Health Care Reform: Draft Proposal

Posted by Ezra Klein
The Washington Post
June 18, 2009
Senate Finance Committee
Excerpts
Benefit Options – Actuarial value
Bronze = 65%
Silver = 73%
Gold = 81%
Platinum = 90%
Tax credit for individuals and families
Up to 300% federal poverty level (FPL)
Medicaid
Children and pregnant women – up to 133% FPL
Parents and childless adults – up to 100% FPL
Individual requirement – fine for non-compliance
Exempt from fine if lowest premium exceeds 15% of income
Exempt from fine if below 100% poverty
http://www.washingtonpost.com/wp-srv/politics/documents/health_care_reform_draft_proposal_061809.pdf

The Senate Finance Committee members were informed by the Congressional Budget Office that the impact their preliminary reform proposal would have on the federal budget would be much greater than a bipartisan consensus would permit. Before moving further forward with the legislative process, the committee is considering changes to reduce the amount of funds that would have to be budgeted. The draft proposal cited above is not a definitive recommendation but merely presents ideas for discussion.
Nevertheless, the process should alarm us. The committee members continue to steadfastly refuse to look at financing options that would be effective in providing affordable health care for everyone. They begin with the insistence that reform be built on the obsolete infrastructure of private health plans, even though they have just proven once again that this archaic model no longer works.
Look what happens when they try to cram reform into this model. They expect an individual or a family with an income of 300% of the federal poverty level to pay 15% of their income for the premium alone, and for that they receive a plan that covers only 65% of the actuarial value of their health care services. They would require Americans to pay to private insurers a premium that they can’t afford, to purchase an underinsurance product that would fail to prevent financial hardship should they need health care, and to fine them should they fail to comply.
So they say, wait, this isn’t final. Let’s work with these numbers so that we can find products with adequate benefits and affordable premiums that do not further burden our federal budget with excess subsidies. As long as our legislators rely on an infrastructure of private health plans, that game will never end. Those numbers do not exist.
There is a way we can do it. We can establish separately a single, equitably-funded, universal risk pool which would be affordable for everyone. We could then use those funds in a much more efficient, single health care purchasing system that would ensure that everyone receives the care that they need.
But you’ve heard this before. And so have the members of Congress. Yet they continue to craft policies that impair the health care finances and health care access of far too many of us merely to ensure the viability of the obsolete, dysfunctional insurance industry. Talk about perverse priorities!
If you haven’t yet co-signed Sen. Bernie Sanders’ Petition to Congress, please do so now, and ask others to do so as well:
http://sanders.senate.gov/petitions/index.cfm?uid=7fd59f2e-88e1-477a-8eaf-762a5b050809

Posted by Ezra Klein
The Washington Post
June 18, 2009

Senate Finance Committee

Excerpts

Benefit Options – Actuarial value
Bronze = 65%
Silver = 73%
Gold = 81%
Platinum = 90%

Tax credit for individuals and families
Up to 300% federal poverty level (FPL)

Medicaid
Children and pregnant women – up to 133% FPL
Parents and childless adults – up to 100% FPL

Individual requirement – fine for non-compliance
Exempt from fine if lowest premium exceeds 15% of income
Exempt from fine if below 100% poverty

http://www.washingtonpost.com/wp-srv/politics/documents/health_care_reform_draft_proposal_061809.pdf

Comment:

By Don McCanne, MD

The Senate Finance Committee members were informed by the Congressional Budget Office that the impact their preliminary reform proposal would have on the federal budget would be much greater than a bipartisan consensus would permit. Before moving further forward with the legislative process, the committee is considering changes to reduce the amount of funds that would have to be budgeted. The draft proposal cited above is not a definitive recommendation but merely presents ideas for discussion.

Nevertheless, the process should alarm us. The committee members continue to steadfastly refuse to look at financing options that would be effective in providing affordable health care for everyone. They begin with the insistence that reform be built on the obsolete infrastructure of private health plans, even though they have just proven once again that this archaic model no longer works.

Look what happens when they try to cram reform into this model. They expect an individual or a family with an income of 300% of the federal poverty level to pay 15% of their income for the premium alone, and for that they receive a plan that covers only 65% of the actuarial value of their health care services. They would require Americans to pay to private insurers a premium that they can’t afford, to purchase an underinsurance product that would fail to prevent financial hardship should they need health care, and to fine them should they fail to comply.

So they say, wait, this isn’t final. Let’s work with these numbers so that we can find products with adequate benefits and affordable premiums that do not further burden our federal budget with excess subsidies. As long as our legislators rely on an infrastructure of private health plans, that game will never end. Those numbers do not exist.

There is a way we can do it. We can establish separately a single, equitably-funded, universal risk pool which would be affordable for everyone. We could then use those funds in a much more efficient, single health care purchasing system that would ensure that everyone receives the care that they need.

But you’ve heard this before. And so have the members of Congress. Yet they continue to craft policies that impair the health care finances and health care access of far too many of us merely to ensure the viability of the obsolete, dysfunctional insurance industry. Talk about perverse priorities!

If you haven’t yet co-signed Sen. Bernie Sanders’ Petition to Congress, please do so now, and ask others to do so as well:

http://sanders.senate.gov/petitions/index.cfm?uid=7fd59f2e-88e1-477a-8eaf-762a5b050809