The health care reform discussion is beginning—at last!—to get real. On June 9, the Senate Health, Education, Labor, and Pensions Committee released a draft bill, and the Congressional Budget Office published an estimate that the bill would cost $1 trillion over 10 years and leave 35 million uninsured.
To be more precise, the HELP Committee released fragments of a bill; it did not include extensions of Medicaid or mandates on employers that everyone anticipates it will add, nor did it specify how the added costs would be paid for. And CBO’s estimates referred only to fragments of the incomplete draft bill that was actually released.
But even that low degree of specificity was enough to send tremors through the health policy community. Then came a large after-shock–Chairman Max Baucus of the Senate Finance Committee announced a delay in issuing the committee’s bill because initial cost estimates were even higher–$1.6 trillion over 10 years.
After months of trading in generalities—high-flown goals and policy changes so vague that no one could possibly understand who would be required to do what differently from what they do now—the legislative language hit the table and the cost estimates hit the fan.