HELP Releases Public Plan Outline
HELP Releases Public Plan Outline
The Senate Health, Education, Labor, Pensions (HELP) committee has released its much anticipated outline of the public health insurance option. Earlier this month, in an effort to find common ground with Republicans and iron out some of the most contentious issues, the committee’s ‘“Affordable Health Choices Act,” omitted language on the employer mandate and the new public option.
At the time, the New York Times had reported that the committee was considering a public plan that would reimburse providers 10 percent above Medicare rates. The outline released today doesn’t preclude that possibility, but it makes it less likely.
The new HELP framework allows the public plan to “reimburse health care providers at rates which will be no more than the average reimbursement rate paid by private plans offered through Gateways.” Under this arrangement, the new public plan would have to negotiate its own rates and play by the same rules as other private insurers within the Gateway (i.e. Exchange) — it “would follow the same rules as private plans for defining benefits, protecting consumers, and setting premiums.” What’s more, the public option would be responsible for attracting providers and would thus have to rely on competitive rates (instead of Medicare-like rates) to retain enough participants.
During its first few years of operation, the public plan would be protected from becoming a dumping ground for sicker and costlier patients. Under the outline, it would qualify for “risk corridor protections” to “offset or reclaim excessive losses and gains which could result during the start-up period (identical to those in Medicare Part D). Subsequently, its premiums would be set to make it self sufficient.”
On the whole, then, the plan follows Sen. Chuck Schumer’s (D-NY) level playing arrangement. Some of the public plan’s inherent advantages — i.e. its ability to use Medicare rates and Medicare leverage — are intentionally dulled. Still, the national option would be able, in due time, to build a strong market presence and use its size and market presence to inject competition in the insurance markets and drive down costs.
6 Responses to “HELP Releases Public Plan Outline”
Register
RSSLogin
Topic Cloud
ArchivesBlog RollAbout Wonk RoomContact Us
Donate
Great…another step closer to making sure Barrack HUSSEIN Obama’s socialism isn’t watered down.
I’m going to Canada!
June 30th, 2009 at 12:01 pmStephanie,
By all means, please, do leave. But since Canada has universal healthcare and is much more socialist than than the USA, you ‘ll want to reconsider your options. You’ll also need to disqualify almost all of the westernized world. Happy hunting!
June 30th, 2009 at 12:42 pmDear Stephanie,
Please learn to read and comprehend information before making such idiotic posts. Canada comment aside, your post is flawed in that you fail to understand that the public plan (or “socialism” as you call it) is in fact being watered down. By paying at the avg. private payment rate, the HELP plan actual ensures that a public plan wouldn’t have any unfair advantages.
A public plan would only devolve into single-payer (which you equate so eloquently with “socialism”)if insurance companies fail to reform their wildly expensive administrative costs. Sure, perhaps the insurance companies would have to take a cut out of the profits that they provide to shareholders (and lower their exorbitant CEO salaries)–but really, I think this is a fair trade-off for the insurance companies who have been skimping on coverage to maximize profits for decades.
June 30th, 2009 at 4:46 pmUnfair advantage? I don’t think so.
This plan is very similar to the rejected wait-and-see-if-we-need-the-public-option plan. It’s just wrapped in different words.
We need to inject competition into the health insurance market place. Not run from it!
Health-Care Market Characterized By Consolidation, Not Competition
http://tpmmuckraker.talkingpointsmemo.com/2009/06/healthcare_market_characterized_by_consolidation_n.php
“The report, released by Health Care for America Now (HCAN), uses data compiled by the American Medical Association to show that 94 percent of the country’s insurance markets are defined as “highly concentrated,” according to Justice Department guidelines. Predictably, that’s led to skyrocketing costs for patients, and monster profits for the big health insurers. Premiums have gone up over the past six years by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent from 2000 to 2007.
“Far from healthy market competition, HCAN describes the situation as ‘a market failure where a small number of large companies use their concentrated power to control premium levels, benefit packages, and provider payments in the markets they dominate.’”
“So extreme is the level of consolidation, in fact, that one former top Federal Trade Commission official working with HCAN has sent a letter to the Justice Department’s Antitrust Division, asking for an investigation into the health insurance marketplace. …”
:The report doesn’t consider how this reality stands to affect the forthcoming congressional battle for reform. But extreme consolidation may actually be making it harder, not easier, to win support from lawmakers for a public option.
“That’s because insurers who control large swathes of a given market stand to see their bottom lines particularly threatened by the introduction of a lower-cost public option. So, in turn, they’ll be particularly aggressive in pulling out all the stops to pressure lawmakers to oppose the plan. Given the healthy amount of campaign dollars that some wavering members take in from the major insurers, that’s hardly encouraging.”
June 30th, 2009 at 8:47 pmAMERICA’S NATIONAL HEALTHCARE EMERGENCY!
It’s official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.
STAND READY AMERICA TO SEIZE CONTROL OF YOUR NATIONAL HEALTHCARE SYSTEM.
We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.
And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.
Progressive democrats the Tri-Caucus and others should stand firm in their demand for a robust public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and request that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).
Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.
In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don’t even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!
If President Obama has to declare a NATIONAL STATE OF EMERGENCY to rescue the American people from our healthcare crisis, he will need all the sustained support you can give him. STICK WITH HIM! He’s doing a brilliant job.
THIS IS THE BIG ONE!
THE BATTLE OF GOOD Vs EVIL!
Join the fight.
Contact congress and your representatives NOW! AND SPREAD THE WORD!
God Bless You
Jacksmith – WORKING CLASS
July 1st, 2009 at 11:55 pmThe independently-funded healthcare policy research organization, The Commonwealth Fund, compared possible savings ‘a health insurance exchange’ could bring under three different scenarios. One would include a Medicare-like plan along with private insurance. Another would instead offer only a government-run plan with rates somewhat higher than Medicare. The final one would be private insurance with no government plan at all.
Commonwealth’s study found cumulative health system savings between 2010 and 2020, compared with projected trends for that period, would range from $3.0 trillion under a Medicare-like plan along with private insurance paying providers at Medicare rates in competition with private plans, to $2.0 trillion for a public plan paying providers at rates between Medicare and private plan rates, to $1.2 trillion in the private plan-only scenario. All three options would help insure nearly all Americans, it said, with the number of uninsured dropping to about 4 million people by 2012. ‘Such an exchange’ would offer a central point for consumers to shop for and compare health plans.
Under the Medicare-like plan along with private insurance, all U.S. residents would be required to obtain health coverage. The plan would establish a new government-sponsored health program for people younger than age 65 who are not eligible for Medicare. More than 40 million people would be expected to enroll in the program, according to Cathy Schoen of the Commonwealth Fund.
The government-operated insurance exchange would be similar to an existing program in Massachusetts and would allow people to compare coverage offered by private insurers and the new public program. In addition, the plan supports wide adoption of health information technology, better disease prevention efforts and ‘changes to the insurance payment system’ that promote efficiency. Health spending would continue to increase under the plan, but at a slower rate than current projections over the next 10 years. The Commonwealth Fund said the plan would reduce annual health care spending growth from a projected 6.7% to 5.5% and save a cumulative total of about ‘$3 trillion’ by 2020, adding a national health insurance exchange program that includes a federally managed health insurance option could potentially save $1.8 trillion more than a plan consisting only of private plans.
The group’s analysis assumed other changes would also be made to the U.S. healthcare market. These include an expansion of existing government coverage and new regulations that would require insurers to cover a wider range of consumers. Hospitals and doctors would also see their revenues grow with any of the three exchanges but at a slower rate, the report said.
The proposal’s advocates have argued that a government-sponsored insurance plan would offer the 46 million uninsured Americans an affordable alternative to costly private insurance, adding that It would provide a strong incentive for private plans to strealine, innovate and compete.
Thank You !
July 4th, 2009 at 9:05 am