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Tuesday, September 29, 2009
Health Reform Continues to Move Forward
By Lisa Kaplan Howe, NH Voices for Health
Federal health reform took an important step forward last week as the final Congressional committee of jurisdiction – the Senate Finance Committee (SFC) – began considering health reform legislation. Like the Senate HELP bill and the tri-committee House bill, the SFC bill makes critical reforms to our health care system – making coverage more accessible, affordable, stable and higher quality; driving efficiency, quality and equality in our health care system; and strengthening our health care workforce. Maybe most importantly of all, however, with this last piece of the puzzle falling into place, the legislative process can continue moving forward toward the ultimate goal – health reform this year.
When you dig into the bill, it’s clear that it’s a mixed bag. Like its HELP and House counterparts, the bill includes important consumer protections to make sure that health insurance coverage is affordable, stable, accessible, and provides access to needed health care. It also includes affordability credits for low and moderate-income individuals and small businesses. Given the high cost of health insurance in NH (the average family premiums in NH are upwards of 20% and more of income for those under 400% of the federal poverty level, the target population of the credits), affordability protections are critical. However, the affordability protections for individuals are not as strong as those in the other 2 bills and likely aren’t strong enough to make coverage affordable for everyone in the targeted population. The SFC bill also allows for premiums to vary by age up to 4 times (twice as much as the other 2 bills). This threatens to keep coverage out of the reach for NH’s older residents.
The bill includes “Exchanges” to help individuals and small businesses make apples to apples comparisons as they shop for insurance, but unlike the House and HELP bill, the SFC Exchanges would not include a public plan option. Instead it includes non-profit, member-run co-ops – plans that are likely not as well-positioned to compete with private insurers and drive affordability and innovation in the health care system.
Like the other bills, it includes a Medicaid expansion (with extra federal financing to support the expansion) and important reforms to make Medicare work better for enrollees and more sustainable. However, the bill phases out the Children’s Health Insurance Program (NH Healthy Kids Silver in NH) transitioning children to coverage through the Exchange. Healthy Kids Silver is an incredibly successful program – it is critical to make sure that CHIP is phased out, equivalent coverage is maintained for children.
All three bills are based on shared responsibility, but unlike the other two bills, the SFC bill does not have an employer “play or pay” requirement. Instead, it will require employers that don’t cover their employees and have employees that get affordability credits, to contribute toward those credits. This “free rider” provision raises concerns that it will encourage discrimination in hiring among employers trying to avoid a fee.
Finally, the bill includes a unique funding mechanism – based, in part, on a tax on insurers offering high cost plans. This raises two concerns – first that the tax will be passed on to consumers through premiums and second that, given the high cost coverage in NH (our state is at the top in rankings of the cost of insurance), the tax will unduly impact coverage in NH.
Though the Finance Committee bill certainly isn’t perfect, it’s important to keep things in perspective. Senator Baucus has already revised his proposed legislation to address many of these concerns. Though they have not been rectified in full, there are still many opportunities to make the bill stronger – through the committee mark-up process that continues, as the bill is rectified with the Senate HELP bill and as the ultimate Senate bill is rectified with the House bill. And, the fact that the bill is moving forward is good news for supporters of health reform. The bill expected out of committee as early as next week, leaving plenty of time a final legislative package to make it to the President’s desk by the end of the year. Health reform is certainly on track.
Tags: Citizens Health Initiative, health form legislation, Health Reform, Insurance Coverage, New Hampshire, Senator Baucus, Voices for Health
The healthcare insurance industry has an incredibly lucrative racket, and they don’t want anything messing it up. So, they’re doing everything they can to scuttle the idea of a public option.
Their lobbyists and propagandists have been working overtime to protect their interests. Make no mistake about it; they’re playing to win.
Their paid PR mules are spreading lies, calling names and making up facts — in short using every tool in the propagandist’s tool box to thwart any government involvement in healthcare. Even though the most successful social programs like Social Security, Medicare and the Veterans Administration are government run. And even though other countries have successful government-run healthcare.
As a diversionary measure, they’ve gotten their Congressional patsy, Max Baucus, to present a self-serving counter-proposal. The Baucus Plan was carefully structured by the insurance industry to guarantee them a multi-billion dollar windfall.
Here’s how it works. The government passes a law that the 40 million uninsured Americans must purchase health insurance. The law is added to the Internal Revenue Tax Code and calls for a $1900 “excise tax” if you don’t buy insurance. In other words, the IRS comes after you if you don’t pay, and it can attach your assets and put you in jail.
Under the pretense of solving the healthcare problem, Baucus’ plan uses the IRS to blackmail 40 million Americans into buying his benefactors’ insurance. It’s no different than any other organized crime protection racket.
Who will pay the price? The working poor who can least afford it.
Unless enough Americans see through this con and raise some hell with their Senators and Representatives, this legalized extortion could become part of the US Tax Code.
When will the government realize that people do not want these people to get involved with health care reform. Almost every federal program is mostly a fiscal wreck, and tax payers are eventually left holding the bag. If they can not get the job done that they had been chosen to try and do, they’re going to find in November that us residents tend to be fed up with their disappointments and can get rid of all of them.
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