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November 19, 2009
THE REID BILL.... As promised, Senate Majority Leader Harry Reid (D-Nev.) unveiled the Senate's health care reform bill late yesterday afternoon, presenting it first to an impressed Democratic caucus, and then to the media. As far as the politics of the rollout are concerned, Reid has to be thrilled.
OK, so what's in it? Let's briefly review some of the key elements: Cost and deficit reduction: The Senate bill carries a price tag of $848 billion over 10 years, well below the arbitrary White House limit of $900 billion and less than the House version. The CBO estimates that the legislation will cut the federal budget deficit by $130 billion in the first decade, and a hard-to-believe $650 billion in the second decade. Timing of implementation: To make the bill more affordable, the effective date of the Senate reform package would be 2014, a year later than the House bill. Financing: To pay for reform, Reid's plan would impose an excise tax on the so-called "Cadillac" plans (insurance packages worth more than $23,000). There would now also be a 5% tax on elective cosmetic surgery (which would exclude procedures on those with congenital abnormalities, disfiguring diseases, or traumatic injuries). Reid also proposes a 0.5% increase to the Medicare payroll tax for families earning more than $250,000. Subsidies: Medicaid would be expanded to 133% of the poverty line, and subsidies would help those making up to 300% of the poverty line -- which is short of the 400% threshold that many progressive reform advocates had hoped for. Instead, Reid would impose regulations on insurers to cap expenses for those between 300% and 400% of the poverty line. Coverage: The bill would extend coverage to 31 million uninsured Americans, bringing insurance to 94% of the population. About a third of those left out would be undocumented immigrants. Public Option: As expected, Reid went with a national public-option plan, which states could pass laws to opt out of. Abortion: Reid steered clear of the Stupak amendment language, but would separate abortions paid for through premiums and taxpayer subsidies. The provision is a little complicated, but to make a long story short, Sen. Barbara Boxer (D-Calif.) loves what Reid came up with, and the U.S. Conference of Catholic Bishops is livid. Mandates: There's an individual mandate, but the penalties are fairly weak. There is no formal employer mandate, but there are some modest fines imposed on larger employers who fail to cover their workers. Anti-trust: Buckling to demands from Sen. Ben Nelson (D-Neb.), the Senate bill does not end anti-trust exemptions for the insurance industry. For a caucus that's been at odds with itself for quite a while, Senate Dems left their meeting smiling. Sen. John Kerry (D-Mass.) said, "We're going to pass this legislation." On the other side of the aisle, Sen. Orrin Hatch (R-Utah) vowed, "It's going to be a holy war." —Steve Benen 8:00 AM Permalink | Trackbacks | Comments (27)
Comments
The real question now is when will Reid pre-emptively cave to right-wing demands that haven't even been made yet. I'm sure the lack of a Stupak amendment was just an oversight. And the bill seems to be missing direct taxpayer subsidies to the poor downtrodden insurance companies. Posted by: Domage on November 19, 2009 at 8:05 AM | PERMALINKGood for Reid. Orrin Hatch should recognize his own irrelevancy. Posted by: glutz78 on November 19, 2009 at 8:08 AM | PERMALINKa holy war hatch must think that the health care industry as well as corporate America is doing GOD's work will they ever wake up? Posted by: keith loomis on November 19, 2009 at 8:15 AM | PERMALINK"Pre-existing conditions? Recission?" I was wondering the same thing....capping out of pocket expense? These are the things that drive people WITH insurance into bankruptcy. Are they accounted for in elements of the bill? Posted by: SaintZak on November 19, 2009 at 8:29 AM | PERMALINKThe question that will determine whether this bill is a step forward or a cruel (and expensive) joke: What penalties will be imposed if insurance corporations decide to go ahead and deny coverage for pre-existing conditions or drop the coverage of people who get sick? If the fines the insurance companies pay aren't draconian, if they aren't more expensive than the cost of providing covage, then they have every incentive to continue business as usual. The House bill ties enforcement to the Social Security Act, which sets fines at $25K -- too low since major surgeries can run over $100K and life-long care of debilitating conditions can run into millions.
Good points made above. But we have to keep in mind that any Senate bill must be reconciled with the House bill, which I'm pretty sure is more progressive. Is that right? Posted by: terraformer on November 19, 2009 at 8:35 AM | PERMALINKPublic option? Which one? At this point, "Public option" by itself has no meaning. Posted by: inkadu on November 19, 2009 at 8:36 AM | PERMALINKLets see... Why not ditch all this crap, go reconciliation and do whats right. I doubt this will ever pass anyways. Posted by: Wayne on November 19, 2009 at 8:45 AM | PERMALINKHere's the politics for me, I pay a fortune in premiums now, my taxes will increase (the 1.95 payroll tax) and I get? Nothing, zero, nada. Good luck Harry and good luck Dems, you've compromised yourself away from effective reform. Posted by: JM on November 19, 2009 at 8:54 AM | PERMALINK2014?! Way to not learn a damned thing from credit card reform. In the short time before those changes take effect, credit card companies are bilking consumers with 30% APR. So I wonder what insurance companies will do over a 4 year holiday... Plus, what a loser that will be in the 2012 elections. "We gave you healthcare America, just wait 2 more years for it!" And when Republicans sweep to victory on a raft of anti-government teabagging bullshit, they'll dismantle the entire thing before it even takes effect. Another fine job by the Senate Dumbocrats! Posted by: John S. on November 19, 2009 at 8:54 AM | PERMALINKPublic Option: PASS/FAIL. Those in repub states will be SOL. If state-level republicans try to take away the public option from their constituents, they will suffer at the polls. Personally, I don't think they'll fall for it. The opt-out is a clever mechanism to give cover to center-right democrats. Posted by: Marko on November 19, 2009 at 8:56 AM | PERMALINKThree words: MAKE THEM FILIBUSTER. Seriously. Dare the conservadems to filibuster against a cause which has been a major Democratic goal for decades. Dare them to take a stand against something which their own constituents say they want, and to then defend that filibuster to those same constituents. -Z Posted by: Zorro on November 19, 2009 at 9:37 AM | PERMALINKI guess I am really ignorant about this, but, why is "elective cosmetic surgery" even a part of "insurance"? I mean, what, exactly, is being insured? The idea that some guy will effectively bet that later in his life he will decide he needs a penis extension or a female will decide that she needs a boost to her saggy boobs? Posted by: IntelVet on November 19, 2009 at 10:07 AM | PERMALINKAllow me to add my voice to the chorus of outrage concerning the timing of this bill. How much will the next 4 years cost us while rescission continues and rates rise geometrically? How many more uninsured Americans have to die? Posted by: doubtful on November 19, 2009 at 10:08 AM | PERMALINKanother vote of dismay over the 2014 idea -- how many people will die in the interim? how many more bankruptcies?? and how many bills that will chip away at the minuscule progress in this bill? Posted by: elisabeth on November 19, 2009 at 10:13 AM | PERMALINKOf course I share everyone's significant concerns about the more than four-year delay on this bill kicking in. I'm very interested to know whether any parts of it will begin taking effect immediately, as I believe the House bill stipulated. I guess I am really ignorant about this, but, why is "elective cosmetic surgery" even a part of "insurance"? I don't think it usually is. I'm curious about how many policies even cover it. Posted by: shortstop on November 19, 2009 at 10:33 AM | PERMALINKStill protecting the insurers from antitrust. Kerry, stick your fucking license for predation up your ass. We need to purge these Dems. Posted by: forcible overthrow on November 19, 2009 at 10:40 AM | PERMALINKTo pay for reform, Reid's plan would impose an excise tax on the so-called "Cadillac" plans (insurance packages worth more than $23,000). There would now also be a 5% tax on elective cosmetic surgery This is BULLshit. Posted by: kc on November 19, 2009 at 11:27 AM | PERMALINKIt's a bleeping joke. Just forget it, forget the whole damn thing. The Democrats as a group don't have the brains, balls, or morals to enact decent reform. Posted by: kc on November 19, 2009 at 11:28 AM | PERMALINKI guess I am really ignorant about this, but, why is "elective cosmetic surgery" even a part of "insurance"? It's not. They're just going to put a tax on elective cosmetic surgeries. So someone having a face lift will pay out of his pocket an extra 5%. I guess they figure people who want to have elective plastic surgery are not a particularly sympathetic or powerful group, so no one's gonna fuss about that. It is peculiar to tie it to a so-called health care reform bill, suggesting there IS a connection. I don't see what the big hold up is they should have already passed the damn Health Care Bill these people are out of control and need to get a life lesson of how other people are depending on having some type of hope for a better health care system America is so jacked up I swear. Posted by: Judy Smith on November 19, 2009 at 12:16 PM | PERMALINK"Public Option: As expected, Reid went with a national public-option plan, which states could pass laws to opt out of." At their peril. Posted by: stevenz on November 19, 2009 at 4:37 PM | PERMALINKMany different variables might push health plans into "Cadillac" territory, including geographic location, plan demographics, and other characteristics of the insured population. More at http://www.healthcaretownhall.com/?tag=cadillac-plan Posted by: Jeremy Engdahl-Johnson on November 19, 2009 at 4:54 PM | PERMALINKI would imagine that elective cosmetic surgery could also include repairing the damage caused by various forms of surgery; ceasarian-section births possibly? Or any visible scar for that matter. Posted by: Doug on November 19, 2009 at 8:09 PM | PERMALINKvery useful read. I would love to follow you on twitter. By the way, did any one hear that some chinese hacker had busted twitter yesterday again. Posted by: Heathercgv on February 8, 2010 at 3:34 PM | PERMALINKI was very happy to seek out this site.I wanted to thank you for this great learn!! I undoubtedly enjoying every little bit of it and I have you bookmarked to check out new stuff you post. Anyway, in my language, there aren't a lot good supply like this. Posted by: so dep on January 27, 2011 at 7:25 AM | PERMALINKPost a comment
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