and Mr. Vargas acknowledge that Mr. Brown's election was a demonstration of voter dissatisfaction with all the logrolling in Washington.
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