This article first appeared in the St. Louis Beacon, Nov. 16, 2009 - U.S. Sen. Claire McCaskill, D-Mo., isn't sure if Congress will get a health care bill passed by the end of the year.
What she is sure of, she said in an interview with the Beacon over the weekend, is that Republican opponents "have taken obstruction as a new art form."
McCaskill -- who generally supports the Democratic quest to revamp the nation's health care system -- says she is particularly mystified by the repeated GOP call to allow insurance to be purchased across state lines, which Republicans and their allies contend would reduce insurance costs.
If across-state-lines insurance purchases are allowed, she said, that likely would mean an end to state regulations on insurers.
The upshot, she continued, could be "the regulations they think are OK in California" might also end up being the national standard that would be imposed in Missouri and other states.
States now have widely different mandates on insurance coverage, when it comes to illnesses, medicines or medical procedures -- such as coverage of mammograms, Viagra or childbirth -- and even who is covered. In Missouri, for example, children lose their family coverage when they reach age 23. In some other states, the coverage cutoff is older.
And then there is abortion coverage. Missouri is in the news, at present, because it is among a handful of states that bar private insurers from offering abortion coverage, except through special riders available at extra cost.
If across-state-line insurance purchases are allowed, McCaskill said, there would most likely be a national standard regarding how abortion or other medical matters are handled.
And that standard, she continued, might be at odds with what Missourians want.
Her point: "I don't think we should wipe out the ability of the states to regulate what insurance products are sold in their states."
Overall, McCaskill asserted that senators in both parties agree on the bulk of the health care proposals, and on the general need to make changes. But, unfortunately, she added, "What gets most of the oxygen are the few things they don't agree on."
The most notable item: The largely Democratic effort to set up some sort of public insurance option for people who can't get private insurance, or can't afford it.
McCaskill offered her observations during an interview Saturday, after she had addressed hundreds of people who had shown up at Lexington School in St. Louis to participate in her office's Economic Development and Grant Training Workshop. Attendees, many of them from small businesses and non-profit groups, met with representatives of various federal agencies to learn what requirements.
The workshop was the sixth that McCaskill's staff has conducted, and more will be held, she said.
"This grew out of the fact that I refuse to do earmarks,'' McCaskill said, referring to the practice of some individual members of Congress (including Missouri's senior senator, Republican Christopher "Kit" Bond) to earmark federal money in various bills for specific projects in their states.
"What we're trying to do ... is to make these competitive grants more available and accessible'' to Missouri businesses and groups, by offering help in applying for the money. McCaskill said such workshops can be particularly helpful during the current economic downturn.
She also supports President Barack Obama's decision to hold a jobs summit in December to discuss how best to tackle the nation's rising unemployment, even as other parts of the economy appear to be stabilizing.
McCaskill, generally a staunch Obama ally, said that the summit should help dispel any public misperception about the president's concern. "I know the White House is focusing on jobs," she explained, "but it doesn't feel like it to most Americans because of all the focus on health care."
