Moments ago, President Obama signed into law the most sweeping health care reform legislation in the nation’s history. As Obama and Vice President Biden approached the podium, the group of Democratic lawmakers and health care advocates gathered in the East Room of the White House, began chanting, “fired up, ready to go,” echoing the president’s campaign slogan. The audience, clearing relishing in the greatness of their accomplishment, interrupted with frequent applause and standing ovations, giving the ceremony a distinctive campaign-like atmosphere. Not a single Republican voted for the health care reform legislation and none attended today’s event.
During his speech, the president noted the reform efforts of all those leaders who had come before him and recognized the challenges lawmakers faced in passing the health care bill. “I’m signing this bill for all the leaders who took up this cause through the generations, from Teddy Roosevelt to Franklin Roosevelt, from Harry Truman to Lyndon Johnson, from Bill and Hillary Clinton to one of the deans who’s been fighting this so long, John Dingell to Senator Ted Kennedy, ” Obama said, fully embracing the historic nature of the occasion:
OBAMA: Our presence here today is remarkable and improbable. With all the punditry, all of the lobbying, all the game playing that passes for governing in Washington, it’s been easy at times to doubt our ability to do such a big thing, such a complicated thing, to wonder if there are limits to what we as a people can still achieve. It’s easy to succumb to the sense of cynicism about what’s possible in this country. But today we are affirming that essential truth, a truth every generation is called to rediscover for itself: that we are not a nation that scales back its aspirations, we are not a nation that falls prey to doubt or mistrust.
Watch the highlights:
“In a few moments, when I sign this bill, all of the overheated rhetoric over reform will finally confront the reality of reform,” Obama said, suggesting that now that the bill is law, the way we talk about it will change. No longer will we be arguing over conflicting interpretations of the same provision or debunking claims of death panels and taxes on small businesses. No, despite the best efforts of Republicans to transfer the pre-reform debate into the post-reform world, the conversations about health care reform will now focus on how reform affects every day people. Rather than arguing about the burden reform will place on small businesses, we’ll discuss the adequacy of the tax credits they receive. The sensationalistic claims about government takeover of health care will cede to an evaluation of the effectiveness of the exchanges in holding insurers accountable. The bill, in other words will, for the first time in this debate, be judged squarely on its merits. And Democrats shall rise and fall by its failure or success. Here is what Americans can expect and when:
|Insurance Reform||Effective Date|
|No lifetime limits on coverage||6 months after enactment|
|Restricted annual limits, defined by HHS Secretary||6 months after enactment|
|No rescissions||6 months after enactment|
|Coverage of preventive services||6 months after enactment|
|Extension of dependent coverage||6 months after enactment|
|Stay on parents policy until 27th birthday||6 months after enactment|
|No discrimination based on salary||6 months after enactment|
|No pre-existing condition exclusions||6 months after enactment for children
2014 for adults
|Medical loss ratios – 80% individual and small group market, 85% large group market, with rebates||2011|
|Summary of coverage provided to applicants and enrollees||24 months after enactment|
|No annual limits||2014|
|No rating based on health or gender, 3:1 age rating||2014|
|No discrimination based on health status||2014|
|Coverage of essential health benefits||2014|
|Limits on cost-sharing||2014|
The health care reform debate is by no means over, however. While the repeal rhetoric will likely abate, Republicans will seize on every system failure and imperfection, on every flaw and every kink to argue that reform has failed to live up to its expectations. Progressives will have to remain vigilant both in the way they implement reform and in the way that they defend it.