Max Baucus released his Senate Finance Committee health reform plan today, and there are no huge surprises. As Ezra writes, low subsidies and high premiums mean health care costs will continue to cause personal bankruptcy for many unlucky Americans. The better news is that Baucus expands the health insurance exchanges to large employers; in the House bill, only small companies can participate in the exchanges. And of course, the expansion of Medicaid to childless adults is a major progressive victory.
Abortion and immigration are two issues that divided the bipartisan Gang of Six until the bitter end, so I took a close look at where Baucus came down. On abortion, his mark-up is clear: The basic health care package he envisions does not cover most abortions:
Federal funds continue to be prohibited from being used to pay for abortions unless the pregnancy is due to rape, incest, or if the life of the mother is in danger.
Private insurance companies can choose to offer plans that provide additional, elective abortion coverage -- as 87 percent of employer-provided plans already do -- but they must "segregate" public funds from paying for the procedure. This means that if an insurer wants to cover abortion, it must create a special fund to do so, made up of money garnished from premimums and co-pays. Government-provided affordability credits will not be able to contribute toward the cost of abortions. This is a bureaucratic headache for insurers, and it certainly has the potential to dissuade abortion coverage. The House bill continues to be much more progressive on reproductive health, as it sets up a public plan that would most likely include abortion as part of primary care.
On immigration, Baucus requires a confirmation of legal status before receiving health care subsidies, through a check of Social Security numbers. He also denies affordability credits to anyone whose legal resident status is set to expire in less than a year, which seems unjust -- especially if future immigration reform provides more paths toward legality.
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