December 8, 2009

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Congress dithers as healthcare reform looms. Check it out for yourself!

Congress dithers as healthcare reform looms. Check it out for yourself!

With Congress dithering on health care, there hasn’t been much to report. However, the healthcare debate is so complex—and so filled with lies, distortions, and half-truths—that it’s hard to keep track of what’s actually in the legislation and what’s not. So here’s a brief overview, with lots of links so you can read about it yourself.

Whatever you think of these weak, watered-down, pork-filled pieces of legislation (now you know what I think!), they are the starting points of the debate, and there’s still a chance of improving a few things.

What’s in the legislation

Overall, both the Senate and the House versions would do four major things:

  1. Create a Health Insurance Exchange—a one-stop marketplace where people could choose from among various insurance plans, including a (much watered-down) public option.1 The key is that it gives individuals bargaining power and clout.2
  2. Cover more than 30 million more people—give or take 5 million depending on whether you are looking at the House bill (36 million covered) or the Senate bill (31 million covered).3
  3. Outlaw current insurance-based exclusions based on preexisting conditions and gender. Insurance companies would not be able to deny coverage to people with preexisting conditions or to charge women more than men for the same coverage.4
  4. Eliminate coverage limits and price gouging. The bills differ in some details, but in general they place limits on how much people would have to pay for health care beyond their premiums. Both bills cap out-of-pocket costs and ban insurance companies from setting limits on how much health care would be covered per person each year.5

What’s out (at least for now)

  1. Both bills would leave millions uninsured. The House bill would leave 18 million uninsured, while the Senate bill would leave 24 million uninsured.6
  2. The Senate’s public option is even weaker than the House’s, and legislative horse-trading is likely to make it weaker yet. Without a public option, private insurance has no meaningful competition—and without competition, prices cannot be kept down. The House version creates a national public option; the Senate version lets states opt out.7
  3. Implementation would be delayed for 4 years. While some parts of a health reform bill would take effect immediately, the larger structural changes are not scheduled to go into effect until 2013 (House bill) or 2014 (Senate bill). This includes the Health Insurance Exchange, the public option, and subsidies—the major ways coverage will be expanded to more people.8
  4. The insurance mandates are still too expensive for many. Both bills would require virtually all Americans to have insurance, but the caps on how much the insurance would cost are way too high and the subsidies are way too low.9
  5. Access to abortion services is restricted in the House bill, which virtually prohibits anyone who purchases insurance in the Exchange from buying a plan that covers abortion—even when paying for it with one’s own money.10
  6. The Senate bill contains a version of what’s called the “free rider” provision, which would essentially penalize employers for hiring lower-income workers.11

The devil is in the details, so the backstairs arm-twisting will be beyond belief.

And now for my accountability: You can check out more about the House bill here and the Senate bill here or here. To learn about the impact of healthcare reform in your state, click here. If you want to read the full bills, click here for the House version; click here for the Senate version.

Sources:

1 A Health Insurance Exchange: The Fine Print. New York Times, August 20, 2009. http://www.moveon.org/r?r=85241&id=18172-2011066-NxA2pVx&t=3
Health Reform at a Glance: The Health Insurance Exchange. House Committees on Ways and Means, Energy and Commerce, and Education and Labor, July 14, 2009. http://www.moveon.org/r?r=85665&id=18172-2011066-NxA2pVx&t=4

2 Health Insurance Exchanges: The Most Important, Undernoticed Part of Health Reform. Washington Post, June 16, 2009. http://www.moveon.org/r?r=85664&id=18172-2011066-NxA2pVx&t=5

3 H.R. 3962; Affordable Health Care for America Act. Congressional Budget Office, November 20, 2009. http://cbo.gov/doc.cfm?index=10741
Patient Protection and Affordable Care Act, Congressional Budget Office, November 18, 2009. http://cbo.gov/doc.cfm?index=10731

4 Top 10 Ways Health Insurance Reform Works for You. Speaker of the House, October 29, 2009. http://www.moveon.org/r?r=85669&id=18172-2011066-NxA2pVx&t=6
How Health Insurance Reform Will Help Your Family. Senate Democratic Policy Committee. http://dpc.senate.gov/dpcdoc-responsiblereform.cfm
Meeting Women’s Health Care Needs. Speaker of the House. http://www.speaker.gov/newsroom/legislation?id=0327
Reports on Health Insurance Reform—Women. Senate Democratic Policy Committee. http://dpc.senate.gov/dpcdoc-responsiblereform.cfm

5 Top 10 Ways Health Insurance Reform Works for You. Speaker of the House, October 29, 2009. http://www.moveon.org/r?r=85669&id=18172-2011066-NxA2pVx&t=7
How Health Insurance Reform Will Help Your Family. Senate Democratic Policy Committee. http://dpc.senate.gov/dpcdoc-responsiblereform.cfm

6 H.R. 3962, Affordable Health Care for America Act. Congressional Budget Office, November 20, 2009. http://cbo.gov/doc.cfm?index=10741
Patient Protection and Affordable Care Act. Congressional Budget Office, November 18, 2009. http://cbo.gov/doc.cfm?index=10731
Report: How the Senate Bill Compares to Other Reform Legislation. Think Progress, November 19, 2009. http://www.moveon.org/r?r=85670&id=18172-2011066-NxA2pVx&t=8

7 Sen. Reid Announces “Opt Out” Public Plan. New York Times, October 26, 2009. http://www.moveon.org/r?r=85673&id=18172-2011066-NxA2pVx&t=9
Carper: Conservative Democrats Not Likely To Support Senate Public Option. Talking Points Memo, November 17, 2009. http://www.moveon.org/r?r=85675&id=18172-2011066-NxA2pVx&t=10

8 Top 14 Provisions That Take Effect Immediately. Speaker of the House. http://www.moveon.org/r?r=85676&id=18172-2011066-NxA2pVx&t=11
What happens before 2014? Washington Post, November 19, 2009 http://www.moveon.org/r?r=85677&id=18172-2011066-NxA2pVx&t=12
Senate, House Democratic health bills compared. Associated Press, November 18, 2009. http://www.moveon.org/r?r=85667&id=18172-2011066-NxA2pVx&t=13

9 Details of the New Merged Senate Bill. Think Progress, November 18, 2009. http://www.moveon.org/r?r=85668&id=18172-2011066-NxA2pVx&t=14
Report: How the Senate Bill Compares to Other Reform Legislation. Think Progress, November 19, 2009. http://www.moveon.org/r?r=85670&id=18172-2011066-NxA2pVx&t=15
Analysis: How the Senate health care bill stacks up with the House health care bill. Think Progress, November 19, 2009. http://thinkprogress.org/2009/11/19/senate-house-comparison/

10 The Ban on Abortion Coverage. New York Times, November 9, 2009. http://www.nytimes.com/2009/11/10/opinion/10tue1.html

11The noxious “free rider” provision,” Washington Post. November 25, 2009. http://www.moveon.org/r?r=85671&id=18172-2011066-NxA2pVx&t=16
Senate Health Bill Improves Employer Responsibility Provision. Center on Budget and Policy Priorities, November 19, 2009. http://www.cbpp.org/cms/index.cfm?fa=view&id=3003
The Baucus Bill: The Worst Policy in the Bill, and Possibly in the World. Washington Post, September 16, 2009. http://www.moveon.org/r?r=85672&id=18172-2011066-NxA2pVx&t=17

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