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How the Congressional Health Care Plan Was Developed


In the bowels of Congress, Democratic Senator Jay Rockefeller encountered Republican Senator James Imhoffe on the way to the cafeteria.


Senator Imhoffe thought this would be a golden opportunity to reshape the national debate about health care reform: "My distinguished colleague and good friend, Senator Rockefeller, the American people do not want to add to our nation's deficit during these times of recession, and they do not want the government taking over any part of our health care system."


Senator Rockefeller responded: "My longtime friend, Senator Imhoffe, have you forgotten Medicare? And as I know you are aware, there are over 50 million Americans uninsured, and we have to pass a plan that will help a small number of them."


The mishmash plan Senator Rockefeller was proposing would force millions of Americans to buy private, for-profit health insurance they couldn't afford. It would slightly expand government insurance, either by creating an expensive and inefficient "public option" or by allowing people over 55 to buy into Medicare for an exorbitant monthly fee. It would also allow the insurance companies to set an annual coverage ceiling for those with serious health conditions. Under either Senator's plan, health care "reform" was mainly going to be a big gift to the private insurance industry since a national, non-profit, single-payer "Medicare for All" plan had been taken off the table by Congressional Democrats a long time ago.


"Rockefeller, my buddy" Senator Imhoffe retorted, "we in the Republican aisle are going to torpedo your fucked up plan and make sure the American people know that the Democratic senators are mostly a bunch of pussies."


"Imhoffe, my out-of-touch pal, get off your pro-global warming space ship and join us here on Earth."


The highly distinguished Senator Imhoffe answered by taking a pen from his suit jacket pocket and stabbing Senator Rockefeller in the knee with all his might, drawing a thick spurt of blood and breaking Senator Rockefeller's left knee cap.


Senator Rockefeller grabbed the briefcase he had temporarily placed on the floor and smashed Senator Imhoffe in his right ear, causing Imhoffe to go deaf in that ear for an unknown period of time.


Weeks later, a health care plan passed Congress and was signed by President Obama. It included some helpful elements, including expanding Medicaid eligibility, allowing young people to stay on parents’ insurance plans until age 26, and prohibiting insurance companies from denying coverage based on pre-existing conditions—although the penalty for insurance companies violating that prohibition was a relatively small fine of $100 per day. The final plan also included a mandate that all Americans buy private health insurance that many folks without employer-provided coverage would not be able to afford, given people’s already exorbitant rents, mortgages, student loans, car repairs, child care, or credit card debts. It placed very few meaningful regulations on the private insurers, included no limits on how much they could charge for premiums or copays, but it did require them to cover injuries caused by a pen stuck in the kneecap or a briefcase-thrown ear injury.