Why in God's name are they waiting until 2014 and the exchanges to ban recisions and denials based on pre-existing conditions? Aren't these some of the most onerous actions taken by private insurance companies today?

And you can expect that, just like the credit card industry, they will jack up rates just prior to the bill going into effect.

Enact the ban on those two items the day the President signs it.

The impression received here was that the bill reduced H care input into the GDP by a percent or more , reduced the federal deficit by over 100 billion smackers' over a decade . Why wait ?

I think you're underestimating the likelihood that Lieberman will stick his finger in the eye of the Democratic caucus for no other reason than he can do it.

There is a provision in the bill that stops insurance companies from hiking rates excessively before the exchanges are created.

The pre-ex ban is also going to take place immediately.

I have no idea why you think that raising the cost ceiling isn't going to be a problem for center-right Democrats. And I have no idea how you think this won't be an issue for senators with a particular taste for the limelight, like Nelson & Lieberman. Have you not been paying attention?

In the "mean"time, how many people will die or become otherwise incapacitated for lack of access to affordable healthcare? How many ERs will be closed for lack of funds to care for the many whose only HC system is the ER?
I know they can't do it by the end of the year, but 2013 or 2014? What a joke!

I can just hear Joe Lieberman, in his best "more in sorrow than in anger" voice, explaining how he'll vote to filibuster this--as a matter of conscience--because he's so concerned about the national debt. "We can't pass this debt on to our children," he'll say. (What he's really concerned about, of course, is giving progressives anything to smile about.)

And you can expect that, just like the credit card industry, they will jack up rates just prior to the bill going into effect.

The manager's amendment says that any company that does that will be excluded from the exchange. So they could do it, as long as they don't want any of those 30 million new customers.

"There's always a gap between bid and ask."--B. Nelson.

There's room for at least a little push and pull here.

Personally, however, I'd like to see it fly through as is, which I believe includes an immediate ban on denial of coverage.

People have died during the debate this week because they neither have nor can get insurance. This isn't something that can be put off.

No can do. It will take a year or so to collect the data necessary for assembling the rationing metrics. Hell, it's going to take the better part of 4 years just to appoint and confirm the death panels.

Can someone explain to me -- in easy term, allowing for my half-Polack brain to comprehend them -- just how postponing the implementation is going to save money?

The longer people have to depend on ER as their primary healthcare provider, the more the whole thing is gonna cost, no? The inflation, however slowly creeping it may be, is gonna kick in too, so that what costs $1 today may well cost $2 by 2014, no?

Chopin, that's the lamest excuse for inefficiency I've ever heard in my life. Privatisation is the answer to your problems, esp vis-a-vis the death panel work. We already have death panel mechanisms in place -- they're called insurance companies -- why not just keep those, on contract?

Deficits don't matter; it's our due.

Exlibra: "cost" here means new outlays by the federal vogt, not total health care spending. The subsidies are only available to those with access to the exchanges, and such access starts with the unemployed and uninsured and then phases in access for small businesses over five years. So it's only in 2019 that the maximum spending (and access) kicks in.

To answer steves question, I'd assume that by accelerating implementation, you replace a zero spending year at the front end with an additional max spending year at the back end of the ten year window. That mean that the increase in spending for moving up implementation by one year would be closer to $200B than $50B. A more viable approach might be to allow states to implement ahead of schedule if they have an exchange set up. The CBO would have a hard time scoring that at much more than $50B a year, if not much less than that.

The cost shift occurs because the Cadillac tax cuts in immediately but the subsidies do not. So in essence the CBO gets 10yrs of income for 6 yrs of outgo. That's ENRON accounting, to my POV, and the only possible reason for the silly delay. Meanwhile we throw billions with no strings attached to the Effing banksters.

Also, let's not forget the rampant immorality of the DFH for arguing against this particular form of insurance reform. They were going to delay health insurance for 30 million people. Pot, meet kettle?