Campaigne for America’s Future
Progressive Breakfast:
By Bill Scher
July 15, 2009 – 10:19am ET
Cost-Saving Public Plan In House Bill
The Hill on timing for legislation: “Three House committees will begin marking up their legislation before the end of the week, setting up what would be a historic vote on President Obama’s signature domestic issue in just over two weeks. In the Senate, the Health, Education, Labor and Pensions (HELP) Committee was poised to complete its four-week-long markup of its portion of the upper chamber’s bill Tuesday evening. Meanwhile, the Finance Committee would begin its markup as soon as next week.”
Change.org’s Tim Foley assesses the House health care bill: “What’s striking is that the major controversial pieces in the bill haven’t been watered down in the face of opposition. They didn’t need to be. It still has a public health insurance option that’s more robust than the version in the Senate HELP committee, in that it would start off with Medicare rates for doctors and hospitals (although it would modify those rates upwards if the doctor took both Medicare and the public plan) before shifting over time to negotiating with providers like any health insurance plan. Far from adding to the cost of health care reform, that more robust public plan is a cost-saver, generating a surplus of $150 billion over ten years. Those who complain that the public plan will ‘crowd out’ private insurance no longer have the numbers to back it up – the CBO projects even this robust public plan will only enroll 11 to 12 million people. That’s a frustrating low number for those of us who think the public plan will truly be a better deal. But if it helps diffuse the ‘fast march to socialism’ meme, I’m all for it.
Wonk Room’s Igor Volsky notes public plan found not to decimate private insurance: “the CBO coverage tables undermine the conservative claim that a public option would eliminate private insurance and erode employer-sponsored coverage. The House bill actually increases the number of people who receive coverage through their employer by 2 million (in 2019) and shifts most of the uninsured into private coverage. By 2019, 30 million individuals would also purchase coverage from the Exchange, but only 9-10 million Americans (or approximately 1/3) would enroll in the public option, the rest would enroll in private coverage.”
Jonathan Cohn praises, but cautions about timeframe: ‘It will be a while before people see the best stuff. Most of the major elements–the insurance exchange, the subsidies, the insurance regulations, the public plan–won’t come online until 2013 or later. This is, I believe, also true of counterpart bills in the Senate. There’s a sound policy rationale for going slow; it takes a lot of work to set up exchanges, regulations, and the like. But four years is a long time. And I suspect money has a lot to do with the pace. Slower implementation makes it possible to keep the price tag to around $1 trillion. On the bright side, some provisions–filling in the Medicare drug donut hole, bolsteirng the primary care workforce, among others–would start in the next two years. And at least one key insurer regulation would kick in right away: Come 2010, insurers could no longer yank coverage from people retroactively because they’ve uncovered new evidence of pre-existing conditions. This practice, known as “rescission,” is among the most patently unjust features of our health care system.”
Bloomberg explains the surtax on the wealthiest: “[It] would be imposed based on adjusted gross income, meaning it would also apply to capital gains and dividends, which are currently taxed at a 15 percent rate.”
Senators still protecting millionaires from higher taxes. W. Post: “‘Tax is a four-letter word’ with voters, said Sen. Ben Nelson (D-Neb.). Even families not ranking in the top 1 percent of earners ‘hope they’re going to be there someday,’ he said. ‘So they don’t necessarily think it’s fair.’ Senate negotiators have all but abandoned plans to directly tax the wealthy and are focusing instead on an array of smaller, more narrowly targeted revenue measures that would raise money from drug and insurance companies, as well as individuals and corporations. A tax on employer-provided health benefits remains part of that discussion, but Sen. Kent Conrad (D-N.D.), who is promoting a tax on the most generous 1 percent of private plans, conceded yesterday that such a proposal is ‘a very tough sell.’”
USA Today reminds some of the “cost” is to help small biz “buy coverage for their workers.”
Politico on Big Pharma fight: “[Waxman] refused to strip a provision that reinstates price controls on drugs purchased by seniors who qualify for both Medicare and Medicaid, despite the pleas of more than 60 fellow Democrats. Those rebates will cost drug companies more than $50 billion, and they’ll lobby fiercely against them.”
Blue Dogs may be assuaged with PAYGO. CQ: “Members of the House Blue Dog Coalition may have some concerns with the health care overhaul bill unveiled Tuesday, but when it comes to the floor, the legislation could contain one of their top priorities: language putting the pay-as-you-go rule into law. No decision has been made on whether to combine the two issues, but House Majority Leader Steny H. Hoyer, D-Md., said it is an option being discussed.”
The Walker Report: “Overall, I’m fairly happy with the structure of the public option but unhappy with the restrictions on who can sign up for it. Expanding access to the pubic option should be an easier political fight than changing its structure. If I had to choose, I would select a well structured public plan restricted to a few, over a poorly designed public option open to all.”
GoozNews laments weak funding for comparative effectiveness: “…significantly less than the $1.1 billion in the stimulus act (that’s over 18 months) and less than the $4-5 billion-per-year program some analysts were hoping for.”
Joe Paduda predicts: “the horse trading is about to ramp up to fever pitch; if stakeholders start believing reform may actually pass, they are going to renew their efforts to be ‘part of the solution’, also known as ‘do it to yourself before Congress does it to you’.”
Bloomberg: “President Barack Obama may rely only on Democrats to push health-care legislation through the U.S. Congress if Republican resistance doesn’t eventually give way, two of the president’s top advisers said.”
DNC running ads to pressure wavering Dems. CNN: “President Obama’s political operation will begin running television ads Wednesday targeting fellow Democrats and centrist Republicans urging them to support the president’s call for health care reform this year. The 30-second TV commercial will run in eight states: Arkansas, Indiana, Florida, Louisiana, Maine, North Dakota, Nebraska, and Ohio for two weeks, according to a preview of the ad provided to CNN by Obama’s Organizing for America (OFA).”
