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House Proposal on Health Care Prompts Question of Affordability

By Ceci Connolly
House Democratic leaders are circulating a brief overview of their plans for reforming the U.S. health system that would tighten payments on insurers that sell Medicare-managed plans, increase reimbursements to primary care doctors and cap total out-of-pocket spending on all health policies to prevent personal bankruptcies due to medical bills.

Similar in philosophical approach to legislation drafted by aides to Sen. Edward M. Kennedy (D-Mass.), the House proposal calls for placing new requirements on both individuals and employers and the creation of a new government-run insurance program that could compete against private firms.

The overview, which will be discussed in a House Democratic caucus today, has few numbers and no real explanation of how Congress would pay for an ambitious extension of health benefits to as many as 46 million people.

The government’s Medicaid program for the poor would be expanded, according to the document, though it does not specify to what level. It does however propose giving subsidies for purchasing coverage to people earning up to 400 percent of the federal poverty level, or about $22,000 for an individual and $88,000 for a family of four.

In anticipation of likely criticism that the figure is too generous, the document attached an explanation: “NOTE: The average cost of family coverage today is 14 percent of a family’s income at 400 percent of poverty.”

The approach outlined in the brief summary envisions a new “Health Insurance Exchange” along the lines of a concept introduced by President Obama during the presidential campaign. It would “create a transparent marketplace for individuals and small employers to comparison shop,” according to the document.

Under the slogan of “shared responsibility,” House Democratic leaders argue that individuals must be required to own health insurance and the vast majority of employers must contribute to that cost. The so-called individual and employer mandates have been met with mixed views among industry groups and Republicans. The approach has been somewhat successful in insuring many more people in Massachusetts.

Three House committees are working on the health legislation—Energy and Commerce, Ways and Means and Education and Labor. The “Tri-Comm,” as it is known on the Hill, offers little information about its ideas for a new public insurance option, arguing only that it will “compete on a level field with private insurers in the exchange.”

By Washington Post editors  |  June 9, 2009; 9:34 AM ET
Categories:  Daily Dose  
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Next: Senate Health Committee Releases Reform Bill

Comments

How can we posssibly be talking about the "affordiblility" of hmnan being's lives? We need to be able to defend ourselves as a country. If we didn't spend another dime on the armed forces beyond keeping the nuclear triad going (or even two prongs) then the US would remain "invincible" from attack by another major power as we have been since the invention of the nuke by MAD. We waste so much money at DOD that it's beyond human comprehension. Depending on how you define "defense" between 25% and 53% of the US Budget each year goes to DOD and we already spend way more than the rest of the entire world combined. We need Universal Health Care Now! American Kids are Dying! Thats unaceptable. Its got to stop. Now. That's the "line in the sand" we should have drawn years and years ago. We should never have surrendered in the "War on Cancer" If we hadn't taken our eye off the ball we would have cured cancer years ago.

Posted by: UniversalHealthCareNow | June 9, 2009 11:33 AM | Report abuse

How can we spend Trillions of Dollars on a war for Bush's ego and Republican Oil money in Iraq and then talk about the "affordability" of Universal Health Care where the worst estimates of its cost are less than the damm war in Iraq????

Posted by: UniversalHealthCareNow | June 9, 2009 11:35 AM | Report abuse

The 2009 Poverty Guidelines for the 48 Contiguous States and the District of Columbia 1 person- $10,830 4 persons- $22,050 http://aspe.hhs.gov/poverty/09poverty.shtml 400% of those figures would be $43,320 for one and $88,200 for a family of four.

Posted by: jskdn | June 9, 2009 11:42 AM | Report abuse

I thought Bush was out of office? Did I miss something? Let us have an intelligent dialog of the issues and not all this rhetoric.

Posted by: swahealy2 | June 9, 2009 12:31 PM | Report abuse

In Massachusetts, which also has subsidized plans available for those up to 400% poverty level (i.e., about $44,000), the least expensive non-subsidized plan available costs about $11,000 per year for two people age 60. Let's say you are making $45,000 per year (just over the cutoff for the subsidized plan), and assume you are "taking home" about $36,000. Paying $11,000 for plan is almost 30% of your income. Add in the deductible for that plan ($1,350 per person), and your total out of pocket expense before you even begin to receive a benefit is approaching 40% of take home. No wonder Massachusetts, even though it has "mandated" health care, allows a couple making between $44,000 and $82,000 to "waive" the requirement without penalty because the cost of insuring themselves is considered too expensive for their income.

Posted by: jojoma_ananda | June 9, 2009 12:43 PM | Report abuse

Its simply astounding that Republicans are trying to block 48 Million Americans from having access to decent health care. Which party do you guess those 48 Million Americans are going to vote for in the next election, especially if Republicans completely or partially block health care reform? Republicans are dumb. They keep on pissing off more and more of America. Right now they're at roughly 20% of American voters. After fighting tooth and nail to block health care reform, they'll be down to 2%. It couldn't happen to a more deserving group of folks.

Posted by: UniversalHealthCareNow | June 9, 2009 1:56 PM | Report abuse

Universal health care, hopefully through a single payer public option, will become a reality. Unfortunately, the Senate's centrist democrats and conservative republicans opt to defend, in some manner, the continuation of the current health care insurance business regardless of their run away costs. To complicate the reformation effort, private carriers have consistently been abundantly generous with a % of their ever increasing premium costs, to powerful politicians campaign funds. $10's of millions can certainly cause any politician's ego-driven desire to remain in power to look generously at the private insurers "compromise" over that of a citizen driven single payer option. One needs only to view the outrageously difficult effort it took to simply get the single payer option plan included in the discussion, as an indicator of the power that money has in this argument. The financing of a single payer plan should include taxing corporation, businesses and other income earners as part of the overall funding. Given the current volatile cost of private healthcare insurance plans for their employees it seems to me a single payer plan would be a win-win situation. A single-payer plan would immensely decrease the overhead costs of the many administrative agencies each private plan employs. This reduction in cost would be further enhanced by the single payer plans ability to negotiate pharmacy costs. These two endeavors alone would dramatically decrease the cost that our current health care system has on the economy. Yet, it looks like the issue of "privitization" has far more influence than does "fiduciary utilization" in this process. Long has the economic conservatives rallied around the position that private business is more efficient, more effective by reasons of competition and provides a better product for the $$ than does any government program. Why now are they crying that it would be unfair to their private business if the government issues a public plan option? Eating their own words they concede that such a plan would be far more cost effective and would offer greater benefits to the insured and health care providers, than they currently provide. Is this the reason private insurance carriers focus more on destroying a public option plan rather than demonstrating any need for reformation with their business? Lets hope Congress and the Senate have the moral courage to stand up for we citizens and provide a single payer public option plan for anyone, including business, who may open enroll without qualification.

Posted by: wtmbilly | June 9, 2009 2:08 PM | Report abuse

Sign these petitions for single payer universal health care http://BIT.LY/single_payer_baucus http://BIT.LY/single_payer

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Posted by: DEMOCRATZoORG | June 9, 2009 4:58 PM | Report abuse

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