WASHINGTON — It’s like a marathon with hurdles at the halfway point to an uphill race in which any finisher will emerge weakened.

In a late-night historic session, the House of Representatives on Saturday voted, 220-215, to pass the Affordable Health Care for America Act, and now, to use the metaphor of President Obama, the baton has been passed to the U.S. Senate—where more revisions to the so-called Democrats’ healthcare legislation are expected if the measure is to reach the president’s desk this year.

The House legislation, H.R. 3962, derisively called the “Nancy Pelosi healthcare bill” by Republicans after the woman whom Democrats are hailing as the greatest Speaker of the House in history for her efforts in shepherding the bill through the lower house and putting the United States on the threshold of joining other industrialized nations with some form of national healthcare insurance.

The House voted on the bill after revision to appease so-called blue-dog Democrats and garner conservative Republican support by eliminating any government-paid abortion provision. Still, only a single Republican, a Louisiana representative, voted for the bill, which was also opposed by three dozen Democrats (the final tally: 219 and 1 Republican for, 176 Republicans and 39 Democrats against).

Now in the Senate, healthcare reform legislation—which has been proposed in one form or another for decades by administrations of both parties—is expected to be altered to preclude a mandatory public option provision. Ironically, Sen. Olympia Snowe, the moderate Maine Republican, may hold the key. She has proposed a so-called trigger revision that would provide for a kind of universal coverage option only if the private insurance industry doesn’t make meaningful reform available. There is also the ubiquitous state’s rights vs. national wrangling over various provisions of the legislation, if not the entire measure itself.

While the House vote is historic in the sense that healthcare reform legislation has advanced this far on Capitol Hill, partisanship is ever present, Democrats touting the House bill, Republican toting it.

Indeed, Rep. Frank LoBiondo has joined the party faithful by publicly encouraging the public to “read” the House bill—all 1,990 pages; the 2nd District Republican personally taking the 10-sheets-shy-of-four-500-page-ream bill to county libraries in his district. All Republicans in the New Jersey congressional delegation voted against the bill and were joined by one Democrat.

LoBiondo issued a statement in advance of his vote. Here it is in its entirety:

In July I announced my serious concerns about the direction the House committee-passed healthcare legislation was heading. The more than 2,000 page version introduced by Speaker Pelosi last week that will be considered by the full House in the coming days has not resolved my concerns and is still bad medicine for South Jersey residents. Therefore, I will be voting NO.

I have reviewed Speaker Pelosi’s healthcare bill, specifically looking at provisions I objected to in previous drafts for signs of improvement: access to care for South Jersey families and the future of the critical doctor-patient relationship. Regrettably, I found insufficient changes to warrant my support. This final legislation continues to mandate all Americans to pay for coverage or pay a fine, ignores the legitimate concerns of our healthcare providers, and proposes tax increases on small businesses. In fact, given the bleak economic outlook, this legislation could even encourage small business owners to eliminate coverage for employees as a cost-saving measure.



“Despite Congressional and public uproar in the past few months, this legislation would still create more than 100 new bureaucracies and programs. It would also allow the President to appoint an unelected, unaccountable ‘health czar,’ who would have the authority to specify which basic benefits every plan would be required to provide. Services once offered under one’s private plan could be denied under the newly-created government plan. Furthermore, as currently written, the bill would allow the use of taxpayer dollars to pay for abortions, which I have long opposed.

Closer to home, this legislation is especially bad news for New Jersey. In Speaker Pelosi’s attempt to pay for her vision of healthcare, she has proposed cuts to the Medicare program starting in 2010, which would affect the ability of our hospitals, long-term care and skilled-nursing facilities, inpatient rehab hospitals, home health agencies and hospices from maintaining the programs, services and state-of-the-art medical equipment currently available. In fact, New Jersey hospitals would face nearly $4 billion in cuts over the next decade. It is my real concern that South Jersey seniors and disabled residents will be disproportionately affected by the Medicare cuts given their significant use of these services.

Moreover, the creation of a new surtax on the adjusted gross income of some New Jersey residents that is not indexed for inflation will engulf more and more middle-class taxpayers with each passing year. Similar to the Alternative Minimum Tax (AMT) and its negative effect on countless New Jersey residents each year, this surtax will simply cost more in the long-run to correct and will add to annual deficits.

Lastly, the price-tag for Speaker Pelosi’s healthcare bill is far too high given the economic realities of our country. The non-partisan Congressional Budget Office (CBO) has determined the total cost to be up to $1.055 trillion, with $200 billion in additional taxes created on the American people and American businesses over the next 10 years. The Joint Tax Committee has estimated the taxes to reach $560 billion over the next decade largely due to the surtax. Just as we cannot spend our way back to economic growth, we cannot tax our way to more affordable, more accessible healthcare.

On balance, there are several good provisions included that I have long supported; from making preventative care more accessible and removing restrictions on coverage for those with preexisting conditions, to increasing the number of primary care professionals. These provisions are widely agreed upon and could easily receive broad bipartisan support. But Speaker Pelosi intentionally ignored additional legitimate, critical reforms offered by both sides of the political aisle such as common-sense medical malpractice reforms.

Throughout the healthcare debate, I have spoken with countless South Jersey residents who have reached out to my office. As I have said, it is critically important we get healthcare reform done, but it must be done right rather than done quickly. I strongly believe the final bill should keep its focus on what the American people have repeatedly called for: ensuring access for patients, protecting the doctor-patient relationship, and promoting the results-oriented goal of healthy outcomes. Speaker Pelosi’s healthcare bill moved far beyond what my constituents and I are comfortable with and therefore I will not support it.”

As he is wont to do in speaking about healthcare reform, LoBiondo notes that he has always paid for his own healthcare insurance, and has never accepted the taxpayer-funded plan offered to members of Congress.

Countering his view is that expressed by such organizations as the American Medical Association, American Cancer Society and the American Association of Retired Persons. It is noteworthy, however, that many individual members of these organization do not agree with their national associations’ stand.

Here is the AARP view, as exressed in this statement issued by the New Jersey chapter:

Today [Nov. 5] AARP announced its endorsement of the Affordable Health Care for America Act (H.R. 3962) and the accompanying Medicare Physician Payment Reform Act (H.R. 3961). The Association’s support follows nearly two years of work with lawmakers on both sides of the aisle to craft a health care reform plan that meets the needs of AARP’s nearly 40 million members and all older Americans. Among those needs are reforms that strictly curb insurance companies’ discrimination against older Americans and Medicare improvements that strengthen benefits while protecting the program for future generations.

“We started this debate more than two years ago with the twin goals of making coverage affordable to our younger members and protecting Medicare for seniors,” said Marilyn Askin, AARP New Jersey state president. “AARP has read the Affordable Health Care for America Act and we can say with confidence that it meets those goals with improved benefits for people in Medicare and needed health insurance market reforms to help ensure every American can purchase affordable health coverage.”

Today’s endorsement marks the first time in this legislative battle that AARP has put its full weight behind a comprehensive health care reform package. In the coming days, AARP will be educating its members about the health care reform package through its publications, paid advertising and more than five million calls and e-mails to its grassroots activists.

“As members of the House gear up for this historic vote, they will hear from older Americans across the country,” Askin said.

The Affordable Health Care for America Act and the Medicare Physician Payment Reform Act contain critical components AARP has been fighting for on behalf of its members and all older Americans to improve health care for them and their families. They include:

• Protecting and strengthening Medicare for today’s seniors and future generations of retirees;

• Ensuring seniors can see the doctor of their choice or find a doctor if they need one by improving Medicare’s payments to doctors;

• Lowering drug costs for seniors by closing the Medicare Part D “doughnut hole” and allowing Medicare to negotiate with drug makers for lower drug prices;

• Taking steps to reduce waste, fraud, abuse and inefficiency in the Medicare program;

• Requiring Medicare and insurance companies to provide for important preventive services like screenings for diabetes, cancer and osteoporosis free of charge;

• Stopping insurance companies from denying you affordable coverage because of your age;

• Preventing insurance companies from denying you coverage if you have a pre-existing condition or dropping your coverage if you get sick;

• Limiting how much your insurance company can make you pay out-of-pocket;

• Providing affordable health insurance options for those who don’t have insurance; and

• Providing benefits to help seniors and people with disabilities live in their own homes and communities by establishing the Community Living Assistance Services and Supports (CLASS) program.

Askin added: “We cannot continue to let insurers price older Americans out of the market, just as we cannot stand idle while millions of seniors are forced to choose between their groceries and their prescriptions. AARP is proud to endorse the Affordable Health Care for America Act and the Medicare Physician Payment Reform Act, and we urge members of the House to pass this critical package in the coming days to help fix our broken health care system.”