Health Care Makes History, But The Story Isn't Over

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President Obama and the Democrats in Congress managed to accomplish what at least eight previous administrations could not. Lawmakers passed two sweeping health care bills that together promise to expand health insurance to 32 million more Americans, change how health care is organized and delivered, and, possibly, begin to curb rising health care costs over the decades to come. Host Scott Simon is joined by NPR health policy correspondent Julie Rovner to discuss this week's passage of health care overhaul legislation.

SCOTT SIMON, host:

President Obama and Democrats in Congress this week managed to accomplish what at least eight previous administrations did not. Lawmakers passed two sweeping health care bills that together promise to expand health insurance to 32 million more Americans, change how health care is organized and delivered, and possibly begin to curb rising health care costs over the decades to come.

NPR's Julie Rovner has been covering the story for, what, 14, 18 months, Julie?

JULIE ROVNER: Yes, I think so.

SIMON: Thanks for joining us this morning.

ROVNER: Good morning.

SIMON: And after this long drawn-out tooth-and-nail struggle - I love beginning with this question - so, what happens next, Julie Rovner?

ROVNER: Well, the lawmaking part is over, almost over. The president is going to sign the second bill, we hear, on Tuesday. Now comes the big selling job. The president's going back out on the road next week. He'll be in North Carolina and he'll be in Maine and in Boston. Now comes a time where everybody gets to explain what's actually in this bill and hopefully turn some of these negative polls into positive polls - at least that's what the Democrats are hoping.

SIMON: Which presents this question: if the bill is now law, if it's been signed, sealed and delivered, why the need for the administration to keep selling it?

ROVNER: Well, because when you go out and look at a lot of the polls, even some of the polls since the bill has passed and become law, they're still a little bit on the negative side. And, again, the public has been pretty closely split all along, but they're still a little bit more negative than positive.

Interestingly, a lot of the polls, when they ask people about what are some of the elements of this new law, those have been positive. So, I think there is a need for particularly the president to get out on the road with his bully pulpit and say, look these are the things now that this new law is going to do.

Make sure that people know the benefits that are going to come to them, both immediately and down the road, and hopefully make people more comfortable with what is now going to happen. And hopefully make some of those people more comfortable who'll be going to the polls in November - not for the president but for these members of Congress.

And remember, not a single Republican voted for either one of these bills -there have been two bills - in the House or in the Senate since this last round of voting that we've had.

SIMON: They will, I expect, continue to make the argument, certainly as it gets closer to the election, that just the fantastic obligations and costs of this bill will inevitably drive up taxes and will force, for example, insurance companies and health care providers to choose between maintaining the level of coverage or decreasing it to people who are already insured or, say, people under Medicare.

ROVNER: Well, certainly there's going to be lots and lots of claims on both sides about what this new law is going to do. One of the difficulties, of course, is that a lot of it doesn't take effect for several years. In the interim, it's likely health care costs will keep going up. If this new law works as intended, it will start to stem the rise of health care costs but not for a while. So, of course, you're going to be able to have people saying with some legitimacy on both sides, see, it's not working or, see, it is working.

So, I think the debate is certainly going to continue. Of course, Republicans are now going to make their case, their mantra is now repeal and replace. So, they're already saying, you know, that the ink is barely dry - one of the bills hasn't even been signed - and they're saying let's get rid of it already. So, certainly even though the legislating is done, the politicking is not.

SIMON: With the advantage of a couple of days of hindsight, Julie, were the Democrats able to secure the majority they needed when President Obama told anti-abortion Democrats he would sign an executive order that would forbid federal funds from being used for abortion?

ROVNER: You know, from everything we could tell, they probably had the votes without that block of anti-abortion Democrats, but they really wanted to have them on board, and, you know, those anti-abortion Democrats really wanted to be on board. Although it has driven a wedge, I should mention, between anti-abortion Democrats and anti-abortion Republicans, a wedge that I have not seen in 20 years in covering the abortion issue.

SIMON: NPR's Julie Rovner. Thanks so much.

ROVNER: Thank you.

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