Fixing the health insurance system has been discussed for several decades, and the fact that action is finally being taken to extend affordable health insurance is encouraging.

So, in light of the historic vote on Saturday, it is important to understand the major provisions in the legislation approved by the House.

First, the bill guarantees that if you are born with a disease (a.k.a. pre-existing condition), insurance companies will no longer be able to use your illness as an excuse to deny you coverage. For example, currently a mom who has a child born with autism has to pay $50,000 each year for her son’s medical care because private insurance companies don’t want to insure a sick person because there is no financial benefit. This legislation will enable the mom to get insurance for her son.

Second, the bill stops insurance recession. Recession is basically a fancy word insurance companies use to claim that a guy who doesn’t know he has diabetes committed “fraud” by not disclosing the illness he didn’t know about. In other words, recession is often used as a trick by an insurance company’s team of lawyers to get out of their end of the contract (paying for your care) if you get really sick. H.R. 3962 will make unnecessary recession illegal.

Third, (and most controversial) H.R. 3962 includes language that would establish a public health insurance exchange (a.k.a. public option). The public health exchange is basically an additional insurance choice for people who don’t like their current coverage, and a way to expand health insurance to those individuals who can’t afford private insurance.

Insurance companies have been trying to scare people by running ads on TV saying that “the public option is government health care.” This is simply not true. Unlike a single payer health care system (where the government is the only insurance provider), the public exchange gives people the option to select national health insurance similar to the insurance Members of Congress receive.

Some people falsely believe that a national insurance choice means that doctors will be government employees, and that the government will control that the care you receive. This is a lie spread by opponents of reform.

If you select a national insurance plan you get quality, guaranteed care.

Other notable benefits include in H.R. 3962 include:

-Young adults can stay covered under their parent’s plan until they turn 27

- Insurance company lifetime spending caps on your health care become illegal

- Unnecessary premium variances are made illegal

- Health insurance cost discrimination (i.e. against women) ends

- Provides tax credits for individuals who can not afford insurance on their own

-Eliminates the prescription coverage gap (a.k.a. donut hole) under Medicare Part D

-Scholarships/Loans to encourage more individuals to become doctors and nurses

-Gives a tax credit to small businesses so that employers can address the number one concern for small businesses/non-profits (providing health insurance for employees)

-Supports methods of disease prevention (i.e. community health centers, school-based clinics, vaccinations, STD prevention, better nutrition labeling etc)

Finally, H.R. 3962 is budget neutral, meaning that the cost of health insurance reform is fully paid for by changing other areas of the federal budget. Most notably, the legislation passed in the House would stop payments to subsidize private insurance corporations. In addition, the House legislation places a surtax on the very wealthiest of Americans with incomes exceeding $1,000,000 per family. Also, the bill makes important changes to existing patent laws so that drug companies that currently enjoy a monopoly on the distribution of certain drugs are forced to compete with other companies that can create “generic” versions of the same drugs at lower prices.

Again, H.R. 3962 is not perfect, and it is likely to be the most progressive version of the health care bill. The next step in the legislative process is for the Senate to pass its own health reform bill (which is likely to be a watered down version). Next, representatives from the House and Senate have to meet with each other and negotiate so that both chambers can vote again for an identical version of the legislation. If the same version of the health reform bill is approved in both the House and the Senate, then President Obama needs to sign the bill into law.

P.S. The American Medical Association (doctors) and the American Association of Retired Persons (largest advocacy group on behalf of senior citizens) have endorsed the legislation passed by the House of Representatives.

On Tuesday there were 4 major elections. Democrats won 2 (CA-10 and NY-23) and Republicans won 2 (NJ and VA Gov). I don’t like equating political outcomes to sports scores, but since sports references seem to be in style, let’s call what happened on Tuesday night a tie, and neither Democrats or Republicans should be too excited about the outcomes.

I must admit, Republican Bob McDonnell’s victory over Creigh Deeds for VA Gov. was a good win for the Republicans. Although Deeds was a weak campaigner, and it is likely that a better Democratic candidate would have been more of a challenge to McDonnell, I don’t think the end result on Tuesday would have changed if there was a different Democratic candidate. Demographic changes in VA during the past 15 years have made the state moderate, not liberal. Past voting patterns in VA suggest that citizens in the state like political balance, and with 2 Democratic Senators, and 6 (out of 11) Democratic Congressmen, the fact that voters picked a Republican Governor should not be interpreted as anything other than what it is – voters in a moderate state selecting balanced representation.

The Republican also (closely) won the Gov. election in NJ, but there were special circumstances in that case. New Jersey is a state that usually votes for Democrats, so many people thought that Democratic incumbent Jon Corzine would get the win, but no one was really shocked when he lost. Corzine’s loss did not come as a surprise because most voters (rightly or wrongly) associated Corzine with corruption and the bad economic situation in the state. Also, New Jersey has been hit hard by the Wall Street collapse, and Corzine – a former Goldman Sachs executive- was in an odd position of trying to argue that his Wall Street experience was a good reason why he should be reelected. So basically, the citizens of NJ didn’t vote for the guy who a lot of people perceived to be corrupt and inept.

The Democratic wins in the special elections for Congress are not too special, but it is important to note a couple of points. First, while CA-10 is a Democratic favored district, the Democratic advantage is not so great that it would have been impossible for a Republican to win the seat.  If the conservative narrative that “the country is overwhelmingly rejecting the policies of Democrats and Obama” were true, the Republican candidate should have finished closer than 10 points behind the Democratic candidate.

Secondly, I think that everyone can agree that Democratic candidate won the NY-23 seat because of Republican in-fighting. The point that I think is interesting with the NY-23 race is that the cause of the Democratic win, (conservatives pushing out the moderate candidate) is likely to continue. Sarah Palin, Dick Armey, and the “tea baggers” have vowed to keep challenging candidates who do not share their extreme views. I don’t think the electoral consequences of the tea baggers will be as significant as in NY-23 because there were a lot of special circumstances involved, (no primary, Republican endorsing the Democrat, excessive media attention etc…) but since the extreme conservatives have promised to challenge more moderates in the future, there will certainly be messaging and leadership problems for the GOP.

Finally, it is important to put all of the elections into context. Now that you have seen my analysis, I can say that I don’t think anyone should read too deeply into what happened on Tuesday.

In short, because the results were mixed and the turnout was low, anyone who tries to make too many connections/assumptions linking the elections of 09′ with the elections of 10′ does so at their own peril.