The Congressional Budget Office Scores Ted Kennedy's Bill And Finds Disappointing Numbers Alongside a Very Bad Idea
The Congressional Budget Office's preliminary analysis of Sen. Ted Kennedy's Affordable Health Choices Act is out. This is, remember, the liberal alternative to the Finance Committee's coming health reform bill. And it is, of course, still somewhat incomplete. But the basic stats aren't terribly encouraging: It'll cost $1 trillion over 10 years, which is less than some feared, but increase insurance coverage by only about 16 million people, which is a lot less than some hoped. The key bit of analysis comes here:
The proposal is assumed to require most legal residents to have insurance (though the draft language is not explicit in this regard). In general, the government would collect a payment from uninsured people, but individuals with income below 150 percent of the federal poverty level (FPL) would be exempt and the payment would be waived in certain other cases. The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) assumed that the annual payment amount, which would be set administratively, would be relatively small (about $100 per person).
In other words, there's an individual mandate, but not very much of one, and so it's not projected to get us all that much closer to full coverage. It's a trillion dollars to cut the ranks of the uninsured by about a third. That's a bit disappointing. Currently, however, the analysis doesn't include any expansion of Medicaid, the creation of a public plan, or the implementation of an employer mandate, because the Health, Education, Labor and Pensions Committee's draft legislation punted on those issues. As those policies get added into the mix, these numbers might well change.
But I'm quite concerned about another aspect of the bill: The legislation, as written, appears to cordon the health insurance exchanges off from people receiving employer-provided insurance. This means that if The Washington Post offers me health insurance, but I want to purchase my own plan on the health insurance exchange (which is where, among other options, the public plan would be), I'm barred from doing so. This is a bafflingly terrible idea, and directly contradicts a promise Barack Obama made in his speech to the American Medical Association this afternoon. “If you don’t like your health coverage or don’t have any insurance," he said, "you will have a chance to take part in what we’re calling a Health Insurance Exchange.”
That should be a key principle in health reform, and it's directly violated in the HELP Committee's draft. More worryingly, sources on the Hill say that the Finance Committee might be following HELP's lead on this. I'll be writing much more on this tomorrow.
(Photo of Sen. Kennedy by Chip Somodevilla)
June 15, 2009; 6:26 PM ET
Categories: Health Reform
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