Advocacy by Amendment

By Anthony Wright
Executive Director of Health Access California

How can Californians engage in the health reform debate?

I often get the question: Do we support the House/Tri-Committee bill? The HELP/Kennedy bill? The Finance/Baucus bill? But these aren't the right question, or at least, not the most useful ones.

First of all, they are all in draft form, and undergoing changes in real-time. And they are going to change significantly in the weeks ahead. The House bill will go through three committees, and be subjected to various proposed amendments. Senate bills will be considered by two committees, and ultimately merged into one product before heading to the floor.

These are the vehicles for health reform, but they will change over the weeks, especially as they go through the committee process, and face amendments and negotiation. This would be true if we started with a single-payer system, or a Wyden-like individual market approach--no legislation is unchangeable. So our main action is not to "support H.R. X" or oppose "S. Y" or anything like that.

The advocacy needed is to support the concept and urgency of health reform, this year, and to support or oppose specific principles and provisions that are important for patient. Whether it is the public health insurance option, for having all employers contribute their fair share, or the need for subsidies up the income spectrum past 400% of the federal poverty level, those are the debates that will make the difference in what the House and the Senate pass, and become the fodder for a House-Senate compromise.

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