I voted in favor of the Senate health insurance reform bill because I believe the status quo is unacceptable.
People die because they can't afford regular health care. Insurance premiums, already outrageously expensive, are headed through the roof in Alaska and the rest of the country. Medicare, which provides essential care to our seniors, is going broke.
My vote was not an easy one. Friends told me the simple thing was to look at the political map and just vote no. But they know me well, and know I didn't come to Washington to do business as usual. I had the responsibility to dig into the details and improve the bill.
I talked with Alaskans across our state at seven town halls, three roundtables and in countless meetings and conversations. I read the mail and listened to you on the phone. I countered the distorted TV ads targeting myself and other senators.
Some reform opponents have framed this as a muscle-flexing fight over party politics. I disagree. My vote came down to this: the vast majority of reforms in the Senate bill are good policies that, if given a chance, will improve the lives of Alaskans.
This leads me back to the status quo. During this decade, health insurance costs for Alaska families increased five times faster than wages. If we do nothing, they will double again in a few years to about $24,000 - that's 40 percent of the average family budget.
Health care currently eats up one-sixth of the U.S. economy. If we fail to act, by the time my 7-year-old son has his own family, it will consume one-third of all spending. America is struggling now to compete in the global marketplace. It won't get better unless we lower health costs.
For Medicare, reform means stability. I believe my mother, my aunts and other Alaskans on Medicare think that's a very good thing. One of the biggest lies is that Senate Democrats planned to cut Medicare.
The truth is the Senate reform bill protects the same level of basic Medicare benefits offered to seniors today. According to the non-partisan Congressional Budget Office, reform will extend the solvency of the Medicare trust fund by an additional 10 years.
I made it clear I would not support a bill that didn't scale back health costs. I joined other freshmen Democrats in writing a widely praised cost containment amendment that will save hundreds of millions of dollars.
The CBO projects the overall legislation will cut the deficit by $132 billion during the first decade after enactment and more than $1 trillion in the second. Cost containment means savings for Medicare, Medicaid, the Indian Health Service and veterans care, which really means savings to taxpayers.
Most important, for some Americans this is a matter of life and death. Lost in the mudslinging is the fact that an estimated 45,000 of our friends and neighbors die each year for lack of medical care. I cannot stand by idly while this is happening.
I challenged the big drug companies and the insurance industry. I supported reform that reduces prescription drug costs, ends denials for pre-existing conditions and prohibits cancellation of policies.
In Medicare, I worked to add more primary care providers to the system and backed a 10 percent payment bonus. About 10,000 Alaska seniors in the "doughnut hole" will see lower prescription drug costs.
The bill extends health coverage to 31 million currently uninsured Americans, including most of the 133,000 Alaskans who report no insurance. More than 52,000 Alaskans could qualify for tax credits to help them afford coverage - for single people earning up to $54,144, and for families of four making up to $110,304.
I pushed a common-sense approach that recognizes we can't slow medical costs until we do more to promote good health and prevent the toll of chronic diseases.
I insisted on protections and tax relief for small business. Businesses with 50 or fewer employees are exempt from mandates, but some 8,600 small Alaska companies could be helped by a tax credit if they choose to offer insurance.
Reform also improves access to health care for military veterans and Alaska Natives.
The legislation builds reform over several years, but there are many immediate benefits. Parents' insurance will cover adult children until age 26. Children younger than 19 no longer will be denied coverage because of a pre-existing condition. Retirees ages 55-64 will be eligible for affordable coverage before entering Medicare. No longer will insurers be able to rescind coverage if a policyholder gets sick.
I read the legislation, worked to improve it, stuck to the facts and listened to and participated in the long debate. Then, as 2009 drew toward its close, I voted yes for a bill I firmly believe will save people's lives, cut health care costs and protect Medicare.
Mark Begich is a Democratic U.S. senator from Alaska.