* Eliminate coverage limits and price-gouging. The bills differ on some
details, but in general would place limits on how much people have to
pay for health care beyond their premiums. They both cap out-of-pocket
costs and ban insurance companies from setting limits on how much
health care they'll cover for a person each year.
Of course, the devil is in the details, and much in these bills still
needs work.
Here's what still needs to be fixed:
* Both bills leave millions uninsured. The House bill leaves 18 million
without insurance in 2019; the Senate bill, 24 million. Neither comes
close to the vision for universal coverage so many of us fought for
for years. We'll all need to fight to continue to expand coverage in
the bills this year, and in the years to come.
* The Senate public option is weak, and conservatives are pushing to
make it weaker. The public option is a core piece of reform that will
create real accountability and competition for private insurance--and
that's why it's at the center of such a huge fight. While the House
bill creates a national public option, the Senate lets states opt out,
denying their residents access to it. Plus, conservatives are working
to weaken it even more. We're all going to have to fight hard for the
strongest version possible.
* Many reforms don't start quickly enough. While some pieces of reform
go into effect right away, the larger structural changes are not
scheduled to go into effect until 2013 (House bill) or 2014 (Senate
bill). This includes the Exchange, the public option, and
subsidies--the major ways coverage will be expanded.
* Required insurance could still be too expensive for many. Both bills
require virtually all Americans to have insurance. But the caps on how
much we're expected to pay are way too high, and the subsidies are way
too low. Many progressives are working to fix this, but it's going to
be a significant fight.
* Reproductive rights are severely restricted in the House bill. An
egregious anti-choice amendment in the bill virtually prohibits anyone
purchasing insurance in the Exchange from buying a plan that covers
abortion--even if paid for with their own money. We need to make sure
the final bill doesn't include this rollback of reproductive
rights.
* The Senate bill could discriminate against lower income workers. The
current Senate legislation retains a version of what's called the
"free rider" provision, which essentially penalizes employers for
hiring lower income workers. This provision needs to be fixed before
the bill is finalized.
There's a lot going on in these bills, and we're all going to need to be
vigilant to ensure the good pieces end up in the final bill, and the bad
ones are fixed. It's going to be a rocky ride. But if we fight together,
we'll come out stronger in the end... ++
Public option likely to be removed from healthcare overhaul
John Byrne, Raw Story
Monday, December 7th, 2009
Chances for a so-called "public option" -- under which the government would set up competitors to private health insurers -- appear to be dimming.
With recent hard-edged comments by Sen. Joe Lieberman (I-CT), who avers that he will vote to filibuster any bill that contains a public-run health insurer, moderates have been meeting to hammer out a deal. And a new alternative, according to Politico, has emerged.
Under the Democrats' new plan, the government would create a national health insurance plan similar to those offered federal employees. It would replace the so-called "opt-out" version of the public option advocated by Sen. Majority Leader Harry Reid (D-NV).
“Seems to me it would be in lieu of the public option,” Sen. Bill Nelson (D-FL) -- a public option opponent and former insurance executive -- is quoted as saying. He added that Reid’s “opt-out” idea “is no longer being talked about.”
The plan would be run by the Office of Personnel Management, which currently manages the federal plan offered to members of Congress. All of the insurance plans would be offered by not-for-profit private healthcare companies.
A Democratic aide quoted by Politico suggested that the new proposal could be used to sway progressives, who might be "tricked" into believing that a government plan run by private companies was a public option.
“The proposal under consideration can be said to provide access to the same type of insurance plans that members of Congress and federal employees get. People think of that as government health insurance; progressives could portray this in the same vein,” a Democratic Senate aide was quoted as saying. “But moderates can simultaneously point to the fact that the government isn’t the payer and say competition was enhanced without growing the government.”
Even so, the opt-out public option probably wouldn't have been a public option after all, even though it would have been more damaging to insurance company's bottom lines. In October, the Washington Post reported that the public option was likely to be managed by private insurers.
"The public option would effectively be just another insurance plan offered on the open market," the paper said. "It would likely be administered by a private insurance provider, charging premiums and copayments like any other policy.
In an early estimate of the House bill, the Congressional Budget Office forecast that fewer than 12 million people would buy insurance through the government plan." ++
AFL-CIO Makes Biggest Push Yet To Kill Portions Of Senate Health Care Bill
HuffPo
As the debate over health care reform enters its final weeks, the AFL-CIO is launching its largest lobbying effort to date, dispatching 175 labor leaders to Capitol Hill and pouring $1.5 million into a new ad campaign to fight key aspects of the Senate's legislation.
In what an aide is calling "the largest fly-in we have done since the health care campaign began," the union conglomerate is blitzing both House and Senate offices this week, demanding a public option for insurance coverage, a requirement that employers cover insurance for their workers and a pay-for system that does not rely on taxing high-end health care benefits. The Senate seems poised to oppose the AFL-CIO on all three of these fronts -- setting up, what will likely be, an intense set of negotiations with the House should the legislation come to conference committee.
The targets of the AFL-CIO's newest effort include lawmakers from at least 16 states, an aide says. Labor leaders will be flying in from Arkansas, Connecticut, Delaware, Indiana, North Carolina, North Dakota, Virginia, Maryland, Florida, Missouri, California, Nevada, Maryland, Nebraska, Texas and Virginia.
"There's the straight-up policy angle that we believe the House version is better public policy, to have the very rich pay instead of working families," said Eddie Vale, spokesman for the AFL-CIO. "But we will also be making the political argument. Democrats campaigned during the election saying, 'We're going to protect workers from having their benefits taxed.' If they don't come through on their campaign promises, [that] is going to depress their base and hurt them in 2010."
In addition to the in-office visits, the AFL-CIO, which has been one of the most forceful progressive players in the health care debate, is also taking to the airwaves. The group is putting $1.5 million behind a new television ad campaign. The spot, which is airing both nationally and in Delaware, Indiana, North Dakota and Virginia, goes after the Senate for "taxing worker's health care benefits."
[open link to] Watch the ad: ++
Yes We Should
digby, Hullabaloo
From a personal perspective, this would be a godsend:
Senate Democrats are discussing the idea of expanding Medicare by lowering the age at which the elderly could enter the government-run insurance program, Democratic sources on the Hill tell the Huffington Post.
The proposal would lower the age of eligibility for Medicare from 65 to 55, though an age limit of 60 has also been suggested. Crucial details -- such as the timing of the implementation of such a reform -- were not provided due to the sensitivity and ongoing nature of the deliberations. A high-ranking Democratic source off the Hill confirmed that such discussions are taking place.
The huge group of baby boomers in my age group (the second wave) are facing an unbelievable squeeze and the latest versions of the public option aren't going to help us much, especially in high cost states, unless we are really doing badly financially. I ran the numbers for myself and the reforms will probably end up costing me more, although my coverage will hopefully be better. Allowing me to buy into Medicare at 55 would be a huge relief.
As a good progressive I'm not basing my support for the public option on my own personal situation. But I do worry about the political ramifications with respect to this huge demographic between 50 and 65 that's likely to have very mixed results in this health care reform just as they are dealing with aging parents, college aged kids, lower pensions, loss of housing equity, insecure employment and deteriorating health. If they are nervous about health care reform it's going to cost the Democrats. The seniors are already falling away.
This would go a long way to alleviating their concerns. ++
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~ Barack Obama
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