What’s Next With Health Care (And Why This Process Was Madness)

What’s Next With Health Care (And Why This Process Was Madness)

By MARIAN WANG

Sometimes things are a little clearer in retrospect. Now that health care reform has passed in the House, it seems there are two main questions in people’s minds:

  • What’s next?
  • Why, procedurally, was the legislative process so confusing and painful to watch?

Let’s answer that second question first. To help do that, we’ve drawn up some helpful infographics.

Exhibit A – How, originally, we thought health care legislation would play out procedurally. This is typically how proposed legislation is melded between the two houses.

Exhibit B – How things would’ve worked under “deem and pass [1],” or a self-executing rule. After questions were raised about the constitutionality of “deem and pass,” the House ended up not going that route.

Exhibit C – How it looks like it’s going to happen, after all.

In that last graphic, the yellow marker (5) is where we’re currently at. President Obama reportedly will sign the Senate bill on Tuesday [2], which means that part of health care legislation is law. The House-passed reconcilliation portion, consisting of 153 pages of “fixes” to the Senate bill (compare the two bills with our side-by-side comparison app [3]), will then move to the Senate (6), and if it passes, on to presidential sign-off (7).

As for the “What’s next” question, Kaiser Health News has a good list [4] of some of the provisions that will take effect in 2010. Most of the bigger changes that will affect millions don’t go into effect in 2014.

Marian Wang blogs for the ProPublica news service. This post first appeared on the ProPublica blog. You can write Marian Marian.Wang@propublica.org.

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NateTonithetigressExhaustedMDDavidLinda Robertson Recent comment authors
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Nate
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Nate

Linda this bill is full of contradictions like that. Successful common sense things that work are eliminated so as to direct more money through the “system”
or example if everyone needs $100 a year in preventive care why do they require the carrier to cover preventive care? Why not all save the $120 in premium and pay for our own preventive care…oops $115 now is all they can mark it up.

Tonithetigress
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Tonithetigress

“I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them” – Thomas Jefferson

ExhaustedMD
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ExhaustedMD

Obama is Bush W Jr. Arrogance, misleading, misdirecting, and even worse than Bush, Obama acts like a celebrity and in continuous campaign mode. How projective and insulting when he said to McCain at the Blair House, in similar words, “we are not campaigning anymore”. Really, Mr Obama? How many consecutive days have you NOT been on TV, radio, or press interviews since this health care issue took off in debate in Aug 2009? I’d bet 3 days! He even had his Hawaii trip covered! Just watch the apologists and defenders rationalize this! And start with his recent Youtube replay of… Read more »

David
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David

As portrayed by the victory of the democrats, and the passage of this landmark legislation, it is patently obvious that the divulgence of knowledge and common sense did not suffice to prevent the mass economical carnage and forthcoming mourning that the people of this once great nation will inevitably bear. This healthcare bill will undoubtedly bestow many with promising hopefulness in alleviating their medical burdens, remove the yoke of arduous healthcare insurance protocols, and set many Americans free from the demoralizing hardship that medical care imparts on those that truly need it. For once, those saddled with illness can treat… Read more »

Linda Robertson
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Linda Robertson

What’s not getting enough press is the fact that buried at the bottom of the bill is the impact on FSAs. For those employees that are making a conscious effort to set aside funds to be able to pay for out of pocket costs, the flexible spending accounts will not be reduced to a maximum contribution of only $2,500 (down from $5,000) and will no longer be able to be used for over the counter medications.

Bruce Toman
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Bruce Toman

Thanks for continuing provide clear, unbiased updates on what is happening!

Wendell Murray
Guest

Helpful illustration. I have been confused about where the version of the bill approved by the House would go next and have been surprised that this bill could be signed by the President while another version of the bill is to go through a reconciliation process. Still confusing, but this sheds some light. Regarding the nutcase commentary above, I have to admit I have never understood the mind of those who write it. The commentary never has a bit of fact to support it. Its tone is strident, tinged with violence and blind fury. What never ceases to astonish me… Read more »

rc
Guest

The reconciliation is a twist of procedure to neutralize the other twist of procedure, the filibuster. If you hate the filibuster you must love reconciliation, if you hate reconciliation, you must love the filibuster. Inappropriate use of both should be prohibited, but while one exists the other can mediate the madness. It’s a shame that so many extreme Republicans, as the few comments above, dominate the voice of the party now with their bitter endless eternal anger. I would love to see some positive constructive contributions from Republicans. I would have loved to see my Republican representative to have collaborated… Read more »

Red Hughs
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Red Hughs

I think people calling Obama a socialist is something of the result of reality far outstripping the categories that we have. Like George Bush, Barak Obama has overseen a vast increase in Federal spending and power. But both these increases have served private interests rather the public interest which a hypothetical “socialism” would serve. Both the Bush and the Obama expansion have involved the modern private-public-fusion approach. These supposedly, hypothetically improve efficiency but definitely, positively prevent the most impoverished from feeling any less of a whip-hand at their back. To the populists and opportunists on the Right, this regime can… Read more »

jessica
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jessica

they forget to tell you that the bill does not affect them they’re health care is paid for life by us not them they wont have to pay a fine we pay it for them how can someone agree to a bill that doesnt apply to them??????? i guess easy

jessica
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jessica

i think this health bill should be thrown out just as the ones who put it together and the so called president who sign it. what happen to the constitution is the president going to start killing people that dont look like him too>>>> is this a repeat of hitler???? not much different than the way that it started in germany soon they’ll be telling us where to work what we can make how we can spend it and what we can eat impeach the so called butt thats president and put someone in there who knows what they’re doing… Read more »

Cat
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Cat

If your head is being filled by falsehoods as to what this bill is about – this is definitely worth a read – consider this one thought:
…these are the same Republicans who thought nothing of spending one trillion dollars (not to mention the wasted lives) on that wild goose chase in Iraq, but now act as if spending less than that on healthcare for their fellow Americans is an act of treason.
http://www.theipinionsjournal.com/index.php/2010/03/obama-delivers-healthcare-reform-to-america/

ed waltz
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ed waltz

Oboma, is a cuss word in my house. My thoughts on him is IMPEACH the socialist. Also his flunky Nancy Poluski

Rick
Guest

Some thoughts from a health insurance industry professional not too happy about this reform…
http://customhealthplans.com/blog/2010/03/obamacare-change-we-simply-cant-believe/

Robert
Guest

The process of passing health care reform was almost as maddening as the health care system itself.