President Barack Obama delivers remarks on the health care system at the annual meeting of the American Medical Association in Chicago, Illinois, June 15, 2009.
(Jonathan Ernst/Reuters)Photos (1 of 1)
House Democrats unveil healthcare plan - but what will it cost?
Price will be a major factor in winning bipartisan support, and the public insurance option could be a sticking point too.
By Gail Russell Chaddock | Staff writer/ June 19, 2009 edition
Washington
House Democrats on Friday unveiled their draft plan to ensure “quality affordable healthcare” for all Americans — but without the politically critical price tag.
The plan relies on a new Health Insurance Exchange, including insurance reforms, consumer protections, and a public health insurance option. At the heart of the draft proposal are two key mandates:
• Individuals must obtain insurance coverage — or pay a penalty based on 2 percent of adjusted gross income, with exceptions for hardship.
• Employers must provide health insurance for their workers — or pay a fee based on 8 percent of their payroll, with exemptions for “certain small businesses.”
In a statement, President Obama dubbed the House healthcare reform proposal “a major step toward our goal of fixing what is broken about healthcare while building on what works.”
CREDITS FOR LOW-INCOME FAMILIES AND SMALL BUSINESSES
To broaden access to healthcare, the plan proposes credits for low- and moderate-income individuals and families on a sliding scale: Credits begin just above the proposed new Medicaid eligibility levels and gradually phase out at 400 percent of the federal poverty level ($43,000 for an individual or $88,000 for a family of four).
Small businesses that “want to provide health coverage to their workers but cannot afford it today” will be eligible for a new small business tax credit.
At the same time, the plan sets up consumer protections for all new policies. It caps annual out-of-pocket spending to prevent bankruptcies from medical expenses and bars discrimination based on an individual’s health status, including preexisting health conditions.
In what is likely to be one of the most expensive elements of the plan, it also proposes expanding Medicare and Medicaid benefits, while also ensuring their long-term solvency. Individuals and families with incomes below 133 percent of the federal poverty level will be eligible for expanded Medicaid benefits — all to be fully federally funded. The House plan also fixes unpopular elements of the Medicare plan, increasing reimbursement rates for doctors and eliminating cost-sharing for preventive services.
BUDGET BEAN-COUNTERS HAVE YET TO WEIGH IN
But none of this plan has yet been scored by the Congressional Budget Office. A CBO estimate seen as prohibitively high was a showstopper for the Clinton health plan in 1994.
This week’s CBO scoring of a healthcare reform plan by the Senate Health, Education, Labor and Pensions Committee — the first of two Senate plans in the works — estimated that the plan would add $1 trillion to the federal deficit over the next 10 years, but only reduce the ranks of the nation’s 45 million uninsured by 15 million.
That score prompted the Senate Finance Committee to postpone the release and markup of its proposed health plan until July. The panel aims to ratchet down costs to a level that could win support in the Senate.
The Senate Finance Committee is “the last best hope for reality in this debate,” says Bruce Josten, the top lobbyist for the US Chamber of Commerce, which opposes a public health insurance option and employer mandates.
REPUBLICANS ARE CRITICAL
House Republicans, who said that they had not been included in the tri-committee discussions, slammed the proposal.
“This plan is nothing less than a government takeover of healthcare, and families and small businesses who are already footing the bill for Washington’s reckless spending binge will not support it,” said House Republican leader John Boehner, in a statement.
House Speaker Nancy Pelosi called the plan “a critical step forward in meeting our commitment to the American people for quality affordable healthcare.”
Hearings on the tri-committee proposal are expected to begin next week. “We seek further comment from the public and our colleagues,” said Rep. Henry Waxman (D) of California, who chairs the House Energy and Commerce Committee.
Leaders of the House Education and Labor Committee and Ways and Means Committee also worked on the health reform draft.
Comments
2. John W. Fort Wayne, IN USA | 06.19.09
When will people learn! Anything that congress creates will not be practical once implemented. And as hard it is to be implemented, it will be even harder to stop.
3. Mike R. | 06.19.09
This is absolute insanity. The children are steering the ship onto the reef.
Sure, let’s destroy the best medical system in the world that everyone comes here for. Let’s go to Canada and UK style waiting lists for lifesaving critical procedures! Let’s do everything with the ease of the IRS and the speed of your local DMV office. Let’s let the same people who let medicare go bankrupt handle this.
Insanity
4. Terence Conklin | 06.20.09
The idea that government, especially federal government, should try to mandate citizens to buy any product including insurance is ridiculous and illegal. It goes to demonstrate the Health Care Indu$try’s grip on our “leader$”. The Health care providers and insurers are analogous to a nightmare scenario wherein private parties have come to own our lakes, rivers and other sources of water and overcharge us for drinking water. It is time for government (and I mean local and State government) to step in and provide health services on a non profit basis. We must invest in education, clinics, equipment and other infrastructure. Then we can break the back of health for profit entities. In a nonprofit health system with low costs, insurance would be reduced to an afterthought-product to protect against the (unlikely) huge medical issues.
5. Les Norman | 06.20.09
This talk about price is a complete red herring. Everyone gets healthcare these days. They may get it too late at the E.R. (which is a scandal) but they get it. So we (the nation) already pay for it. The price issue is about where the money comes from. The proposed plan may indeed add cost out of the public (government) purse, but it will mean reduced cost from the public (citizens’) purse. Let’s compare apples to apples.
6. hsr0601 | 06.20.09
I suppose some common sense and cool head can solve this cost problem.
As we know, the public option currently being discussed is modeled after Massachusetts Plan, under which about 97% of all Massachusetts residents are now covered.
According to the approach of CBO, its rate of the uninsured in Massachusetts should be far greater than the present one at the moment.
Moreover, in case the strong public option, medical IT, increased efforts in prevention, and a broader array of cost-saving plans and beyond add to the Massachusetts Plan, the cost containment does not matter at all. And most importantly, the promising stem cell research is making its way.
To date, private insurers have coexisted profitably with Medicare and Medicaid for many years.
Basically, healthy society leads to better productivity and better performance.
7. Allan | 06.21.09
My sister died in 1992 because when she had a heart problem she did not have health insurance, and I have supported providing free universal health insurance for all Americans for decades, but President Obama’s latest proposal – and that of the House Democrats — would require Americans who can’t afford health insurance to pay to get either private insurance or the government insurance. The reason 47 million Americans don’t have health insurance is that they can’t afford it. Their employers don’t provide it, they don’t currently qualify for government provided insurance, and they don’t make enough money to be able to pay for it. There is some discussion about the government helping some Americans to pay for health insurance, but most of the 47 million Americans without it would not qualify for such assistance or would only qualify for a partial, inadequate subsidy. Americans who can’t pay for the insurance proposed by the president and House Democrats would be fined on their income taxes — and then they would still not have health insurance. This is outrageous and will never work. We need free, universal health insurance for all our citizens, as is provided by every developed nation on the planet except our own.
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1. Skyview | 06.19.09
The only way to obtain healthcare for all Americans is reform with a public option. Anything less will result in only a band-aid effect on the problem. Healthcare should not be about profit; it should be about treatment. The insurance industry is concerned only about profits and not about the well-being of the American People.