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News of the Nation, 2009

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Health Insurance Debate

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Health-Care Reform Takes Center Stage in Congress

President Obama Requests a Public Option
The nation's health-care system has been debated in Congress on and off for more than 70 years, with most agreeing that some kind of reform is necessary, and it seemed that 2009 would be the year of a long-awaited overhaul. Barack Obama has made restructuring the health-care system a top priority of his administration, emphasizing that reform would benefit both the U.S. economy and the vast majority of Americans. With Democrats in charge of both houses of Congress and the White House, Obama seemed well positioned to fulfill this campaign promise.

President Obama said early in 2009 that he believed a public option was the best route for health-care reform, claiming that the only way to reduce health-care costs across the nation and provide insurance for the millions of uninsured is to build a government insurance provider that would compete with the private, for-profit insurance giants. However, Obama was only a minor presence throughout much of the debate; he allowed Congress to make many of the major decisions in crafting the legislation. While both the House and the Senate drafted bill after bill, Democrats and Republicans fought tooth and nail about what provisions to include.

Senator's Untimely Death Coincides with Health-Care Debate
Massachusetts senator Edward "Ted" Kennedy, who had been fighting brain cancer for over a year, died in July. Praised for many accomplishments throughout his career, including spearheading legislation concerning civil rights, education, and labor, he is perhaps most often associated with his support of health-care reform; he was serving as the chairman for the Senate Health, Education, Labor and Pensions Committee at his death. Upon Kennedy's passing, Congress and the nation mourned not only the loss of the man and the senator, but also a leader in the health-care debate that was just starting to take shape.

A lifelong liberal Democrat, Kennedy was known for his willingness to work across the aisle with Republicans and moderates alike. Such bipartisanship was sorely lacking in the health-care discussion in 2009.

A Party Divide, and a Party Divided
Though many Republicans agreed that the current health-care system is not adequately serving the American people, their ideas on reform were not in line with the desires of most Democrats. There are approximately 47 million Americans without health insurance today. While most members of Congress agreed that insurers must drop certain practices, such as refusing coverage to those with preexisting conditions, many-especially those in the Republican Party-felt a government-sponsored health-care system was a symptom of over-regulation and maintained that the current system-with a few small-tweaks was the better option. They also cited the expense of a public plan as a major obstacle and refused to rely on new taxes to pay for the system. Senator Olympia Snowe of Maine was one of the few Republican supporters of bills put forth by Senate Democrats.

Democrats, for their part, were divided about the legislation. The liberal wing of the party, which had initially supported a single-payer health-care plan, demanded that a public option be included in any bill. Speaker of the House Nancy Pelosi announced early on in the debate that she would not support any bill without the public option. However, conservative "Blue Dog" Democrats disagreed about the public option, creating a divide in the party.

The Disintegration of Reform
By the end of the year, a new bill was introduced by Senate Majority Leader Harry Reid. The public option was no longer included; instead, an expansion of Medicare was proposed (allowing Americans age 55–64 to buy into the program for a hefty sum), along with a requirement that private insurers create a variety of non-profit plans to help ensure coverage in every state. (Should the requirement not be met, the government would set up the new nonprofit plans.) Under this bill, all Americans would be required to buy health insurance, with a few exceptions.

While some Democrats and Republicans hailed the bill as a sign of compromise, others saw it as the disintegration of reform, a weak public option that would not benefit the millions of uninsured Americans already struggling to make ends meet during one of the worst recessions in U.S. history. Independent Senator Joe Leiberman, who caucuses with the Democrats, refused to sign any bill with the Medicare buy-in measure.

President Obama, who had planned to finish the health-care debate before Christmas, appealed to Congress to work out their differences and told the American people that a bill without the public option, but including the lifting of current insurance restrictions, would still be an effective beginning to the overhaul of the health-care industry. By the end of the year, many were left wondering if the reform so often discussed in the early part of the year would ever materialize.

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