Matthew Yglesias: House Health Bill

[babylonsister]

http://yglesias.thinkprogress.org/archives/2009/07/house-health-bill.php

House Health Bill


The House of Representatives is now prepared to unveil their health reform legislation with markup taking place tomorrow and Thursday. It’s a good bill (more on that later) but it’s worth also giving a tip of the cap in the direction of the House process. The chairs and members of the three relevant committees did a great mitzvah by putting egos aside, forming a unified “tri-committee” bill writing process, largely shutting up about their internal negotiations, and getting down to the job of writing a bill that fits the parameters Americans voted for in November. I appreciate that the Senate has its own idiotic self-imposed supermajority requirement to deal with, but it would be nice to see the same discipline and seriousness of purpose from Senators at the committee stage.

So what’s in the bill?

Well, there’s a fairly strong public plan. It needs to be financially self-supporting and nobody will be forced to accept its reimbursement rates, but it will be open to anyone with access to the Health Insurance Exchange will model its payments on Medicare and they say the default assumption will be that anyone who serves Medicare clients will also take Public Plan clients.

Speaking of which, there’s a Health Insurance Exchange which will be national in scope, though states will be able to opt-out if they can meet some state guidelines. That seems like a reasonable compromise to me. It’s basically designed for employees of very small businesses, but there’s the possibility of larger businesses entering the exchange via mutual agreement between the employer in question and the Commissioner governing the exchange. Clearly how that cashes out will have a lot to do with how the discretionary authority is used.

Minimum benefits are defined in a slightly circular way as equivalent to the prevailing employer-based coverage in the area.

About half the cost is paid for via entitlement savings—$500 billion over ten years will be saved from Medicare and Medicaid. The other half is paid for via a surtax on rich people. The bill prudently calls for the level of the tax to be adjusted depending on whether or not the bill actually costs what it’s projected to cost.

The CBO sees a net cost of $1 trillion to the non-revenue portions of the bill. The intention is to have the revenue portions cover the cost of the non-revenue portions, but we’ll have to wait and see for that part of the analysis to get done.

[dflprincess]

1. So whether or not you have access to health care will still depend on your employement status?

Sorry, but a "fairly strong" public option just doesn't cut it. I'm still seeing too much of an effort to save the insurance companies' profits in this.

[kenfrequed]

2. I conditionally agree

I will need to see more details about the public option.

[liberalpragmatist]

3. It's a gradualistic opening up

In its early stages, only those who are unemployed, self-employed, can't be employed through other insurers, or are employees of small businesses will get to enroll in any plan in the exchange, including the public plan. However, the legislation empowers the administrator of the public plan to open up the plan gradually to all.

[dflprincess]

5. So they're admitting that the for profits can't compete on an equal setting with a public option

and are limiting the pool that can buy into the public plan. If that plan includes the people who can't be insured by private plans and not allowing it to be balanced out by lower risk people it is being set up for failure.

Meanwhile, those who don't qualify for the public plan, are going to be forced to continue to shovel money to the crooks that broke the system to begin with. - And this is supposedly the "best" plan - imagine what this will looks like once the full House is done with it.

I've said all along that whatever gets passed will probably be something that should be named "The Health Insurance Company Profit and Campaign Donation Protection Act" and that sure looks like what we're going to get.

[quidam56]

4. politician$$$ and profit machine$$$

As a former health care giver, I am shocked and saddened to see what has become of health care in America. $ 1. 4 million is being spent per day in DC by the health care lobbyists so your elected representative is getting taken care of and has quality health care we pay for and can't afford ourselves for our families, I know what is deemed, defended and supported in Tennessee and Virginia as quality health care and clearly profit care comes ahead of patient care. http://www.wisecountyissues.com/?p=62 MRSA ( methicillin resistant staphylococcus aureas ) is infesting our communities because filthy, uncaring hospitals and emergency rooms are breeding them and spreading them into our schools, homes, restaurants. How many more Americans' will be diseased or die while 74 % of Americans' are begging for health care reform ? More people died in America last year from MRSA complications than AIDS. When MRSA and a flu bug start mixing, it won't be pretty and we are being infected by the very health care system we depend on and trust to keep us safe and healthy.