Kennedy Staff Circulating ‘Draft Of A Draft’ Health Care Legislation
Kennedy Staff Circulating ‘Draft Of A Draft’ Health Care Legislation
Sen. Edward Kennedy (D-MA), the chairman of the Health, Education, Labor and Pensions Committee, is circulating draft legislation designed to overhaul the nation’s health care system. This so-called “draft of a draft,” as one Kennedy spokesperson described the set of documents now available, is the first piece of concrete health reform legislation to emerge from Democrats in Congress.
The legislation, called the “American Health Choices Act,” would provide universal coverage to all Americans and establish a new public health care plan to compete alongside private insurers.
As previously reported, the new public plan would reimburse providers Medicare rates plus 10 percent. Under this arrangement, the new public option would not have to negotiate its own rates, but could piggy back off of Medicare’s considerable reach. Using Medicare plus 10 rates, rather than the prevailing market rates, would lower costs and allow the plan to charge lower premium rates.
Moreover, the bill aims to improve access to coverage by regulating insurers, expanding Medicaid and SCHIP, and building state-sponsored insurance gateways (or exchanges) to help Americans find affordable coverage. Individuals and employers would be required to purchase insurance, but families earning up to 500 percent of of federal poverty line (FPL) ($110,000 for a family of four) could “buy insurance on a sliding scale with government subsidies” and anyone earning up to 150 percent of the FPL ($33,000 for a family of four) would also be eligible for Medicaid; the bill also expands SCHIP to cover people up to age 26, from age 18. Currently, an adult with no dependent children could be penniless but still ineligible for Medicaid coverage in 43 states.
Sen. Chris Dodd (D-CT), who is leading the committee’s health care effort in Kennedy’s absence, “has said he hopes to begin debating a bill in committee on June 15.”
More details after the jump:
Ensuring Adequate Coverage, Holding Insurance Companies To Account
- A group or individual health insurance plan may not impose preexisting condition exclusions
- Rates cannot vary by health status, gender, class of business or claims experience. Rates can only vary by family structure, community rating area, actuarial value of the benefit, age (rate variation shall not vary more than by 2:1)
- Insurers “must accept every employer and individual in the state that applies for such coverage”
- Insurers “must renew” coverage
- Insurers must provide value for the premiums paid (a good portion of health premiums must be used on health benefits)
- Limited cost sharing for certain preventive services, immunizations, certain screenings for infants
- No lifetime or annual limits on benefits for any participant or beneficiary
Creating State Exchanges or ‘Affordable Health Benefit Gateways’
- The federal government will provide financial aid for states to establish Gateways
- A Gateway would be required to certify qualified health plans; the plans must provide a level of standard benefits (to be established by a Medical Advisory Council) that would take effect unless Congress rejected them all at once.
- Gateways may raise funds by charging health insurance issuers a surcharge to finance the administrative and operational expenses of the Gateway.
- At the end of the year, the Gateway will redistribute funds among the plans to ensure that those with very unfavorable mixes of risk are protected.
- States can establish regional or interstate gateways; more than one Gateway could also be established in a single state.
4 Responses to “Kennedy Staff Circulating ‘Draft Of A Draft’ Health Care Legislation”
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Go Teddy.
June 7th, 2009 at 2:34 amFor an independent analysis of the Healthcare dilema, read the article from the New Yorker: The Cost Conundrum:
http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?yrail
June 7th, 2009 at 9:02 amLet me get this straight: To our existing broken sham of a health care system, our political leaders have put together a plan that will not only further bloat the administrative costs to health care providers, but has the added beauty of filling the tills of the for-profit insurance industry and HMOs, through subsidies, which will, in turn trickle into the campaign coffers of these very political leaders who are hard at work, ensuring that every American has health care insurance.
Not health CARE, per se. Just the insurance.
What our leaders are concocting is a Frankenstein monster — which I’ll call the Kennedy-Baucus Plan (per the senators’ joint statement on May 30th, in which they stated their intention to produce “similar and complementary legislation that can be quickly merged into one bill for consideration on the Senate floor before the August recess.”)Their plan does nothing to detach the parasitic for-profit insurance industry from the teat of American health care, nor to appreciably cut health care costs. Worse, it does nothing to improve the delivery or quality of actual health care in this country.
In fact, it’s done little more, so far, than to carefully, carefully take into account and appease the interests of corporate America. By necessity, this has required blocking the topic of single-payer health care — the choice of two-thirds of American citizens — from all discussions and media coverage.
The head surgeon in this Frankenstein operation is none other than Senator Max “We-need-more-police” to-shut-up-the-protesters-and-the-59%-of-Americans-in-favor-of-single-payer-health-care Baucus – whose own pockets have been lined by nearly $4 million over the course of his career, by those very industries (insurance, pharmaceutical, HMOs and professionals, et al) that will benefit from his bill.
It is of no coincidence, then, that these industry leaders were given thrones at Max’s health-care-reform table, while single-payer advocates — the voices for those two-thirds of American citizens — were carted away by police.
Taking center stage on the operating table is Senator Kennedy’s “public option plan,” which manages to add yet one more cog in the wheels of billing and adminstration for health care providers (read that: higher costs), while doing nearly nothing to address the tens of millions in this country who are currently under-insured and cannot afford actual health care.
I don’t even know where to begin to dissect this monster of a so-called health care plan. The head seems as a good a place to start (and stop) as any: Obama and the like-minded Kennedy-Baucus proponents are optimistic that this plan will cut health care costs — not by any particular design in their plans — but through the insurance industry’s pledge (because they are, after all, such nice guys, their intentions sterling) to voluntarily shave off $2 trillion in health care costs over the next 10 years.
As one who was robbed (read that: screwed) via the clever footwork/semantics of my own private insurance provider — to the tune of $18k per year in long-term, permanent disability pay, for which I paid premiums, not to mention the brick walls I inherited as a person who now has a “pre-existing” condition– I think I get the general idea of how the insurance industry could accomplish these savings.
Oh, it will entail being more clever. They’ll have to be, to get around the new laws. But, rest assured, they’ll do it. And the beauty of it is that the insurance industry won’t need to resort to Baucus’ “more police” measures to protect and preserve their obscene profit margins because — as has always been the case — sick people are usually to sick to protest. And, besides, there’s no one gonna listen to them, anyway.
…. Except, perhaps, Congressmen Kucinich and Conyers, who are but a few of the only voices on the Hill proposing true health care reform (H.R. 676) for our country. Here, and only here, I can see Obama’s promise for transparency being fulfilled: As he has shunned the expertise of these congressmen’s voices on health care reform — and with it, disregarded the wish of two-thirds of American citizens — Obama has made crystal-clear the true nature of his vision for health care reform in this country.
June 7th, 2009 at 9:31 amThis is not good, especially if it is mandatory! Have you seen what happened to auto insurance rates when they became mandatory? They can charge whatever the hell they want. Not good!!!!!
June 8th, 2009 at 3:29 pm