Health Care Reform: Obama and Kennedy Roll Out Plans

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It seems that President Obama has decided that Congress needs some pushing on health care reform, and is inserting himself back in the health care reform debate.  

 White House budget director, Peter R. Orszag noted in an interview that health care reform “will become President Obama’s plan,” and he “will be weighing in more definitively” this week.

This should not be a surprise however because the President  has been preparing to do this for months through speeches, town-hall-style meetings and proactive ‘lobbying’ of legislators.

On Saturday, the President’s weekly radio and Internet address focused on:

         Extending coverage to the 45 million uninsured while lowering costs;

         Improving quality and preserving consumer choice;

         A “historic down payment” of $634 billion over 10 years, accomplished mostly by slowing Medicare growth and limiting tax breaks for those with high incomes;

          The Mayo Clinic in Minnesota and other institutions as among those that offer high-quality care at low cost; and

         A 50-state grass-roots effort that Organizing for America, the president’s political group, began Saturday to promote a health care overhaul.

Moving to the legislative branch, Senator Edward M. Kennedy (D-MA) has finally drafted and circulated his comprehensive health care legislation known as the American Health Choices Act

Under the legislation:

          Access is given to all Americans for “essential health care benefits,” that include doctors’ services, hospital care, maternity and newborn care, prescription drugs and mental health and substance abuse services, with no annual or lifetime limits;

 

          Employers would have to contribute to the cost of coverage;

 

         The government would create a new public insurance program under sweeping legislation drafted by and circulated Friday;

 

         The government would subsidize premiums for people with incomes up to 500 percent of the poverty level ($110,000 for a family of four); and

 

         Private insurers would have to pay out a specified percentage of their premium revenues in benefits.

 

         The new government-run program would pay doctors and hospitals at Medicare rates, plus 10 percent.

 

         The bill would also establish a new insurance program to provide home- and community-based care for 10 million people with severe disabilities.

 

         Individuals would be subject to financial penalties if they did not have health insurance. The Treasury secretary would set the amount of the penalties, at “the minimum practicable amount that can accomplish the goal” of expanding coverage. The penalties would be added to a person’s tax bill and collected by the Internal Revenue Service.

 

         People would be exempt from the penalties if “affordable health care coverage is not available” or if the premium payments would cause “an exceptional financial hardship.” President Obama recommended such a “hardship waiver” this week.

 

         The secretary of health and human services would establish a panel of experts, the Medical Advisory Council, to recommend a minimum package of insurance benefits. If Congress did not disapprove the recommendations, insurers would generally have to provide the benefits.

 

         Any group health plan or insurance company that provided coverage for children and their parents would have to offer to continue “dependent coverage” for the children through age 26.

 

         Expansion of Medicaid to cover uninsured people with incomes up to 150 percent of the poverty level ($16,245 for an individual and $33,075 for a family of four). That could open Medicaid to millions of people who do not now qualify.

 

         The bill says that “nothing in this act shall allow federal payments” for illegal immigrants.

 

         The federal government would make grants to the states to establish insurance marketplaces or exchanges. Those entities, known as health benefit gateways, would disseminate information about premiums and benefits and would help people enroll.

 

         The new entities would also act as financial intermediaries, receiving subsidy payments from the government and sending the money to insurance companies. The insurance exchanges would also redistribute money among health insurance plans, from those with a large share of healthy subscribers to those with large numbers of sick people.

 

         To protect consumers, federal officials would establish rules for the marketing of insurance policies. States could enforce tougher standards of their own.

 

         The secretary of health and human services would establish the new government-sponsored plan, which would compete directly with private insurers.

The legislation however does not indicate how Mr. Kennedy would pay for his proposals, other than by requiring contributions by individuals and employers.  Anthony Coley, a spokesman for Mr. Kennedy, said the legislative language circulated in Washington on Friday was “a draft of a draft,” and that “there is no final policy,” yet.

The legislation will go to the Senate Finance Committee with their health care reform bill, and the two bills would be merged before going to the Senate floor — in July, they hope. The 170-page draft bill, is a working draft, complete with committee notes and blank spots where pertinent details would be filled in.

Below is more information about the week to come:

– The Post's Ceci Connolly sums up the week ahead;

 Looking back, Roll Call (sub. req.) summarizes some of the acrimony within House Democratic caucus.

– A New York Times piece on Sunday outlined the insurance industry's opposition to any semblance of a public option.

– (USA Today looks at opponents within the business community.) Proponents of such a plan are pointing to the opposition's fear that a public option, "could set premiums so low it would quickly consume the market," as a benefit and not a flaw.

Congress: America’s Health Choices Act

 

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