What is it about the insurance industry that you feel I don't understand? I am particularly interested in the answer to this one.
What sweeping assertions do you feel I make that later prove to be totally incorrect?
About 85% of Americans currently have insurance coverage, either through their employer or purchased on their own. Their situation doesn't change.
Which is a huge problem.
The legislation assumes that the cost of insurance for this family will not exceed approximately $8,000 per year.
Which is a poor assumption.
If you make less than $88,000 a year, you're going to get a subsidy to help pay for that.
Here's what the Center on Budget and Policy Priorities - pretty much the gold standard for responsible economic-impact policy analysis - has to say about affordability:
Changes in Senate Health Bill Make Coverage More Affordable for Millions of Moderate-Income Families, Although not for Those on Low End of Subsidy ScaleAffordability
The bill strengthens affordability by improving the premium subsidies in the Senate Finance Committee bill for the millions of households with incomes between 154 percent and 400 percent of the poverty line — that is, between $28,200 and $73,240 for a family of three. Unfortunately, the new bill reduces the subsidies in the Finance Committee bill for near-poor households at the bottom of the subsidy range, which already were less than adequate. A family of three with income of $27,465 (150 percent of the poverty line) would have to pay $1,250 for premiums, or over $400 more than under the House bill. Many families with incomes this low already struggle to pay the rent and utilities and put food on the table and could have difficulty paying this much for health coverage. http://www.cbpp.org/cms/index.cfm?fa=view&id=3004And here:
Changes in Senate Health Bill Make Coverage More Affordable for Millions of Moderate-Income Families, Although not for Those on Low End of Subsidy Scale
What Low- and Moderate-income Households Would Pay for Premiums
Under the bill, families and individuals with incomes between 133 and 400 percent of the poverty line (between $24,350 and $73,240 for a family of three in 2009) would receive premium credits to help offset the cost of insurance premiums for coverage they purchase in the new health insurance exchanges. The amounts these households would have to pay for premiums would be based on a sliding scale, under which households’ premium contributions would be set at 4 percent of income for households at 134 percent of the poverty line and would rise to 9.8 percent of income for those at 300 percent of the poverty line. The maximum amount that households would be required to pay would remain at 9.8 percent of income for those with incomes between 300 and 400 percent of the poverty line.<1>
These premium charges are lower than those that the Senate Finance Committee bill would have set for households between 154 percent and 400 percent of the poverty line. Middle-income households in the 300 percent-to-400 percent-of-poverty range would receive the largest reductions; they would pay a maximum of 9.8 percent of income for coverage under the new bill, as compared to 12 percent of income under the Finance Committee bill. But the premium charges would be higher than under the Finance Committee bill for households at the bottom end of the subsidy range. (See Table 1.)
Compared to the premiums under the bill that the House passed November 7, households between about 250 percent and 400 percent of the poverty line would pay less under the new Senate bill. Households with incomes below 250 percent of the poverty line would pay more. Some of those at the bottom of the subsidy scale would pay at least twice the amount they would pay under the House bill.http://www.cbpp.org/cms/index.cfm?fa=view&id=3004Now, its important to note that the CBPP concludes that overall the bill is worth passing because in their view, the benefits to middle income earners are more important than the losses to low income earners. But I don't agree with that. My priorities are different.
Instead, I agree with the statement released by National Nurses United in explaining their reluctant opposition to this final Senate bill, which can be summarized as follows: the bill cedes too much to the insurance industry to be supported.
http://www.calnurses.org/media-center/in-the-news/2009/december/nation-s-largest-rn-organization-says-healthcare-bill-cedes-too-much-to-insurance-industry.htmlSpecificially:
1. The individual mandate forcing all those without coverage to buy private insurance, with insufficient cost controls on skyrocketing premiums and other insurance costs.
2. No challenge to insurance company monopolies, especially in the top 94 metropolitan areas where one or two companies dominate, severely limiting choice and competition.
3. An affordability mirage. Congressional Budget Office estimates say a family of four with a household income of $54,000 would be expected to pay 17 percent of their income, $9,000, on healthcare exposing too many families to grave financial risk.
4. The excise tax on comprehensive insurance plans which will encourage employers to reduce benefits, shift more costs to employees, promote proliferation of high-deductible plans, and lead to more self-rationing of care and medical bankruptcies, especially as more plans are subject to the tax every year due to the lack of adequate price controls. A Towers-Perrin survey in September found 30 percent of employers said they would reduce employment if their health costs go up, 86 percent said they’d pass the higher costs to their employees.
5. Major loopholes in the insurance reforms that promise bans on exclusion for pre-existing conditions, and no cancellations for sickness. The loopholes include:
* Provisions permitting insurers and companies to more than double charges to employees who fail “wellness” programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.
* Insurers are permitted to sell policies “across state lines”, exempting patient protections passed in other states. Insurers will thus set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states.
* Insurers can charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.
* Insurers may continue to rescind policies for “fraud or intentional misrepresentation” – the main pretext insurance companies now use to cancel coverage.
6. Minimal oversight on insurance denials of care; a report by the California Nurses Association/NNOC in September found that six of California’s largest insurers have rejected more than one-fifth of all claims since 2002.
7. Inadequate limits on drug prices, especially after Senate rejection of an amendment, to protect a White House deal with pharmaceutical giants, allowing pharmacies and wholesalers to import lower-cost drugs.
8. New burdens for our public safety net. With a shortage of primary care physicians and a continuing fiscal crisis at the state and local level, public hospitals and clinics will be a dumping ground for those the private system doesn’t want.
9. Reduced reproductive rights for women.
10. No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay. Nothing changes in basic structure of the system; healthcare remains a privilege, not a right.
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