We Read the GOP Health Care Plan So You Don’t Have To
We Read the GOP Health Care Plan So You Don’t Have To
When the House released its 1,990 health care bill, Rep. Mike Pence (R-IN) criticized the legislation for including “the mandatory world ’shall’ in the bill 3,425 times.” Today, the Hill obtained the Republicans’ 230 page alternative, which the House leadership plans to offer as an amendment during floor debate.
The bill includes the word ’shall’ 378 times, but does very little to expand access or lower health care costs. In fact, while the House bill incorporated numerous Republican ideas and provisions, the Republican legislation is a message amendment that translates Republican rhetoric against the Democratic proposal into legislative language. “The purpose of this Act is to take meaningful steps to lower health care costs and increase access to health insurance coverage,” the bill states, “without (1) raising taxes; (2) cutting Medicare benefits for seniors; (3) adding to the national deficit; (4) intervening in the doctor-patient relationship; or (5) instituting a government takeover of health care.”
Below is a summary of the Republican plan. In short, the amendment shifts the costs and risks of insurance onto individuals and divides the market into low-cost plans for the healthy and high-cost insurance for the sick:
Access to coverage:
- Establishes high risk pools for sicker individuals: State are required to establish high risk pools for Americans who cannot purchase insurance in the individual market due to pre-existing conditions, but nothing in the legislation prohibits the state pools from excluding coverage for the very condition that makes an individual eligible in the first place (as they do today.) The bill abolishes waiting lists and specifies that the pools must provide at least two coverage options, one of which must be a high deductible plan with HSA. Premiums can be set at no higher than 150% of (state) average. The federal government will provide $15 billion in funding.
- Healthier Americans can purchase coverage on the individual market: For Americans moving from group to individual coverage, the legislation eliminates the HIPAA requirement of having creditable coverage in the past 18 months to receive individual insurance market insurance. Annual or life time spending caps are also eliminated. However, the bill will allow insures to deny coverage for pre-existing conditions and charge very different rates based on gender and age.
- Health insurers can sell policies across state lines: The insurer only has to follow the rules of the state it declares to be its “primary” state, not of secondary states in which it can also sell policies. As a result, all policies will have a ‘buyer beware’ label warning consumers that the plan is “not subject to all of the consumer protection laws or restrictions on rate changes of the state.”
- Businesses can form association health care plans: The legislation creates rules for governing association health plans, which will allow small businesses to come together, by industry or trade, and form health plan through which they can purchase coverage for their employees. Association health care plans have sole discretion in selecting specific items and services that can be included as benefits (i.e. no minimum guaranteed benefit package, or minimum costs etc). The plans are to be operated by Board of Trustees who appoint the actuary to determine financial status and viability.
- Young adults can stay on their parents’ coverage: Dependent adults can stay on their parents’ plan until they are at least 25, although the language would allow a plan to increase that age.
Lowering health care costs:
- Offers bonuses for states that lower premiums, number of uninsured: Establishes state innovation program grants to reward states for lowering the cost of their premiums. Includes bonus for reducing the number of uninsured.
- Establishes a plan finder website: States contract with private entities to create a health “plan finder” website which do not directly enroll individuals in insurance plans.
- Malpractice reform: Specifies that claims must be filed within three years, and caps non-economic damages at $250,000.
Miscellaneous:
- Enhances Health Savings Accounts: Enrollees can build their credit by contributing to their HSA and can use HSAs to pay for high deductible plan premiums. The bill extends the definition of a qualified medical expense.
- Employer wellness programs: Allows group and individual health plans to vary premiums and cost-sharing by up to 50% of value of benefits based on participation or lack of participation in a standards-based wellness program.
- Federal dollars can’t touch plans that offer abortion coverage: The bill does not allow federal funds to go to any insurance plan that offers abortion coverage. This means that a woman who wants to purchase a comprehensive health insurance plan would have to pay for the entire cost of the policy, even if she qualifies for subsidies and uses private premiums to pay for her abortion.
15 Responses to “We Read the GOP Health Care Plan So You Don’t Have To”
Register
RSSLogin
Topic Cloud
ArchivesBlog RollAbout Wonk RoomContact Us
Donate
How does having a Health Savings Account build credit?
And I don’t really understand the point of HSA, really, since you can’t use it against your taxes unless you itemize, and poor people don’t itemize their taxes.
November 3rd, 2009 at 7:51 pmThe go-go Bush years showed America who was important. The number of uninsured rose from 40 to 47 million.
The Carlyle Group grew from $13 billion to $91.5 billion in investments managed.
November 3rd, 2009 at 8:03 pmIf health care is the problem, insurance is not the cause and government is not the answer.
Of those “50 million,” that lack insurance there were 45,000 who died without health care. With health care, 98,000 died FROM health care because of malpractice.
The question is do we want to trust that largest corporation in the world, the U.S. Government.
Do not expect house calls anytime soon.
We have seen how well the government delivers on its promises and its bureaucracies pursue the money without giving us benefits on so many levels. Imagine another organ of the government that only ultimately must listen to the Secretary of the Treasury – another “service” of which is the IRS.
http://theprogressivecapitalist.blogspot.com/2009/10/affordable-health-care-for-america-act.html
That blog of mine above has several .pdf connections (HR. 3962 and two summaries, a few videos, and page references for new taxes and other mandates). If you cannot use the link, google “Progressive Capitalist H.R. 3962.”
If you believe the promises of this bill, you have to deal with the lie that it fosters competition with a government option called the “Public Option” and establishes the government as a monopoly making its own rules.
Don’t worry. You’ll run out of “rich” soon enough. We have at least a$12 trillion economy of which at least $1.8 trillion is spent on health care. If you read the bill, there are plenty of opportunities to soak the middle class, if you do not mind the 1.6 million made jobless.
November 3rd, 2009 at 8:17 pmDo you have a point, John Lloyd? ’cause just about everything you said was pretty much putting words together in such a way to have sentences that mean nothing.
Somewhat 12 Galaxies of you.
November 4th, 2009 at 12:33 amDo you have a point, John Lloyd? ’cause just about everything you said was pretty much putting words together in such a way to have sentences that mean nothing.
Somewhat 12 Galaxies of you.
November 4th, 2009 at 5:42 amBTW I love your blog!
Don’t get sick! They’ll take your house.
November 4th, 2009 at 8:17 amNone of the current plans will fix the problem.
Besides the obvious “political” hinderance to creating good decisions that benefit people, all the plans are 1) hung up on the idea that the “free market” applies to health care and 2) ignores how insurance works.
People cannot choose insurance or health care in the same way that they can decide about a car or other product. They don’t & can’t have enough info to make that choice – they depend on their provider to have the info. Many are also restricted because of the choices their employer has made for them.
The whole idea of insurance is to spread the risk/costs over the most possible participants – that’s how it works. The cost of one person’s catastrophic illness is spread among all the participants. Choice & competition is the antithesis of effective insurance.
So the only way we can control the cost of health care is to have a single-payer system. That brings all Americans into the pool so risk is spread among the most people possible.
Plus it eliminates the inherent administrative costs from having hundreds of insurance companies all advertising, paying obscene executive pay, encouraging excess capacity, and working to deny or delay claims. Many health-care providers claim that up-to 30% of their costs are associated with dealing with the insurance bureaucracies – that in itself is over $500 billion PER YEAR.
Yes, other nations with single-payer systems have problems, but I believe that if Americans work together they can make a system that works for everyone. If we could just get past the demagoguery, maybe we could do it.
November 4th, 2009 at 12:58 pmHow many people are aware of the number of older people or chronically ill persons who are considering stopping care which would result in death,or just to find a way to die since it’s too expensive to live. It’s sounding like that horrid movie where it’s better to care for the rich and let the elderly & sick feed the populations. Obviously the Republicans have no clue what their constituents are going through on a daily basis to keep their lives going. Oh, that’s right; aren’t their constituents the ones who are rich and the lobbyists who have them in the pockets? Would they do this to their own relatives if they were in the same heart breaking cituations I hear from some of my patients? They, the Republicans, are still not seeing it or hearing it. They need to spend time working the the Free clinics for a couple days and see reality.
November 4th, 2009 at 3:27 pm#1: an HSA is taken out pre tax so the ‘poor’ get fewer taxes taken out of their paycheck, even if they don’t end up itemizing. Unless of course these are ‘poor’ who were smart enough to count the correct number of exemptions. It also helps the ‘poor’ if there’s a good plan. IE my employers HSA plan let me spend $1k on healthcare before I’d saved up 1k. HSA’s can help the poor simply because the money is set aside for health expenses so you don’t have the, oh, I need this prescription but have no money problem.
Also whether or not to itemize actually depends on indiviudal deductions vs standard deduction, not income. IE I’m lower middle class, and I still don’t itemize, because I have 3 kids and don’t have over 10k worth of deductions.
November 4th, 2009 at 6:14 pmLook,
I still get my mail, have done so for quite some time. Come rain or sleet or snow, I always get my mail….I dont always have access to the local small business coffee shop, since they have a tendancy to last aout a few years or so. My point, The Government will never go away, so the argument that the federal government cant run a business is hogwash. It really doesnt hold true water. it’s spam on the airwaves.
Now is if the most efficient business out there? NO, Why is that, because the federal govt is extremely fickle, Republicans/Democrats, changes of view points from administration to administration has a tendancy to foster failiure of our government, even in the rality of it functioning well under control of either side.
The GOP plan is seriously lacking, they knew it was not going to be as robust, and they need to be “HAMMERED” by both conservatives and Liberals and Independants for putting out such nonsense. This is serious not some political hack stuff.
November 4th, 2009 at 6:15 pmThis is not about political idealism, this is about the viablity of our current health as a country. These changes need to transcend “party in power” politics.
This is not about whether or not we trust the Government to run healthcare, this is about whther the Government allows the creation of an agency that can keep a reality check on healthcare costs.
Thats what leaders do, they dont allow the weakest of the clan to die off because they realize each member is important. We are not in the old frontier any longer, this is 2010 coming up, and we need to think as a country independant yet aware of each other.
Surely, it must be obvious to even the most ideologically blind among us that the GOP healthcare plan is light years ahead of the Progressive tyranny they Pelosi, Reid and Obama call a “plan”. The GOP approach is a sensible, common sense start to fixing the healthcare flaws without flushing the best healthcare system in the world today. No rationing, no additional deficits, no 2000-page bill–just plain ‘ole American common sense. Lord, how I loathe those who place their parochial party ideology over the best interests of the American people.
November 4th, 2009 at 7:10 pmIt’s obvious and has been my whole life that the Republicans only care about the rich and business that’s why they give them huge tax cuts, start wars then funnel trillions of dollars to business (then go work for those companies when out of office).. They care about the people who sign the checks and don’t care about the people who work their fingers to the bone for those checks.. To them a million dollars a year is middle class anything else is poor.
The Dems only care about the poor and focus their efforts on them with welfare, medicaid etc and don’t care about the middle class.
What this country needs is a third party with some balls who would stand up to both business and the poor. We need a universal single payer system but will not see one in our lifetimes as they cry it will ration health care and there will be long lines.. YES THERE WILL be lines because people who are sick will be able to see a doctor instead of waiting till it’s to late. Wouldn’t want to be an inconvenience to the rich and make them wait for half an hour..
Doing away with the health system and going to a univeral system would also help business and save them millions a year they pay for insurance and would allow them to offer more to their employees or high more people.
They laugh at the idea of medicare for all but it’s going under because right now only sick older americans are paying in. If you have millions of healthy young people start paying in now it would actually save money in the long run and allow the system to continue..
But untill you take Wall Street, Big insurance and pharmacy out of running the country NOTHING will change. And how does this happen year after year? They distract people with gay marriage and abortion instead of real issues …
November 5th, 2009 at 1:29 amFirst, the US Govt only stays in business because it’s “TOO BIG TO FAIL”. What other company could survive with losses the size of our govt. Also, why does our govt put down the companies that they bailed out when we the people bail out the govt year after year with our tax dollars.
November 5th, 2009 at 9:48 amSecond, the only way to bring down health care costs is for America to get healthier by loosing weight, exercising and eating better. If tax we must, lets tax the hell out of the foods that are actually bad for us, but then how would we get congress to agree on what’s bad? I mean, do you have the right to get obese due to your own actions, contract diabetes, and then expect to have the govt take my money to treat it? That’s what happens now for those that are rated disabled, and it’s not right.
Finally, we need term limits on the fools we have sent to congress. When one’s sole job for life consists of serving in the House, Senate, or some appointed position, one is not qualified to tell a business how to operate. We need a lot of new, shorter term reps and senators that have actual business and finance experience to direct the country in the direction the majority of the populace of the nation wants the nation to go, so long as that direction is not illegal, immoral, and just plain wrong, because the majority isn’t always right.
So many people completely miss the point on this argument. PEOPLE MUST HAVE SOME RESPONSIBILITY FOR WHAT THEIR HEALTH CARE COSTS! Eye doctors and dentists have to compete for people’s business as this is not usually insured. Therefore, even the poorest get glasses (Walmart), etc. I can have an HSA and catastrophic coverage for $200 a month as opposed to $1,000 per month for “real” insurance. I can’t afford the latter, but can scrape up $200 per month. If I have to go to the doctor, I call several, tell them I don’t have insurance and ask what they charge. You can’t believe the discount you can get if they don’t have to deal with the insurance company. Furthermore, one can always figure out some way to come up with the $10k deductible, I don’t care how poor you are. You can borrow it, or most hospitals will write it off, or let you pay it out forever, and are glad because you have insurance. I would much rather save $9,600 a year, be on the hook for a deductible, than on the hook for a major medical bill. A few years ago a trend started in my area, where doctors were opening offices and clinics and refusing to take patients with insurance, because it cost so much to process the claims. They are offering services for about 30-50% of what traditional doctors are offering. We just have to change our perspective to solve this problem. Government is not the answer and for profit insurance companies aren’t either, individuals are. We doctors willing to think outside the box, coops and not for profit insurance. Neither party really wants to fix this for the benefit of the average citizen. They only want to satisfy their own agendas and special interests. BOTH sides of the aisle.
November 7th, 2009 at 8:43 amI’m not sure where ert gets his insurance, but every employer insurance plan I have had includes dental and eye care. Doctors might give you a discount for not having to go through an insurance company but that doesn’t mean they can give you a discount on non-generic pharmaceuticals, laboratory tests, or other high-cost procedures. Not every cost is in the hands of the doctors.
And if Delaney really believes that a plan that reduces care, allows insurers to deny coverage due to pre-existing conditions and does little to contain costs is “ahead of the curve” I can only assume the curve he means is “continual and increasing denial of affordable health care to most people.”
November 8th, 2009 at 3:22 pm