The AP has an anonymously sourced report on the compromise health-reform legislation emerging out of the Senate Finance Committee. It isn't looking good. Some features of the bill:
- No government-funded public-insurance option, and no national health-insurance exchange. These features of the House tri-committee and Senate HELP bills are intended to bring down costs by fostering competition on the largest scale possible. Instead, Finance is suggesting regional health co-operatives in which private insurers compete without government intervention. This is likely to lower premiums somewhat, but the smaller size and geographic reach of the co-ops will make them far weaker than a national exchange. And no for-profit company is likely to offer a plan as inexpensive as national public insurance.
- An individual mandate to buy health insurance, but no employer mandate. This is regressive. Large employers that refuse to offer health coverage to their workers will have to reimburse the federal government for part of the cost of subsidizing those workers' coverage....
- BUT Finance also drastically reduces the number of people eligible for subsidies, to only those within 300 percent of poverty ($32,490 for an individual or $66,150 for a four-person family). Senate HELP subsidizes those within 500 percent of poverty and the House bill subsidizes those within 400 percent. Those plans are far more supportive of middle-class families and the self-employed.
- Like the House and HELP Committee, Finance would prevent insurers from denying coverage or charging higher premiums because of pre-existing conditions.
House moderates -- like the Blue Dogs -- are likely to grasp on hard to whatever the Finance Committee suggests and run with it, calling it the only politically viable compromise. That's why Finance's proposal is so important. We don't know yet whether Finance, like the House and HELP, will aggressively expand Medicaid coverage. But probably the most worrying aspect of this compromise is how drastically it weakens competition, by asking insurance companies to compete only on a regional basis, and only with one another. This is a plan that leaves employers and insurers in the power seats, while giving consumers far less support than either of the other reform proposals on the table.
--Dana Goldstein
