Sen. Harkin talks health care at Gazette editorial board session

Sen. Tom Harkin on Thursday called on President Barack Obama to tell Congress in a speech slated for next week that he wants a bill on health care reform by Thanksgiving and that it should include a public option for citizens, insurance industry reforms and support for prevention and wellness.

In comments during a one-hour session with The Gazette editorial board, Harkin said Obama has taken the correct course in not inserting himself in a “heavy-handed” way in the health-reform debate, choosing instead to let Congress work to craft legislation.

“But I think the time has come now for the president to step forward and forcibly - not dictatorially - but with strength and purpose and determination and resolve to let Congress know he wants a bill and he wants one by Thanksgiving,” the Iowa Democrat said.

Harkin also said he wanted Obama to use his speech next Wednesday to Congress to dispel distortions and “outright lies” that have become part of the health reform dialogue in recent weeks.

Harkin said one such distortion is that people will be forced to use a public option for health care if one is provided.

Harkin said a bill now proposed in the U.S. Senate calls for the creation of health insurance “exchanges” in every state that will work exactly like the exchange now in place for federal employees including senators. An assortment of private health insurers would be listed on the exchanges along with a public option, and a person in need of insurance would choose.

As now proposed, the private insurers would have to agree to eight reforms, including not excluding people for pre-existing conditions and not imposing lifetime or annual caps on coverage. Children will be eligible for family coverage through age 26, and people could get certain preventive care without co-pays or deductibles.

The public option would provide “bare-bones, fallback” coverage, the senator said. Employees could not desert their employer's private plan unless it premiums cost the employee more than 12 percent of his or her income, he said. He said the exchanges would be particularly attractive to small business and the self-employed.

Asked about the idea of health-care cooperatives instead of the public option, Harkin said he hasn't seen such a concept work.

Harkin put the cost to the federal government of health care reform between $600 billion and $1 trillion over 10 years. The hope, he said, is that the reform will reduce the $33 trillion that people and employers are expected to pay for health care in that 10-year period and so free up money to be used elsewhere in the economy.

Congressional Republicans, including Sen. Chuck Grassley, have talked much about a need for bipartisan support for any kind of health-reform bill that passes.

Harkin said he didn't know how to define bipartisan. He noted that the Senate Committee on Health, Education, Labor and Pensions on which he sits adopted 161 Republican amendments to its piece of the health-care legislation, only to see every Republican committee member vote against the final bill, which he defined as bipartisan.

As for his Iowa colleague in the Senate, Harkin said the last thing he had heard was that Grassley wouldn't support any health-reform bill unless a majority of Republicans supported it. That will never happen, Harkin said, unless Republicans write the bill and leave Democrats out.

“But I don't think that's what the elections last year were about,” Harkin said.

Harkin said the Democrats in the Senate may have to use a legislative vehicle called reconciliation, which he said could allow passage of a bill with 51 votes and not the 60 required to prevent ongoing debate. He pointed to 2001 when former President George Bush used reconciliation to push through a “big tax bill.”