The Senate Finance Committee’s Affordability Catch-22
The Senate Finance Committee’s Affordability Catch-22
Last night,the Senate Finance Committee approved a series of amendments that reduce penalties for Americans who don’t purchase health insurance and exempt more individuals from the requirement to obtain coverage. Under the legislation, the maximum penalty for a family that does not purchase coverage “would start at $200 in 2014 and rise to $800 in 2017“; people who have to pay more than 8 percent of their adjusted gross income for the cheapest available insurance plan “would not be required to purchase it.”
“This is the major amendment on affordability,” Sen. Chuck Schumer (D-NY) said. “We should make insurance more affordable by increasing the subsidies. That was not fiscally possible to stay within the constrains that we have in this committee. Hopefully we can move them, make them better as we move forward in the process,” he said.
The problem is this: the White House has decided that they don’t want to defend the higher taxes that affordable universal coverage would require. They don’t want to be labeled as ‘tax-n-spend’ liberals. Instead, they’re willing to accept a smaller reform package with less subsidies and less coverage. As a result, Congress is forced to exempt an extra two million people from the mandate to avoid the hits that would come from requiring these Americans to purchase expensive, unsubsidized coverage. If you can’t help people afford insurance, you can’t require all of them to buy it.
But this approach doesn’t make good policy or politics. On the policy front, exempting too many people from coverage maintains the perverse cost-shifts (uninsured to the insured) already in the system, jeopardizes the balance of the new purchasing pools in the Exchanges, and only increases health care costs. Politically, Congress is asking Americans to purchase not-so-affordable coverage from the less-than trustworthy private insurance industry. Medical bankruptcies and out-of-control spending will not disappear over night.
That’s the problem the Senate Finance Committee is facing: they have to make the bill more affordable by making actual health insurance coverage less affordable.
8 Responses to “The Senate Finance Committee’s Affordability Catch-22”
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Schumer said his amendment would barely impact the cost of the bill, making it slightly more affordable. Blue Dog and moderate Democrats don’t want to be painted as tax n spend liberals. You put the White House in this camp.
Of course, Nancy Pelosi’s dance to the center on the nonpublic “public option” looks like Tome DeLay’s choreographed dance steps. The Blue house of health care pox looks remarkably in sync.
As for stuff not going away overnight, CBO shows 25 million uninsured as of 2018.
October 2nd, 2009 at 5:45 pmHere’s what happens:
White House blames Senate Finance Committee
SFC blames Senate Democrats
Harry Reid blames anyone but himself.
They all blame one or two Republicans
No one accepts responsibility for delivering For-Profiteering Corporafornication.
October 2nd, 2009 at 5:48 pmDon’t forget Uncle Sam backstopping reinsurance losses from millions of new, high priced individual policies.
And the $20 billion to migrate people from Medicaid to the private, individual policies (costing more and providing less benefits).
Looking good for the For-Profiteers!
October 2nd, 2009 at 5:50 pmSafety net providers will be the ones taking it on the chin. It will be interesting to see the new CBO score.
The 25 million without coverage in 2018 will rise to what?
October 2nd, 2009 at 6:04 pmSchumer’s point is about individual affordability, not the total cost of the bill. He said the change would have little impact on the bill’s total, generating only slight savings.
Dirty Max let employers off the hook, another clue that reform greases the skids for employers dumping that pesky health insurance benefit.
With employers stepping back, that leaves a tapped out Uncle Sam and the individual. Looks like an era of personal responsibility (under a White House that wants to parent the country).
October 2nd, 2009 at 6:08 pmIMO, a ‘catch-22′ can be found in every health care system, everywhere, because polar opposite problems of access to all, and affordability of all useful medical care, can be found in both homogeneous, and heterogeneous societies!
Switzerland’s homogenous society has fewer overall health concerns, so health coverage there is almost universal. Swiss doctors may practically know and practically treat on average fewer, illnesses. However, any new illness in Switzerland may present some inordinate challenge for the average person, sadly their access may be little, or none! Swiss health care costs are likely bi-polar, in the sense that the most common illnesses, receive the overwhelming majority of health dollars, but those other variable illnesses, such as genetic or age or gender specific illnesses, are much more costly to purchase!
However, our heterogeneous society faces a different comprehensive set of availability, and costing challenges, due to our size and diversity. 1) our large, diverse population contracts many illnesses, and also many different illnesses; our communicable illnesses pose a greater screening, and treatment problems, than within a smaller society. 2) Doctors have an monumental problem in costing specific treatments, in a ‘global diseases environment’; for rarely does one medical device ‘fit all’, and so rather a physician prescribes some combination of treatments, borrowed from already existing treatment paths! Subsequently, costs become hard to standardize, and hospitals’ safety costs, related to treatments, rise in cost and become paramount practical concerns!
In other words, smaller societies with fewer illnesses, in and of themselves, suggest simple regulations which can be accomplished easily from local offices. But due to availability and cost concerns, large and diverse societies like ours, may more easily become victims of monopoly of availability by region, or else, monopoly by costs related to those many individual sectors of the economy which relate to health care; this unbalanced scenario remains a possibility, without the starting point of strong, and comprehensive, national health care regulations!
October 3rd, 2009 at 9:52 pmSchumer said his amendment would barely impact the cost of the bill, making it slightly more affordable. Blue Dog and moderate Democrats don’t want to be painted as tax n spend liberals. You put the White House in this camp.
October 5th, 2009 at 2:52 amOf course, Nancy Pelosi’s dance to the center on the nonpublic “public option” looks like Tome DeLay’s choreographed dance steps. The Blue house of health care pox looks remarkably in sync.
As for stuff not going away overnight, CBO shows 25 million uninsured as of 2018.
This thing has been corrupted by lobbyist dollars to the point that it will benefit few that aren’t their bosses. I’m advising my representatives to vote against this mess. No bill is better than this extremely corrupted one. Bauc-ass is bought and paid for, as are the blue dogs, and most all of those on the right. We’ve seen this before. HMO Act of 1973, anyone?
October 8th, 2009 at 1:36 pm