Healthcare reform must be within all our reach

 The Senate and the House recognize the critical need to protect middle-class families from the skyrocketing costs of healthcare. Both provided a safety net for the most vulnerable and offered protections from unreasonable out-of-pocket costs, along with tax credits that make coverage more affordable.
This is a good start that will provide more security for millions of families, while strengthening our economy. But we are called to do more. Far too many Americans will still find healthcare out of reach if we do not seize this opportunity to strengthen the health reform legislation by combining the best elements of both bills so that no one has to choose between their health and their home, their well-being and their financial security.

{mosads} Too often the needs of everyday Americans get lost in Washington. Congress must remain focused on the families who work hard driving our children to school, keeping us healthy, fixing our buildings and roads. We cannot forget the needs of hardworking people — people who pay their taxes, keep up with their bills, make $10 an hour without benefits and cannot afford to pay an insurance company hundreds of dollars a month. All parents should be able to take their children to a doctor when the children are sick. No American should die because he or she can’t afford healthcare.

 These working families need our attention now. As the debate has rolled on, we have been appropriately attentive to the government’s role in healthcare. Should there be a public plan to restrain costs? How will reform impact the deficit? How will we bend the cost curve? All important questions, but now we must address the key challenge before us: How do we make sure no working family goes broke because they get sick? That’s the heart of why the American people want and need healthcare reform and why the administration and Congress must deliver on this promise.

 The facts: More than 44,000 die every year because they are unable to afford health insurance. Seven of 10 Americans without health insurance live in a family earning less than $50,000. The uninsured and the underinsured are overwhelmingly working people who earn too much to qualify for Medicaid, are too young for Medicare, and work at jobs that don’t offer healthcare, or offer coverage that is completely unaffordable and inadequate to provide them with the care they need.

 So, here we are, on the precipice of passing health insurance reform. But the question remains, What will reform look like for working people? How will we make sure that people who get up, go to work each day and help make this nation great are included in the promise before us? To keep costs down and make this system work, we will ask almost every American to take responsibility for purchasing health insurance. Yet, as we ask people to accept this responsibility, we need to make sure coverage is in fact affordable, that premiums make sense based on people’s income and benefits provide real protections.

 While not perfect, the House approach is grounded in the financial reality of low-wage workers, setting more reasonable limits on out-of-pocket costs for these families. Everyone is expected to contribute, but contributions are at levels that are truly sustainable for families, protecting them from out-of-pocket costs that too often lead to bankruptcy.

 In contrast, the Senate legislation has somewhat more generous subsidies for higher-income families but sets costs at levels that could be out of reach for many lower-income families. For families that get too sick and earn just above the poverty line, coverage and out-of-pocket costs could eat up nearly 20 percent of their income, leaving these families dangerously underinsured. We must do better.

As the administration and Congress negotiate what health reform looks like, they have an incredible opportunity to live up to the promise of affordable care by following the lead of the House when it comes to low-wage workers. By capping premiums and out-of-pocket costs at levels that families can reasonably afford, and extending Medicaid coverage to more families, Congress can deliver on a promise that works for all Americans.

 The key to success is to get affordability right. The great political and policy risk is that reform’s largest natural constituency — those who most need reform — find that they are being required to buy coverage that costs too much and covers too little. The best way to pass and sustain comprehensive healthcare reform is to make sure that it provides a good deal for all working families. And makes sure, like the president said, no one goes broke because they get sick.

Stern is president of the Service Employees International Union. Cummings is co-chairman of the PICO National Network and founding pastor of the Imani Community Church.