Here is a summary of the Baucus bill with analysis and opinions from Morningstar.com. This is the senate finance committee version of the bill to be voted on and merged with other versions circulating in congress. http://news.morningstar.com/articlenet/article.aspx?id=311123&pgid=stockarticle#page=0&part=2 "Assuming the bill passes in the Finance Committee, it will be combined with the bill from the Senate Health, Education, Labor, and Pensions Committee before being brought before the full Senate." Guaranteed Issue, Rate Bands, and an Individual Mandate - The bill would require insurance companies to offer coverage on a guaranteed issue basis, forbidding them from rescinding policies or denying coverage for those with pre-existing conditions. - The bill would require the vast majority of citizens and legal residents to carry health insurance or pay an excise tax. - The bill would eliminate medical underwriting, allowing premiums to vary based only on the following characteristics: region, tobacco use, age, and family composition. Amendments: What does this mean for you? - During the bill markup, the rating bands were tightened, so that premiums are now only allowed to vary at a 4:1 ratio based on age, or a 6:1 composite ratio within a family category. This tends to lower or maintain premium levels for older Americans in the individual market, while significantly increasing premium levels for younger people. - The maximum tax penalty for families who fail to carry health insurance was also greatly reduced from the original level of $3,800 per year. - In the final version of the bill, the maximum tax penalty per uninsured adult is set at $200 in 2014, $400 in 2015, $600 in 2016, and $750 starting in 2017. - Failing to carry health insurance carries no civil or criminal penalty, and interest does not accrue on unpaid excise taxes. - The only enforcement mechanism for the individual mandate is for the government to withhold the penalty tax from the uninsured person's annual tax refund. Morningstar's opinion: "The amendments around the individual mandate have made it almost completely ineffective, which will likely mean lower overall insurance coverage and higher insurance premiums as healthy families become even more likely to opt out of the insurance pool. A reduction in the number of uninsured Americans would also result in an increase in the demand for drugs, which would largely offset the pricing concessions and fees imposed on the pharmaceutical industry in other parts of the health-care reform bill. Device manufacturers would also see an uptick in volume." ---------------------------------------------------------------- Annual Industry Fees and Excise Taxes - One of the more controversial components of the bill is its attempt to impose annual fees on pharmaceutical manufacturers ($2.3 billion), medical device manufacturers ($4 billion), health insurance providers ($6 billion), and clinical laboratory services ($750 million). - Essentially, any plan that exceeds the threshold amount of $8,000 for individuals and $21,000 for families would be taxed at a 35% rate for the portion in excess of the threshold. Amendments: What does this mean for you? - More plans will remain exempt from the excise tax for longer, making this measure less effective at lowering the rate of health-care cost inflation. - The annual fee on health insurers was increased by $700 million, to $6.7 billion, while the annual fee on clinical laboratories was eliminated. - It should be noted that the pharmaceutical industry scored a victory when a proposal to require drug companies to provide $100 billion in additional rebates to Medicare over 10 years was defeated, essentially upholding the $80 billion deal the pharma lobby had previously negotiated with the White House. Morningstar's opinion: How may this bill impact you? "We expect the vast majority of fees on pharmaceutical companies, device makers, and health insurers to be passed on to consumers in the form of higher insurance premiums and cost sharing. Managed-care organizations are accustomed to passing on significant annual medical cost increases to customers in the form of higher premiums, and we expect the same to occur with the $6.7 billion in new fees levied against the industry" We think any tax on employer-sponsored benefits makes good economic sense, we consider this provision a negative for most health-care companies. ------------------------------------------------------------------- Consumer Oriented and Operated Plan (CO-OP) - Co-ops that would attempt to foster competition with private insurers. These entities would be funded initially by the U.S. government through loans and grants in the amount of $6 billion. Amendments: What does this mean for you? - Weak support for a government insurance option due to defeated amendments that would have created a public health insurance option. Morningstar's opinion: "We continue to think there is not enough support for a public option, particularly among certain key moderate Democrats in the Senate. We remain skeptical that co-ops would be able to achieve the scale necessary to compete with large private insurers. The absence of a government-run insurance plan from the SFC bill--especially one using Medicare's below-market provider fee schedule--is a major victory for the health insurance industry. The lack of a public plan and the associated strong pricing power means a major risk overshadowing the drug group will likely recede." -------------------------------------------------------------------- Health-Care Tax Credits - Refundable tax credits would be available on a sliding scale for individuals and families with adjusted incomes of up to 400% of the Federal poverty level who purchase insurance through the state exchanges. - New tax credits will enable more low-income people to purchase insurance, increasing revenue and profits for the MCOs. - Tax credits should increase the demand for drugs and devices as people who couldn't afford insurance previously will likely enter the market. Increasing the number of insured people is the major offsetting factor to the fees and pricing concessions offered by the pharmaceutical industry. Morningstar's Opinion: While many Democrats, particularly in the House, continue to say that any bill without the public plan is a non-starter, there are many Republicans who think the bill is too expensive, especially coming on the heels of the bailout and stimulus packages from earlier this year. We think that this bill will be the basis for any reform, and if the House and Senate end up rejecting it or its revised forms, health-care reform is unlikely to be accomplished in 2009. ---------- This thread was created to help fellow members understand the baucus health care bill. I recommend that people research other reliable sources for greater and varied information. This is an important piece of legislation that will impact your lives and the decisions your employers will make. Visit OpenCongress.org to read the version of the Baucus Bill as it was on September 22, 2009. http://www.opencongress.org/baucus_bill_health_care.html On Tuesday, the senate finance committee will vote on the baucus healthcare reform bill. Does this mean that the public option is dead. No. "Action in the House and Senate is expected in the coming weeks. "Democratic Speaker Nancy Pelosi says the votes exist in the House for a "robust public option" in a healthcare reform bill." http://ozarksfirst.com/content/fulltext/?cid=195171 What does all of this mean for you? How will the merged bill affect employment, consumer culture, and the economies of our 50 states. We can argue endlessly about the nuances of the baucus bill and what the final merged bill will contain. What is important is that you research and understand how the final bill to be signed by president obama, will impact your family and your employer. If you own a business, research how the final bill will impact your company.
There is nothing keeping costs down. I brought this up with my Senator who likes this plan to some degree that they could take the mandates on covering people and then jack up the premiums 50%, 100% or more and there is nothing preventing it. Nothing. I think the best approach would be to cover the very poor first, use free market mechanisms guided by government oversight to make insurance for everyone else accessible and add the use of outsourcing to cover care for expensive patiants. Its odd the one idea that would not cost a dime for the government and can only save money, sending cases where its cost effective to the best international for-profit hospitals in nations like India is not even in a bill. Even sending a loved one with the person and covering all the costs of travel and the other needs its a no brainer to me. I could right now get a coronary bypass graft in India for $20,000 all that included with extraordinary care. In the US the care would be far less impressive for aftercare and cost five or six times more.
I agree that there needs to be something to keep costs down. I have health insurance through work. I investigated the cost of health insurance on the open market for a daughter that is too old to be covered through my program and is not covered through her work. It was ridiculously expensive, many times the cost for a group negotiated health insurance program. That is why I think that there needs to be a public option. To get group negotiated prices at the individual level. There needs to be commercial competition for that level of the health care business. Today there is only an anti-competitive agreement by the health insurance companies to rip off the individual.
- "The bill would eliminate medical underwriting, allowing premiums to vary based only on the following characteristics: region, tobacco use, age, and family composition." So where do the young and health flee to?
No I meant say they add several new mandates on insurance companies what is going to keep them all from saying: ok we have to cover more preventative care, no lifetime limit, take everyone and maybe even cover longterm care so we are going to double the premiums. They could and likely will do that since there is no limit on that is there?
