The major health care bills moving through Congress would require nearly all Americans to have health insurance. But as lawmakers struggle to achieve the goal of universal coverage, a critical question is whether the plans will be affordable to those who are currently uninsured.
All the bills offer some kind of assistance to lower-income people who do not get health benefits through the workplace. The bills would provide premium subsidies to millions of people and would establish limits on consumers’ out-of-pocket costs. But lawmakers and consumer groups say insurance could still be out of reach for many families with modest incomes who receive small subsidies or none at all.
“We have to make sure that the health plans are affordable to average Americans, and to low-wage workers who are not eligible for Medicaid, because they would confront a penalty if they do not have health insurance,” said Senator Olympia J. Snowe of Maine, a Republican who is leading efforts to forge a bipartisan bill.
The question of how to make insurance affordable to all Americans is just one of the difficult issues facing Congress as it debates what is President Obama’s top domestic priority. The House speaker, Nancy Pelosi, despite resistance from conservative Democrats, vowed on Sunday that a health care overhaul would pass. “When I take this bill to the floor, it will win,” Ms. Pelosi said on CNN.
Under the legislation, insurers generally must accept all applicants and could not deny coverage because of a person’s medical history.
But Senator Ron Wyden, Democrat of Oregon, acknowledged that “there are some questions” about whether insurance would be affordable. “People who are making $50,000 or $60,000 a year and are spending $13,000 on health insurance may not get much of a subsidy,” said Mr. Wyden, a member of the Finance Committee. “Those people will ask, ‘How am I going to make this work for me and my family?’
Reach of Subsidies Is Critical Issue for Health Plan – http://www.nytimes.com/2009/07/27/health/policy/27health.html?_r=1&hp
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I’m sure the prospect of private insurance for ALL Americans has the insurance industry salivating. Why should they care where the money comes from as long as their balance sheets stay healthy? The source of premiums for unemployed and poor people would, of course, be subsidies (read “taxes from those still able to pay taxes”) or direct tax credits.
How can there NOT be a public alternative?
The private companies have already offered to cover all as long as all are REQUIRED to have coverage. We agree with this. Please read the ‘details of the plan’ on our blog and you will see that we achieve regulatory reform within the framework of a private market. The template is that of regulated utilities. It works and has worked for a long time. It will work for private health insurance.
How can there not be a public alternative? Well, if you have one, you will have no private alternative for very long. That is the natural history of federal intervention in health insurance. Wherever the federal government steps in, the private sector steps out. The reason is simple. The government has limitless ability to raise funds via taxation. Private companies cannot raise premiums endlessly and stay in business. Private companies need to be profitable but the government can run limitless deficits and make up the difference via confiscatory taxation.
A public option will be the final blow to private health insurance in America and is the Trojan Horse for those seeking single payer coverage. Everyone who is paying attention knows this.
I understand. And it helped me to listen to Maggie Mahar’s interview this afternoon with Terry Gross on Fresh Air. Her understanding of the issue is encyclopedic.
As for a public plan, isn’t Medicare exactly that? And although the Advantage plans have seriously overloaded the boat and will be pinched back, the old “alphabet” plans should remain viable. Seems to me a Medicare-like public option, especially for those at the bottom of the income scale, would not be any serious loss for the insurance people.
On a different point, I only have a vague notion of what is meant by “insurance exchange.” Can you put an explanation into Reader’s Digest form for lay understanding? In my mind that’s what has to happen when no one is left out, cannot be kicked out and no exclusions would be allowed for pre-existing conditions. Some kinda way an exchange allows competing companies to split the risk pool after one or some of them get into deep doo-doo?
Yes, Medicare is a ‘public plan’, but only Part A (hospital coverage). Part B (doctor and other professional coverages) costs a bit over $90 per month (more if you have higher income) and then there is Part D which is the drug benefit passed under the Bush administration. But, you make the point we have made by saying Medicare is a public plan, and there are no other primary coverages that will cover anyone eligible for Medicare (unless they are still working and it is through an employer).
The health insurance exchange is essentially a listing of policies that meet certain basic requirements and are offered on a competitive basis through the exchange. While we are not overly enthusiastic about this, it could work, but only if there is no additional public plan to force out private competition. It seems that some of points we have so aggressively argued for in terms of health coverage reforms will be included in any bill that comes out (no pre-existing condition denials, no drops due to illness, etc.) but there are others that should be in there. Those reforms would keep them out of the ‘doo-doo’.