We need the Wyden Free Choice Act in addition to the public option

[t0dd]

Wyden's bill doesn't include a public option, but it lets anyone join the new health insurance exchange. It prevents your employer from dictating what type of health coverage you can receive. His amendment, in addition to a robust public option tied to Medicare rates, is the ideal outcome we should strive for.

Enter Wyden. The Free Choice Act is not a health-care-reform bill. It is best understood as a reform of the health-care-reform bill. In particular, it reforms the nature of the Health Insurance Exchange. Under the bills being considered right now, the exchange will be limited to the uninsured, the self-employed and small businesses. Maybe it will be expanded over time. Maybe not. In addition, it is barricaded by what's called a "firewall." The firewall essentially bars individuals from entering the exchange so long as their employers offer them a basic level of health-care coverage.

The Free Choice Act starts by setting the rules for the exchange: Within five years the exchange is open to all employers. More importantly, it's open to all people. The firewall is extinguished. But as the late, great, Billy Mays would say, that's not all!

The key component of the Free Choice Act is called "cash-out." Under the Free Choice Act, if I decide that I don't like any of the health-care coverage options being offered by my employer and would prefer to choose from the many options being offered on the Health Insurance Exchange, my employer has to give me a voucher that covers 65 to 70 percent of the cost of the lowest level of exchange plan. (That is the average portion that an employer pays of his employee's health insurance premiums.) I can take that voucher and, along with whatever money I want to throw in, choose a plan on the exchange.
More here: http://voices.washingtonpost.com/ezra-klein/2009/07/the_idea_that_could_save_healt.html

But there is one legitimate reform that could lower costs for both individuals and the government, increase competition in the marketplace, and provide the best coverage at the best cost for everyone. That would be Ron Wyden's Free Choice Act, and it's what I think progressives ought to really push at this point.
...
We keep hearing the mantra of "if you like what you have, you can keep it." Wyden's reform preserves that. But it also opens up the health insurance exchange to everyone, and forces both insurers and the public option into real competition. The public option would not be walled off simply to those who don't have insurance from their employer or certain small businesses. It would have the opportunity to get market share to compete with private insurers. And for the first time, insurers across regions would compete with one another, as the companies inside the exchange would be able to entice workers who get insurance through their employers. All of this could actually change the dynamic in the insurance market and force competition on price and quality, rather than the current competition among insurers, which is "who can pay for the least amount of health care." It gives individuals the freedom to choose without stripping them of their bargaining power - in fact, it empowers them more. And it strengthens the public option, by opening the market to potentially tens of millions more consumers.

The employer-based system is nice for some, but it really delivers health care inefficiently, and Wyden's Free Choice Act would allow over time for an alternative to emerge that maintains the economies of scale to allow that alternative to compete. And this would save money, as it encourages cost effectiveness since everyone is competing on price.
More here: http://digbysblog.blogspot.com/2009/07/killer-app-by-dday-house-ways-and-means.html

Wyden, as you may know, has his own version of health care reform, which is entitled the Healthy Americans Act (HAA). The HAA is, in some ways, a more radical restructuring of the health insurance system than any of the other plans currently being contemplated by the Congress. It would completely remove the benefits tax exemption, create a national health insurance exchange (which would be open to everyone including those who opted out of their employer-provided coverage), and set some rather explicit cost-containment targets.

I'm on record as being a fan, as are a lot of health care policy wonks like Ezra Klein. The interesting thing about Wyden's bill is that it has co-sponsors from all over the political spectrum: not just centrists but also fairly liberal Democrats like Jeff Merkley, Ted Kaufman and Daniel Inouye, and rather conservative Republicans like Idaho's Mike Crapo and Utah's Dick Bennett.
More here: http://www.fivethirtyeight.com/2009/07/on-health-care-bipartisanship-without.html

I wonder if those Republican cosponsors will still support his amendment when it is brought up in the Senate Finance Committee. I know some Dems also support it.

[grantcart]

1. For the first time he explained it really well today

sounds like a good ammendment - but only if the public option is included.

[sandnsea]

2. Employers pay such a large part of insurance

Nobody is going to opt out of their plan and get anything cheaper anywhere else. Making sure everybody can get a subsidy is what is most important.

[t0dd]

3. If you get a voucher from your employer, you can join

the insurance exchange and use that as credit towards a plan as if it were the default policy offered by your employer.

[sandnsea]

10. So employers have to hire another employee

Just to manage where the vouchers are going. And you wonder why they oppose this?

[DearAbby]

4. AMEN

[eridani]

5. This is about as useful as a free choice of what size you want to make electrical outlets

I don't want a bunch of choices invented by sociopaths, thankyewverymuch.

[TheKentuckian]

6. So, you'd argue in favor of and support LESS choice because you think they are all bad?

You don't even want the least worse and would prefer to just be told what poor coverage is assigned to you?

That's the stance of a crazy person. How everybody isn't very much on board with this, I can't even begin to guess. At the bare minimum it would seem like the people that are currently covered would like to have access to the public option if it is available and even if not, I can tell you that PLANS ARE DIFFERENT AND YOU MAY WELL FIND THAT ONE OPTION MAY SERVE YOUR NEEDS BETTER THAN ANOTHER.

Only an absolute fool is too blind to see that choices tend to improve any market based system. Why would you NOT want to force some level of competition between companies regardless or in addition to a public plan? What would be the downside of this plan?

[eridani]

9. "Choosing what is best for you and ;your family" is not the slightest bit different

--from just coming out and saying that some families deserve good health care and other families (who can only afford garbage insurance plans that bleed them dry and cover little or nothing) are themselves disposable human garbage. Market bases systems in health care say that people of modest means deserve to die or go bankrupt if they get seriously sick. They are despicable and should be flat out abolished. You should not have the right to choose worthlessness for other people.

One and the same COMPREHENSIVE plan for everyone! Of course, this would not preclude people with more money (or union negotiating clout) from buying all the extra bells and whistles they might want on their own dime or through 'boutique' private insurance. That happens in all other universal health care countries, and is analogous to Bill Gates buying an expensive alarm and sprinkler system that most of us could not afford. This doesn't matter, as long as everyone gets the same fire trucks in the event of fire.

[eomer]

7. It would make the choice of the public option available to everyone.

That's what's useful about it.

The public option won't be available to me, otherwise, because my employer provides a fairly good plan and I'm sure will continue to do so. But if Wyden's amendment succeeded I would be inclined to choose the public option.

If there is no public option then I don't care about Wyden's amendment.

[eridani]

8. That's precisely the problem with the proposed versions of the public option

It isn't available to enough people. Why not just let everyone who wants to enroll in Medicare?

[eomer]

11. You can't just let them -- you have to make them (enroll in Medicare).

If you leave it optional and you have no pre-existing condition exclusion then young, healthy people will all opt out and pay nothing. They will wait until they get a major illness and then will be able to opt in since there is nothing to stop them.

You can't let people wait until their houses burn down and then buy fire insurance and you can't let people wait until they get serious illnesses and then let them buy health insurance. You've got to have a way to make them pay when their houses are still standing and when their health is good, respectivley.

Medicare for everyone (not optional) is a great solution. Medicare for only those who choose it will fail because you can't let people wait until they've experience a major loss and expect that they will be able to pay for it -- by then it is too late.

[eridani]

12. But voluntary enrollment would create a demand for Medicare for All, no? n/t