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When President Barack Obama signed the historic health insurance reform bill, he said it was, “Change we can believe in.” He noted that his party has sought reform for more than half a century. The effort began long before President Harry Truman recommended to Congress on Nov. 19, 1945 a comprehensive health program, noting: “People with low or moderate incomes do not get the same medical attention as those with high incomes. The poor have more sickness, but they get less medical care.”

The legislation Obama signed will tax the wealthy – those earning more than a quarter million dollars a year – to help pay for extending insurance to millions of poor and working people and for guaranteeing insurance companies can’t deny access to those with pre-existing conditions or withdraw coverage from those who get sick.

Republicans have vowed to overturn or repeal this law that would aid tens of millions of Americans. House Republican leader John Boehner yelled, “hell no” repeatedly to the reform proposals and described them as “Armageddon.”

Every historic moment in this country – from the Revolution and the Civil War to the enactment of Social Security and Civil Rights legislation – compelled Americans to assess their values and choose sides. In the case of Civil Rights legislation, for example, some, including the late Republican senator from South Carolina, Strom Thurmond, stood with the Klu Klux Klan and other hate-mongers seeking to deny civil rights to black people. By contrast, others favored peaceful enactment and enforcement of what they perceived to be fair civil rights laws enabling black adults to vote and black children to receive the same quality education as white youngsters.

This is such a moment. Americans must decide what is just and decent in the richest Democracy in the world. They must choose whether to side with the rich and the hate mongers or to align themselves with working people and hope.

“The bill I’m signing will set in motion reforms that generations of Americans have fought for and marched for and hungered to see,” Obama said during the ceremony in the East Room of the White House. That makes it a landmark bill, but it’s also historic because this measure is the first government attempt in thirty years to halt rising income inequality, the New York Times reported a day after the signing.

The wealthy – those earning more than $250,000 a year – will pay for part of the reforms with tax increases. For example, those in the $1 million salary, perks and bonuses club will pay an additional $46,000 a year in 2013, according to the Tax Policy Center, a Washington research group. This million dollar club is the very group that has benefited most over the past eight years from the Bush tax cuts for the rich.  

The richest one percent in this club now take in 23.5 percent of all income in this country – the largest percent since 1928, the year before the Great Stock Market Crash and the onset of the Great Depression. Then it was 23.9 percent.  Income inequality has risen since the 1970s, when the fortunes of the nation’s rich began skyrocketing while middle class wages stagnated. Simultaneously, the rich got tax rate breaks much larger than those given the middle class and poor.

Beyond taxing the rich, the bill contributes to reducing income inequality in another way. New York Times reporter David Leonhardt described it:

“In the broadest sense, insurance is meant to spread the costs of an individual’s misfortune — illness, death, fire, flood — across society. Since the late 1970s, though, the share of Americans with health insurance has shrunk. As a result, the gap between the economic well-being of the sick and the healthy has been growing, at virtually every level of the income distribution.”

During his presidential campaign, Obama promised to reform health insurance, and signing this bill fulfilled that pledge. Here’s how: It ensures that children with pre-existing conditions get insurance, that adults with pre-existing conditions have access to insurance from a temporary high-risk pool, that senior citizens get help paying for prescriptions during the “donut hole” in their Medicare drug coverage, that every insured person gets free preventive care, that children up to age 26 can stay on their parents’ insurance plans, that no lifetime limit on benefits may be imposed by insurance companies.

It provides for approximately 24 million people who don’t have access to affordable coverage through their employers to get tax credits to buy insurance from new state-based exchanges. It enables everyone who earns less that 133 percent of the poverty level – approximately 16 million people – to get Medicaid. It gives small businesses tax credits of up to 35 percent of premiums to help make coverage affordable for their workers.

And, a benefit for everyone — even the rich — is that the bill will lower the national deficit by $100 billion in the next decade, a determination made by the non-partisan Congressional Budget Office.

Republicans are intent on preventing Americans from receiving these benefits. Republicans in Congress contend they’ll try to repeal the law. A dozen Republican state attorneys general filed suit seeking to overturn it.

Those opposing health insurance reform don’t mention the benefits. Instead, they call names, engage in vandalism and incite violence. Sarah Palin posted a map on her sarahpac website marked with 20 gun sight crosshairs on the congressional districts of Democrats who voted for health insurance reform. The Republican National Committee posted on its website a photo of House Speaker Nancy Pelosi surrounded by flames and urging her firing.

The FBI is investigating death threats made since the vote against Democrats and their families. A brick was thrown through the office window of a New York congresswoman who supported reform and bricks shattered glass doors at a New York Democratic committee office. An Arizona Democrat’s office was vandalized after the vote. Opponents of the bill spit on one Democratic congressman and shouted racial and homophobic slurs at others before the vote and afterward faxed to a black Congressman the image of a noose. Conservative commentators including Glenn Beck compared the reform measure to the devastation on 9/11.

Former Republican presidential candidate John McCain said that because the measure passed, “there will be no cooperation for the rest of the year” from the GOP. Republicans made good on that threat, using an obscure Senate rule to prevent hearings past 2 p.m., forcing cancellations.

Republicans in the Senate have announced they will do everything in their power to prevent passage of a package of amendments adopted by the House to improve the Health Insurance Bill. These amendments include elimination of perks given several states, including the so-called Corkhusker Kickback and the Gator-Aid, both of which Republicans have attacked for weeks. Still, Republicans say they’ll attempt to retain those deals in the final bill by blocking the amendments. Similarly, the package of amendments provides a method to close the donut hole in the Medicare prescription program, providing financial relief to millions of senior citizens. The Republican’s plan to prevent passage of the amendments would force senior citizens to pay nearly $4,000 extra each year for prescriptions.

With their anger and vitriol, Republicans and Tea Partiers are banking on Americans rejecting health insurance reform. But their plan is in peril. Americans appear to be embracing hope and change in health care.

Before the vote, polls showed a majority opposed the bill. Many argued that could be explained by the fact that a significant number of those counted as opponents simply wanted stronger reform, such as a public option. Poll results are different now. A Gallup Poll taken after the House vote found 50 percent enthusiastic or pleased, while only 42 percent were angry or disappointed. Similarly, in that poll, 49% thought the reform measure to be good for the country while 40% thought it was bad.

Hate and obstructionism are ugly. Americans prefer to see themselves and their country as hopeful, constructive and goodhearted.

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