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Old 11-19-2009, 05:06 AM   #1 (permalink)
ratbastid
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Senate Health Care Bill Unveiled

From Electoral-Vote.com, a (really excellent) non-partisan political news outlet:

Quote:
After nearly a year of deliberations, majority leader Harry Reid released the full text of the Senate's health-care bill, which consists of the Finance Committee Bill merged with the HELP Committee bill and some new twists. Here are some key features of the 2074-page (doubled-spaced) bill:

* Insurance exchanges will be set up in 2014 to help the uninsured get coverage.
* A public option will be available on these exchanges.
* Anyone below 133% of the federal poverty line will be eligible for Medicaid.
* Anyone between 133% and 300% of the poverty line will get subsidies to buy insurance.
* Insurance companies will be required to accept all new customers, even with preexisting conditions.
* Annual and lifetime limits on coverage will be prohibited.
* Insurance companies will be forbidden from canceling policies when a person got sick.
* Insurance companies will not be allowed to charge sick people more than healthy people.
* Employers with more than 50 employees will be fined for not providing health insurance.
* Small businesses will receive tax credits to help them buy insurance for their employees.
* Uninsured individuals will be fined $750 per year.
* The size of the Medicare donut hole will be reduced by $500.
* Children will be allowed to stay on their parents' policies until age 26.
* Policies will have to explain their benefits in a standardized form in simple English.
* An appeals process will be created so patients can fight back when coverage is denied.
* There are many provisions encouraging preventive medicine.

The bill will result in 31 million additional Americans getting insurance and will cost the government $848 billion over 10 years but this amount is more than covered by new taxes, resulting in a net reduction of the federal debt by $130 billion over this period. In the second decade, the savings will reach $650 billion. President Obama insisted that the bill come in below $900 billion simply for political reasons--then the Republicans would have to talk about an $848-billion-dollar boondoggle instead of a trillion-dollar boondoggle, which sounds much worse. There are new taxes are on gold-plated health-care plans, medical devices, and elective surgery. Medicare payroll taxes for high earners will be increased and growth of Medicare expenditures will be curtailed. The new taxes proposed are one of the major areas where the Senate and House bills differ so there will be much haggling in the conference.

Health-insurance exchanges would be set up on which private companies as well as a public plan would be offered to people not covered by their employer's plan. Any state that wanted to prevent its residents from choosing the public plan could ban it by legislation, but it is hard to envision many state legislators running in 2010 or 2012 saying: "If elected, I will vote to make sure you can't choose the public plan." Since both the House and Senate bills now have public options, it is highly unlikely it will be stripped out in conference. While many members of Congress have been pontificating about how even a tiny public plan will destroy in the insurance industry, no knowledgeable person believes this. Even with Medicare, insurance companies prosper by selling supplemental plans to seniors. What the public plan might actually do though, is reduce insurance company profits a little bit, but for a senator to say: "I am against reducing insurance company profits" wouldn't sound so good. Even in socialist France there is a thriving private-sector health insurance industry selling supplemental plans.

A sticky issue is abortion coverage. The House bill went very far in prohibiting insurance companies from offered abortion coverage. The Senate bill does not go as far. It merely sets up a firewall to make sure federal money is not spent on abortions. Adding irrelevant bits and pieces of legislation to a bill has been a congressional staple for decades. It is surprising that no opponent of the war in Afghanistan has proposed an amendment to the funding bill requiring the Army to provide an abortion to any female soldier requesting one. It would kill the bill.

Democrats of all stripes praised the bill as being the greatest thing since sliced bread. Republicans of all stripes said it would be the end of the world as we know it. If you expected a rational discussion of the bill's many provisions, welcome to Planet Congress.

Reid will file a cloture motion today, which means the vote will be on Saturday (Senate rules require an intervening day). Then we will find out whether Reid has managed to corral all 60 members of his caucus. Probably even the holdouts will find some cover in the bill. For example, Ben Nelson could say: "While I oppose this government takeover of our wonderful country, the bill reduces the federal deficit by 2.6% a year so I am voting for it" or something equally stupid. Also, Nelson, Sen. Mary Landrieu (D-LA) and Sen. Blanche Lincoln (D-AR) could find some reason to vote for cloture but vote against the bill itself (when their votes are not needed). Some Democrats are willing to ditch their deeply held fundamental principles for a small bowl of pork. Sen. Evan Bayh (D-IN) has miraculously dropped his opposition to this government takeover of the country when the tax on medical devices (many of which are produced in Indiana) was halved.
So I obviously haven't read the whole thing (nor, to be honest, do I plan to), but from the bullet points pulled out above, this bill meets my approval much more than the House bill. There's obviously all sorts of opportunity to water this thing down and turn it into the sort of toothless non-change that the House bill became, but where we're starting here is a pretty damn good place to start, I think.

I think we've been adequately over the general "pro" and "con" positions about health care reform. I'm interested in specific responses to the specific bullet points above from anti-health-reform people. In particular, ace, I'm curious about your response to the pro-small-business stuff listed above, and dksuddeth, I'm curious your response to the poverty-line-related subsidies and the fine for being uninsured.

Last edited by ratbastid; 11-19-2009 at 05:11 AM..
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