Moving forward, together, on health care reform

Without a single Republican vote, President Obama and his Democratic majority pushed through significant health care legislation that supporters celebrate as the largest social policy change since Medicare and Social Security.

It came after a year of debate that pitted parties against each other and gave rise to the vocal tea party movement that called it a government takeover and challenged claims that the legislation was necessary to control costs that have led to the country's unimaginable debt.

Unfortunately, it also carried too much inflammatory language: charges that it's socialist, accusations that death panels would put a price on life, outbursts of "you lie!" and "baby-killer" in the halls of Congress. We thought the public debate hit a new low when protesters used homophobic and racist epithets when heckling members of Congress. Now we are hearing reports of death threats against Democrats and Republicans.

Democrats have insisted those who are happy with their insurance can keep the plan they have. The fact is, no one really knows how insurers will change plans and premiums.

It's time for a new, more productive conversation to begin. This is especially important for candidates on the November ballot.

We won't know the full effect until after 2014, when most of the rules, taxes and benefits are effective. But we will learn a lot in the coming months as the first changes begin to take hold.

Beginning this year, insurers will be required to cover children with pre-existing conditions, lift caps on lifetime coverage, create a high-risk pool for adults who have been refused coverage and subsidize the gap in Medicare Part D. Tax credits for small businesses and a 10 percent tax on tanning also kick in.

Each component carries a cost as well as the benefit. These first measures of the legislation's impact will come long before the tally hits the estimated $938 billion cost and 32 million uninsured Americans get coverage as promised.

Lawmakers must use these early indicators to determine whether the projections appear accurate. This is a real opportunity to better understand the legislation's impact on the economy, the health care industry and the people - and make improvements if needed.

The people will not be served unless both sides can step away from the partisan rhetoric that has unfortunately defined the debate.

As he signed the bill Tuesday, Obama took a shot at opponents when he said, "all the overheated rhetoric of reform will suddenly confront the reality of reform." Meanwhile, Republicans are chanting, "repeal and replace."

As we move forward, we urge every elected representative, candidate and special interest group to set aside the animosity and see whatever reality emerges - whether it reflects the arguments made by today's supporters or its foes. There's too much at stake to do otherwise.

It's a shame such landmark legislation passed without bipartisan consensus. We hold both parties responsible.

Democrats failed to do enough to reach out to Republicans. Republicans appeared unwilling to engage in meaningful dialogue.

Despite a yearlong debate, the people knew too little about the specifics in the bill until too late. Even now, there is confusion about what it will mean to the average American.

The reality, though, is that this is how our democracy works.

Republicans can protest. But the voters elected strong Democratic majorities in both houses and the White House. With that comes the power - maybe even the responsibility - to effect the change the party espoused.

We'd prefer a different political reality: one where Democrats and Republican respectfully and openly debate important issues with the intent of reaching consensus.