I'm going to split my commentary on Max Baucus's policy paper (pdf) into two posts: The plan and the politics. First, the plan:Do not think of this as Max Baucus's health care plan. It isn't. Not yet. As of now, it's a policy paper, not a piece of legislation. It is the beginning of Max Baucus's attempt to create a health care reform process. What Baucus has offered is not the Max Baucus health care plan, but the generic Democratic health care plan. The place from which the policy process among congressional Democrats can start. It is extremely similar to the Obama plan if you added a mandate, and to the Clinton and Edwards plans if you left them untouched. If you liked those plans -- and most Democrats, eventually, did -- you like this one. It's as basic as that. The plan is really less a legislative document than a concrete articulation of what politically attuned Democrats currently understand to be the party's consensus of health reform, and this document is part of Baucus's bid to lead the resulting legislative process. It is not Baucus's final say on what the eventual product will look like.The principles are simple. This is a plan that builds on the current system. If you like what you have, nothing changes for you. The employer based system isn't merely preserved, it's actually strengthened. Small employers are subsidized to offer health insurance. Large and midsize employers have to offer health insurance or pay a percentage of payroll (undefined as of yet) into a public pool that subsidizes coverage for the uninsured. The plan sets up a Health Insurance Exchange -- similar to the exchange envisioned by Obama -- where the government would set up a market pitting regulated private and public insurance options against each other. The plan specifically says that individuals and small businesses could buy into the market. As for midsize and large businesses, more on that in a moment. Importantly, the Exchange is not the only space where insurers will find themselves subject to new regulation. "Under the Baucus plan, insurance companies could not deny coverage to any individual nor discriminate against individuals with pre-existing conditions...[this] would apply in the Exchange as well as the private non-group and small group markets." In other words, everywhere. An important addendum to the exchange is that while the Exchange is being set-up, Medicare is opened to anyone between 55 and 64 who doesn't have employer based health coverage. After that point, no new applicants in that age range are accepted, but those who bought into Medicare can stay in the program, or move to the Health Insurance Exchange. THE BAUCUS WHITE PAPER: THE PLAN.
I'm going to split my commentary on Max Baucus's policy paper (pdf) into two posts: The plan and the politics. First, the plan:Do not think of this as Max Baucus's health care plan. It isn't. Not yet. As of now, it's a policy paper, not a piece of legislation. It is the beginning of Max Baucus's attempt to create a health care reform process. What Baucus has offered is not the Max Baucus health care plan, but the generic Democratic health care plan. The place from which the policy process among congressional Democrats can start. It is extremely similar to the Obama plan if you added a mandate, and to the Clinton and Edwards plans if you left them untouched. If you liked those plans -- and most Democrats, eventually, did -- you like this one. It's as basic as that. The plan is really less a legislative document than a concrete articulation of what politically attuned Democrats currently understand to be the party's consensus of health reform, and this document is part of Baucus's bid to lead the resulting legislative process. It is not Baucus's final say on what the eventual product will look like.The principles are simple. This is a plan that builds on the current system. If you like what you have, nothing changes for you. The employer based system isn't merely preserved, it's actually strengthened. Small employers are subsidized to offer health insurance. Large and midsize employers have to offer health insurance or pay a percentage of payroll (undefined as of yet) into a public pool that subsidizes coverage for the uninsured. The plan sets up a Health Insurance Exchange -- similar to the exchange envisioned by Obama -- where the government would set up a market pitting regulated private and public insurance options against each other. The plan specifically says that individuals and small businesses could buy into the market. As for midsize and large businesses, more on that in a moment. Importantly, the Exchange is not the only space where insurers will find themselves subject to new regulation. "Under the Baucus plan, insurance companies could not deny coverage to any individual nor discriminate against individuals with pre-existing conditions...[this] would apply in the Exchange as well as the private non-group and small group markets." In other words, everywhere. An important addendum to the exchange is that while the Exchange is being set-up, Medicare is opened to anyone between 55 and 64 who doesn't have employer based health coverage. After that point, no new applicants in that age range are accepted, but those who bought into Medicare can stay in the program, or move to the Health Insurance Exchange. 
