Warren's MFA-funding plan would punish businesses now providing better insurance than they have to

[highplainsdem]

I ran across this info after seeing an EJ Dionne tweet recommending people read Ezra Klein's analysis of Warren's plan:

https://www.vox.com/2019/11/1/20942587/elizabeth-warren-medicare-for-all-taxes-explained


It's a very long analysis, goes into a lot of detail, but I recommend people read all of it.

My initial take is that Warren is greatly underestimating costs and overestimating revenues to make this work.

And there's already a lot of debate about her numbers.

This is the section explaining how her program penalizes employers providing better than the minimum insurance required, and small businesses providing insurance when the law doesn't require them to:

Between federal, state, and local governments, most US health spending is already publicly financed. Warren shunts all that money toward Medicare-for-all, leaving a $20.5 trillion hole over 10 years.

Warren does the same with employer spending. Under the Affordable Care Act’s employer mandate, all workplaces with more than 50 employees have to purchase health care or pay a fee. Warren simply takes the money they’re spending now and redirects it to Medicare-for-all. To sweeten the deal for employers, she shaves their contribution by 2 percent — so whatever they’re spending on private health insurance, they send 98 percent of that to the government.

There’s wide variation in the quality of insurance employers purchase, and this plan has the consequence, at the outset, of punishing employers who purchased better insurance for their employees — now they’re paying more than stingier competitors, but without any recruiting benefit. Over time, Warren says she’ll adjust all employers to the same level, though the details of how that will work are sparse.

There’s an even worse inequity for employers with fewer than 50 employees. They’re not required under law to provide health insurance, but a bit over half do. Warren’s plan says that small businesses “would be exempt from the Employer Medicare Contribution unless they are already paying for employee health care today.” That’s a fairly direct penalty to small businesses that offer health insurance today: They have to keep paying a cost their competitors have dodged, but paying that cost no longer gives them an advantage in hiring.

Altogether, holding the employer contribution constant gets Warren almost $9 trillion.

If I read this correctly, Warren's plan, if it looks at all likely to become law, would incentivize businesses to provide worse (cheaper) insurance as long as they're required to provide insurance, and -- in the case of small businesses -- to drop employee insurance completely before it turns into a serious penalty for them.

[LonePirate]

1. Ah, here comes the anti-MFA crowd peddling industry and right wing talking points again.

[highplainsdem]

2. That's how you describe Ezra Klein and Vox? LOL!

[LonePirate]

3. "incentivize businesses to provide worse (cheaper) insurance" is a RW talking point

I stand by my comment.

[highplainsdem]

5. Pointing out economic incentives Warren's plan creates is simply an observation.

[Voltaire2]

20. Please provide a few examples of businesses providing better plans than the

plan detailed by the Senate MFA legislation.

That plan has zero premiums, zero deductibles, zero copays for health services, max $5 copay for prescriptions, dental, vision, mental health same as medical. No networks, no balance billing (or as we so fondly refer to them wtf bills.)

I'll wait.

[dsc]

45. that isn't what is being said

what is being said is that if you have two small businesses call them Acme and Bane. Acme provides insurance to it's 49 employees while Bane doesn't provide any to its employees. Warren's plan passes. Acme will have to continue to pay 98% of what they are paying in premiums now while Bane will have to pay 98% of 0 which, of course, is 0. So Acme will be punished for having provided insurance that Bane didn't.

[highplainsdem]

47. Exactly! Thank you!

[highplainsdem]

46. Try reading the OP. From the excerpt I quoted:

Warren does the same with employer spending. Under the Affordable Care Act’s employer mandate, all workplaces with more than 50 employees have to purchase health care or pay a fee. Warren simply takes the money they’re spending now and redirects it to Medicare-for-all. To sweeten the deal for employers, she shaves their contribution by 2 percent — so whatever they’re spending on private health insurance, they send 98 percent of that to the government.

There’s wide variation in the quality of insurance employers purchase, and this plan has the consequence, at the outset, of punishing employers who purchased better insurance for their employees — now they’re paying more than stingier competitors, but without any recruiting benefit. Over time, Warren says she’ll adjust all employers to the same level, though the details of how that will work are sparse.

Emphasis added.

[Cha]

33. Yeah, you stand by calling "Ezra Klein & Vox rw".. it

says more about you than Ezra Klein, Vox, or anyone who's getting actual information out that isn't glowing about MFA.

[George II]

7. What "right wing talking points"? Because the opinion differs from yours? Here's a question....

If you could get better insurance at a lower rate than the still very undefined "MFA", would you keep it or switch to something that's speculative?

[LonePirate]

9. The RW talking point is worse insurance at a higher cost while today's system is better and cheaper.

That talking point is complete hogwash. It is certainly an interesting point of view for someone who presumably supports the Canadian health care system given your avatar.

[George II]

10. I live in Connecticut and am on Medicare, thank you!

[LonePirate]

13. Why are you on Medicare if private insurance is cheaper and better?

Either your talking point is bullshit or you are a hypocrite. Which is it?

[George II]

14. Because I'm over 65. The Medicare in "Medicare for All" is entirely different from my Medicare.

[LonePirate]

15. Except it is not. There will not be separate MFA and Medicare systems.

I'm not sure where you received your information but you have bought into a line of bull if you think there will be two systems one for the under 65 crowd and one for the 65 and over crowd.

[George II]

18. But IF "Medicare for All" is implemented it will differ drastically from the current Medicare system

Sure, it will be one system but the existing one will be different and not as good and more expensive.

It's not a line of bull, it's reality.

[George II]

22. Do some research into how the current Medicare program works and is administered.

[TidalWave46]

37. M4A is far different than Medicare.

Just one of the reasons it shouldn’t have been branded as M4A.

[George II]

41. Yes, using the "Medicare" terminology is a major misnomer.

[Voltaire2]

23. Both the Senate and House bills propose plans that are vastly superior to medicare.

But indeed, how dare those damn socialists try to replace your expensive medicare program with a better, and for you free, plan?

Damn socialists. Amirite?

By the way, do you support John Conyers' last MFA bill? Still wondering.

[George II]

25. There are huge holes in both of them.

[Voltaire2]

29. Um, please be specific. Compared to medicare what 'huge holes' are there?

[Demsrule86]

39. Than I am definitely against it...sis in law can't get any more therapy in house because of medicare

rules...trying to get her on medicaid. We can't care for her at home...I guess if she doesn't qualify, they would toss her out? I don't know... Big holes in the current Medicare plan...I thought that Medicare was going to be new not the existing plan...it would bankrupt families with kids...premiums for all members individually...the ACA with a public option is the way to go. And no way, jobs will give folks extra money in their paycheck.

[sop]

36. "How Health Inurance Industry allies are going to lie and attack Warren's MFA Plan"- Wendel Potter

I find Wendel Potter's analysis more credible:

https://www.salon.com/2019/11/03/how-health-insurance-industry-allies-are-going-to-lie-and-attack-warrens-medicare-for-all-plan_partner/

If every other industrialized nation can provide healthcare for its citizens as a basic right, and manage to pay for it, the US can do so as well. The healthcare and insurance industries will fight MFA tooth and nail, much like the extractive energy interests continue to deny climate science and fight any attempts to create a green economy. It's all about profit.

I have one objection to MFA as it's currently being described: forced participation. MFA should be like our public school system; everyone has to pay for public education through local, state and federal taxes, however if anyone wants to opt out and send their kids to expensive private schools, or religious schools that support their world view, then do it...it's your right.

[still_one]

59. There is a name for posts like this. It must be quiet over at JPR this time of year

[BeyondGeography]

4. This could end all the joys of the current system!

From a commenter at Kos newly qualified for Medicare on what he won’t be missing from his annual Obamacare signup exercise:

Oh, that most wonderful time of the year!

The joy of trying to figure out whether to gamble on a high-deductible plan with lower premiums and unaffordable out-of-pocket costs, or to pay higher premiums for lower outlays!

The roulette game of “Is my insurer’s provider directory accurate?”

The thrills of prognosticating one’s future self-employment income lest one be socked with a tax penalty for underestimating!

And best of all: insurance “coverage” that exposes one to sky’s-the-limit balance & surprise billing in the event of hospitalization!

Alas, this year I will miss out on all the fun of the individual marketplace because at long last I qualify, as an official Old, for that dang taxpayer-funded socialized healthcare regulated by the government instead of the taxpayer-funded profiteers’ cartel.

[Backseat Driver]

11. Congrats fellow senior (for healthcare purposes)!

So what's the plan - in this time of uncertainty of coming changes, are you opting for regular Medicare, with/without supplemental private policies and no public option save if you'd qualify for Medicaid? and also separate privates for dental, vision, hearing services or will you grab onto an Advantage plan? Will regular Medicare with it's non-coverage of that 20% be converted in the future with coverages for those private policy services that have co-pays and premiums. You'll also begin with some choice in Part D private plans that have co-pays and premiums - what are your thoughts?

I'm afraid that the craziness of open enrollment season won't be over until the fat lady sings for all others, so maybe never?- happy phone screening calls from pushy reps and wasteful mailings cluttering the mailbox!

[BeyondGeography]

12. That's not me...it's from this most excellent Wendell Potter diary

How Health Insurance Industry Will Lie and Attack Liz Warren’s Medicare for All, by Wendell Potter

https://m.dailykos.com/stories/2019/11/1/1896635/-How-Health-Insurance-Industry-Will-Lie-and-Attack-Liz-Warren-s-Medicare-for-All-by-Wendell-Potter

I’m 60 and hoping to stay employed and insured until I qualify.

[OilemFirchen]

40. You said that was "from a commenter at Kos".

Not gonna click the link, but you clearly told the truth.

Did that vaunted health care expert state which Medicare plan he or she is selecting?

[BeyondGeography]

43. Our health care system is a cruel joke and everyone wants to move on from Obamacare

You actually need proof?

[Cha]

50. "..Everyone.."? No.. Biden's plan is winning.

Link to tweet

Link to tweet

https://www.democraticunderground.com/1287319357#top

[BeyondGeography]

51. Joe Biden Wants to "Get Rid" of Half of Obamacare

By creating a public option for Medicaid expansion, Biden’s plan pushes over half of those who gained coverage through Obamacare into a new plan.

https://prospect.org/health/joe-biden-wants-get-rid-half-obamacare/

Biden's plan would significantly increase subsidies for individuals buying insurance on their own, and let people with employer insurance get access to the subsidies, which Obamacare explicitly prohibits. Also, while promoting his plan Biden made a bold promise: “If you like your health-care plan, your employer-based plan, you can keep it. If in fact you have private insurance, you can keep it.”

It will prove very tough to keep all these promises. If the new public option does use the government's full power to negotiate significantly better rates with providers, it will likely drive most private insurers out of the market. Combined with significantly improved subsidies for the public option or private coverage, many employers would likely drop their current health plans. The Lewin Group did an analysis of the Americare bill in 2007, a public option plan which fully exploited the government’s ability to negotiate low prices, and offered very similar cost sharing and premium caps to BidenCare’s model. Lewin projected that the public option would be so appealing, all employers would eventually stop offering coverage as nearly everyone signed up for it.

It seems unlikely that Biden would attack Medicare for All, but instead call for a Medicare-like plan that would wipe out nearly all private insurance over time. Obamacare preserved employer coverage by purposely making the exchanges an inferior alternative. But the more you improve the alternatives to employer coverage, the more you risk unraveling it.

So, and this is a compliment, the private insurance industry will fight Biden’s plan just as hard as they will MFA:

The CEO of America's Health Insurance Plans said a healthcare plan proposed by Democratic presidential candidate and former Vice President Joe Biden is not much different than "Medicare for All," which the industry strongly opposes, according to The Hill.

In an interview with The Hill, AHIP CEO Matt Eyles spoke out against Mr. Biden's healthcare plan, which aims to strengthen the ACA while also introducing a public health insurance option. Mr. Eyles said the public option, which would be similar to Medicare, would lead to too much government involvement in the healthcare system.

"If you're creating a government-run option that essentially leverages price controls, and relies on a government-administered system, that doesn't create what would be a competitive playing field," Mr. Eyles told the publication. "We're viewing Medicare for All and all of these other … variations on it, as similarly bad."

https://www.beckershospitalreview.com/payer-issues/ahip-comes-out-against-biden-s-healthcare-plan.html

[Onthefly]

16. Private insurance just does not work

Last edited Sun Nov 3, 2019, 08:15 PM - Edit history (1)

When health insurance companies use smoke and mirrors to keep shareholders satisfied.

MFA will benefit many people who cannot afford high option insurance. Employer provided insure is expensive for the employee with high deductibles and fees for specialty services or diagnostic tests.

[KPN]

21. +1000!

[George II]

6. That's the big drawback to these "M4A" plans that do away with private insurance. LOTS of people...

....have good insurance at a premium that they KNOW about (not speculative) and want to keep it.

[LAS14]

60. I'm beginning to be persuaded that I might change my mind...

... about my (so far) wonderful, no co-pay insurance if I hit a great big health crisis. Apparently it's happened to other people. Still, I'm willing to take a hit so everyone can be covered and our costs aren't tied to someone's profits. I have no problem asking "good hearted" businesses to shift their charitable impulses to supporting a single payer system.

[BluesRunTheGame]

8. I'd be willing to bet that most of us do not work for those businesses.

My personal experience is that my insurance gets shittier every year. In the last two years I've twice had the opportunity to discover that Obamacare was unaffordable for me.

[emmaverybo]

27. Millions of state and fed workers and those in large union negotiated pools do have excellent

and affordable plans. Those who are vested can keep these at the same rate even after leaving
employment. In retirement, these same millions can pay no premiums for a supplemental plan and their benefits may even Pay their Medicare fee. You ask these millions to be altruistic and propose that the only way they can do that is by giving up their affordable plan to pay higher taxes.

First, it is simply not true that only M4All can get us to universal healthcare. Medicaid and Medicare, the popular ACA plans, a public option and then subsidizing those not covered by anything can do the same. Sure, those programs need tweaking. Fine. We know they have good bones.

But millions should just trust that M4All will not have the problems the NHS has or the VA hospital or worse because Sanders and Warren say so?

Oh, and millions should wait years for this new magic program? In other words, it is M4All or the highway AND one is a selfish GOP lite if one does not endorse this particular plan.

[Voltaire2]

30. And those plans are superior to what is proposed for MFA?

Please provide an example of a plan that is better.

[emmaverybo]

32. I don't know what M4All will end up being like.

[Voltaire2]

55. Evasive non answer.

The bills in the house and senate are quite specific.

[Cha]

34. Yes, and their excellent plans are guaranteed..

Why would anyone give up something they appreciate to go for something that is only talked about?

Affordable Health Care is too precious and vital .

[Voltaire2]

56. Many have unaffordable shitty plans.

but who cares about them or the millions of families that go bankrupt every year over medical expenses.

[BluesRunTheGame]

48. Seriously?!!! This is your answer?

You’re going to go into the general election and propose that government workers and union workers are gonna keep their primo plans and the rest of us are going to remain on our “bend over” private plans. The only difference being how much lube the “moderates” are willing to negotiate for us?

Let me point out that the “moderates” aren’t proposing that the rest of us will get any sort of “specific” plan.

We’re not going to get the same plan that government workers get. We’re not going to get the same plan that union workers get. We’re not going to get the same plan that a US Senator or former Vice President gets.

The beauty of MFA is that it’s a specific plan that presently exists. We can measure other offers against MFA. If you’ve got something better please offer it.

Four years ago I had a private plan with a $1500.00 deductible. An ear infection cost me $1500.00 out of pocket. Today, after several changes, my new private plan has a $6000.00 deductible. $6000.00 is a lot of fucking money! It’s more that most folks have laying around.

Twice in the last two years I’ve been without insurance and have found Obamacare unaffordable.

It boggles my mind that the moderates have the nerve to suggest that we can tweak the current system and solve our health care problems.

[Andy823]

17. Harris has the best plan

Check it out:

https://kamalaharris.org/issue/health-care/

[mcar]

44. Yes she does.

But don't expect anyone to pay any attention to it.

[Andy823]

49. Yeah they seem to be to busy to bother

or they know it's the best plan, they just aren't going to admit it!

[oldsoftie]

24. You'll be accused of everything Right Wing under the sun; regardless of facts.

Thats how bad its gotten now.
FACTS DONT MATTER

[highplainsdem]

26. I'm used to the kvetching from the usual gang. I'll keep posting facts anyway.

And I do hope people will read Klein's analysis of Warren's plan.

[emmaverybo]

28. Thanks for keeping keeping on. We need various sources of information and analysis.

[Cha]

35. That's their default.. they think it works.. it

doesn't. EW started that in one of the debates or sooner for all I know.

Must be nice to brush away valid questions with that.. After the last debate though she's coming out with more info.

[ritapria]

31. These exchanges of Opinion on MFA are very informative

Keep it up !

[BlueMTexpat]

38. SSDD eom

[highplainsdem]

42. You saw Ezra Klein's analysis posted elsewhere here? Excellent analysis. EJ Dionne tweet:

Link to tweet

Wherever you stand on ⁦⁦@SenWarren⁩’s Medicare-for-all plan, it would be a good idea to read ⁦@ezraklein⁩’s clear & careful analysis of what it does, and how it does what it does. He’s also v-shrewd about the politics of health care reform.

https://www.vox.com/2019/11/1/20942587/elizabeth-warren-medicare-for-all-taxes-explained

[BlueMTexpat]

53. Yes, it's a worthwhile read

and Klein makes some cogent points.

But as for "analysis," Klein is a professional blogger and journalist (whom I generally admire) but his "analysis" here is as speculative as anything else and he is not anywhere near as versed in finance, etc. as EW or the experts Warren has relied on. So why should he be our "guru" instead of the experts?

Why do you continually snipe at Warren instead of touting the strengths of your own candidate? Are you so afraid of her?

Why don't you compare Biden's health plan to hers - step by step - not just that he would "improve" the ACA. How exactly? If he only has a vague idea now, he certainly won't formulate a detailed one later.

Of course, as anyone here who lives in the real world knows, we're not likely to get ANYTHING near what we want insofar as affordable health care or anything else with the political system we currently have where literally everything but the House is controlled by RW GOPers.

So why not shoot for the moon instead of for piecemeal crumbs? What we end up with will be less than asked for in any event. Why tear our candidates apart now and, in so doing, help the GOP's smear work later on?

Had Prez O appointed Howard Dean to HHS in 2009 (as was Dean's most fervent desire) instead of the "politically acceptable" Kathleen Sibelius, our current ACA would likely have been a LOT stronger than it is now.

Kansas would certainly be in better shape, as the departure of Sibelius left it to the tender mercies of Sam Brownback.

But Dean was considered to be a "threat" by some Dems who advised Prez O NOT to appoint him. And so here we are.

[highplainsdem]

57. I'm glad you looked at Klein's analysis, and hope others will. As for relying on experts --

they often disagree, and they're definitely not all in agreement with the experts Warren relied on.

Howard Gleckman of the Tax Policy Center, for instance, has the same criticism of Warren's employer tax that Sanders has:

https://www.taxpolicycenter.org/taxvox/understanding-warrens-medicare-all-employer-tax

I don't "continually snipe at Warren." I post a lot of positive OPs about Biden.

And Biden has probably been sniped at more than any other candidate in this forum, while it seems that even a slight criticism of Warren is treated as lese-majeste by certain of her followers (not all of them, but it's particularly noticeable with a handful).

This OP is about Warren's policy proposal, and Klein usually seems very supportive of Warren.

But even someone like Krugman, who's described himself as a "huge fan" of Warren's plans, has admitted that experts will argue over whether her numbers make sense.

And like Klein, Krugman doesn't see much chance of getting MFA passed.

The problem with "shooting for the moon" is that MFA really ISN'T all that popular with the general electorate, especially when it's made clear that it will eliminate private insurance. It's often confused by people with "Medicare for all who want it" or the public option, which IS widely popular.

MFA could cost us not just the presidential election next year, but many down-ballot races as well.

The public option isn't likely to do that.

And as for ACA...Obama got as much included as he could find support for. Having Howard Dean as HHS secretary would not have changed that.

And Obama probably wouldn't have been able to get ACA at all without Biden's help:

https://www.democraticunderground.com/1287262162

Or the stimulus, as is pointed out in that thread.

Or Dodd-Frank, which included the CFPB.

With Biden, I think we have a pretty good chance of getting the public option and other improvements building on Obamacare. And if enough people want the public option, we'll move closer to single payer.

I polled our very liberal group here, a few months ago, on whether they believed that, even if we managed to elect someone who wants MFA, they could get MFA through Congress in a first term.

Only 11% said yes. 78% said no. 2% said maybe later.

https://www.democraticunderground.com/1287226281

I've seen a lot of posts here from people saying MFA should be used as sort of an opening bid, or bluff. But if no one believes you have the votes, that has no chance of working.

And if you lose the GE running on a proposal that's unpopular, you don't even get a chance to start any negotiating.

And Trump, or whoever the GOP nominee is, has more years to continue destroying Obamacare and other parts of the safety net.

[BlueMTexpat]

58. Thanks for your response.

But our rationales are running in parallel and I don't see a meeting point for us insofar as primary candidates are concerned.

I just do not believe that Joe is the fighter that Elizabeth is. I have good reasons for that belief and a long history and memories with the Dem party. Now more than ever, we need a fighter. So I will stay firmly behind my candidate and her proposals.

I believe that she and they are winners. More voters seem to be agreeing by the day. And more will come on board. Will that be enough?

Well, we shall see.

[Cha]

61. Kicking this thread..

[andym]

52. Ezra's analysis is sound, but the employer inequality will just maintain the status quo

So in actuality that aspect is fairly reasonable for a transition, but that will have to change down the line, as the plan suggests without details and Ezra mentions.

Obviously, there could be a look back to prevent businesses from gaming the system just before implementation, to prevent the temporary worsening of insurance benefits.

The permanent solution can be dealt with-- probably on the basis of the number of employees, size of the business. I'm impressed Ezra was so positive about the plan. He is quite knowledgeable.

[aikoaiko]

54. Neither of those things are really penalties.