From Ezra Klein: The legal theory currently in vogue in conservative circles holds that the Constitution's vision of "a central government with limited power" -- to use Judge Vinson's phrase -- permits the government to establish a single-payer health-care system that every American pays into through payroll taxes and that wipes out the private insurance industry but forbids the government from administering a regulated market in which individuals purchase private insurance plans and pay a penalty if they can afford coverage but choose to delay buying it until they're sick.
There's a chance conservatives will come to seriously regret this stratagem. I think it's vanishingly unlikely that the Supreme Court will side with Judge Vinson and strike down the whole of the law. But in the event that it did somehow undermine the whole of the law and restore the status quo ex ante, Democrats would start organizing around a solution based off of Medicare, Medicaid, and the budget reconciliation process -- as that would sidestep both legal attacks and the supermajority requirement.
The resulting policy isn't too hard to imagine. Think something like opening Medicare to all Americans over age 45, raising Medicaid up to 300 percent of the poverty line, opening S-CHIP to all children, and paying for the necessary subsidies and spending with a surtax on the wealthy (which is how the House originally wanted to fund health-care reform). That won't get us quite to universal health care, but it'll get us pretty close. And it'll be a big step towards squeezing out private insurers, particularly if Medicaid and Medicare are given more power to control their costs.
AHIP - the insurance industry, has funded a new study attacking the Senate Finance Committee health reform bill, claiming it will hike family premiums.
- The White House to then issued new talking points attacking the study as a “self serving” effort to defend its “profits."
- While the study seems to help reform foes, it actually makes a good case for Single-Payer or a Medicare like Public Option and should make it easier for Dems to cast opposition to reform as orchestrated by the insurance companies.
- Even some GOP aides are worried about this.
- Ezra Klein shreds the report on the facts, as does Jonathan Cohn who got MIT economist Jonathan Gruber to review AHIP's PriceWaterhouseCoopers report and says that the AHIP Claim on Benefits Tax is "Implausible".
msnbc.com reports:
The health insurance industry has been working until recently to help draft legislation, while publicly endorsing President Barack Obama's goal of affordable coverage for all Americans. The alliance has grown strained as legislation advances toward votes in Congress.
Late Sunday, the industry trade group America's Health Insurance Plans sent its member companies a new accounting firm study that projects the legislation would add $1,700 a year to the cost of family coverage in 2013, when most of the major provisions in the bill would be in effect. I think they make an excellent case for Single-Payer... Medicare For All:
Study: Premium increase
Premiums for a single person would go up by $600 more than would be the case without the legislation, the PricewaterhouseCoopers analysis concluded in the study commissioned by the insurance group.
"Several major provisions in the current legislative proposal will cause health care costs to increase far faster and higher than they would under the current system," Karen Ignagni, the top industry lobbyist in Washington, wrote in a memo to insurance company CEOs.
The study projected that in 2019, family premiums could be $4,000 higher and individual premiums could be $1,500 higher.
But the PricewaterhouseCoopers analysis attempted to get at a different issue — costs for privately insured individuals.
It concluded that a combination of factors in the bill — and decisions by lawmakers as they amended it — would raise costs.
The chief reason, said the report, is a decision by lawmakers to weaken proposed penalties for failing to get health insurance. The bill would require insurers to take all applicants, doing away with denials for pre-existing health problems. In return, all Americans would be required to carry coverage, either through an employer or a government program, or by buying it themselves. Other factors leading to higher costs include a new tax on high-cost health insurance plans, cuts in Medicare payments to hospitals and doctors, and a series of new taxes on insurers and other health care industries, the report said. While I do believe the Insurance Industry through AHIP is being disingenuous with this report, it does still demonstrate how current plans under review are far more complicated and expensive than they need to be. We have a historic opportunity for members of Congress to go on the record in support of single-payer legislation and we should push for those votes. A significant of YES votes helps establish a benchmark so with healthcare reform returns for debate again - as it will given the plans offered - we won't have single payer taken off the table before then negotiations begin.
Note that the text in the above forms will need a bit of revising - which you are free to do and should do. I would also urge you to ask them to request that the Congressional Budget Office score HR-676. Let Congress and the public see where the real efficiencies are.
More Info on upcoming Single Payer votes here.
This blog has spent a lot of time over the years digging through the details of this or that health care plan. But it's worth taking a moment to appreciate that the language in today's budget is something entirely different: Not an idea, but a directive. Not a document to win a campaign, but a document to kickstart the congressional process.
This is what health reform looks like. This is happening.
As reported here earlier in the week, the budget document does not offer a detailed plan. Rather, it's partial funding paired with detailed principles. The money is significant: $634 billion over 10 years. It comes from limiting the itemized deductions upper income Americans can use to lower their tax bracket and squeezing the private insurance providers who are charging Medicare 114 percent what the program traditionally spends. It comes from accelerating the adoption of generic drugs and changing hospital payment policy to reduce the need for follow-up visits.
According to documents obtained by The Prospect, the budget also says that "the President looks forward to working with the Congress over the coming year, and as he does, the President will adhere to the following set of eight principles:"
• Guarantee Choice. The plan should provide Americans a choice of health plans and physicians. People will be allowed to keep their own doctor and their employer-based health plan.
• Make Health Coverage Affordable. The plan must reduce waste and fraud, high administrative costs, unnecessary tests and services, and other inefficiencies that drive up costs with no added health benefits.
• Protect Families’ Financial Health. The plan must reduce the growing premiums and other costs American citizens and businesses pay for health care. People must be protected from bankruptcy due to catastrophic illness.
• Invest in Prevention and Wellness. The plan must invest in public health measures proven to reduce cost drivers in our system—such as obesity, sedentary lifestyles, and smoking—as well as guarantee access to proven preventive treatments.
• Provide Portability of Coverage. People should not be locked into their job just to secure health coverage, and no American should be denied coverage because of preexisting conditions.
• Aim for Universality. The plan must put the United States on a clear path to cover all Americans.
• Improve Patient Safety and Quality Care. The plan must ensure the implementation of proven patient safety measures and provide incentives for changes in the delivery system to reduce unnecessary variability in patient care. It must support the widespread use of health information technology with rigorous privacy protections and the development of data on the effectiveness of medical interventions to improve the quality of care delivered.
• Maintain Long-Term Fiscal Sustainability. The plan must pay for itself by reducing the level of cost growth, improving productivity, and dedicating additional sources of revenue.
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