More Details on the Health Insurance Reform Deal.

Filed in National by on December 8, 2009

According to CNN, Harry Reid has announced a “broad agreement” between among the “Team of Ten” liberal and conservative Democrats that have been negotiating on the public option, with the possible alternative being an expansion of Medicare down to 55, as well as making the FEHE open to all. I will post details as they come….

Morning Update:

The opt out public option is gone. In its place will be many of the alternatives we’ve been hearing about, including a Medicare expansion and a triggered, federally-based public option, the aide said.

As has been widely reported, one of the trade-offs will be to extend a version of the Federal Employees Health Benefits Plan to consumers in the exchanges. Insurance companies will have the option of creating nationally-based non-profit insurance plans that would offered on the exchanges in every state. However, according to the aide, if insurance companies don’t step up to the plate to offer such plans, that will trigger a national public option.

Beyond that, the group agreed–contingent upon CBO analysis–to a Medicare buy in.

That buy-in option would initially be made available to uninsured people aged 55-64 in 2011, three years before the exchanges open. For the period between 2011 and 2014, when the exchanges do open, the Medicare option will not be subsidized–people will have to pay in without federal premium assistance–and so will likely be quite expensive, the aide noted. However, after the exchanges launch, the Medicare option would be offered in the exchanges, where people could pay into it with their subsidies.

It appears as if liberals lost out on a Medicaid expansion that would have opened the program up to everybody under 150 percent of the poverty line. That ceiling will likely remain at 133 percent, as is called for in the current bill.

In addition to the new insurance options, the group has tentatively agreed to new, and strengthened, insurance regulations, which the aide could not divulge at this time.

As with the process Senate Majority Leader Harry Reid undertook in merging the Senate Finance Committee and Senate HELP Committee bills, CBO will evaluate a menu of options, some of them interchangeable, so there’s no certainty that this list won’t change in the coming days. However, a senior leadership aide says that all of the options sent to CBO include the (triggered) public plan. Reid and other senators declined to offer specifics earlier tonight, as part of an agreement with CBO not to publicly discuss the policy options on the table while actuaries analyze competing ideas.

I am a liberal and I am a pragmatist. I am not one of those liberal purists who, like the current fringe of the right wing, scream like petulant children when they do not get 100% of what they want. So I will take this deal despite my disappointment in the lack of a robust public option. In the end, we want to forbid insurance companies from rescinding coverage when you get sick, and denying coverage for preexisting conditions, and we want to lower costs across the board for everyone so that premiums for everyone stop rising 10-20% each year, and we want to make insurance available to those who do not have it and cannot afford it. This compromise accomplishes at least three of the four goals there, and makes significant inroads on the fourth. So I will take it for now.

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  1. Delaware Dem says:

    Federal Employees Health Exchange.

    And yes, LaNuit, I am writing a post after I get an explanation for the vote from Kaufman’s office. I have an email out to his office already.

  2. LaNuit says:

    My mistake! Just checking DelDem 😉

  3. I wish the rest of us would get a public option. I’ve still got a long time before I can access the public option. The insurance company investment in Lieberman and Carper was obviously money well spent.

    I was actually thinking of writing a post about Kaufman’s vote. I would like an explanation for his pro-Stupak/Nelson vote.

  4. Here’s some more details:

    But Democratic aides said that the group had tentatively agreed on a proposal that would replace a government-run health care plan with a menu of new national, privately-run insurance plans modeled after the Federal Employee Health Benefits Program, which covers more than eight million federal workers, including members of Congress, and their dependents.

    A government-run plan would be retained as a fall-back option, the aides said, and would be triggered only if the new proposal failed to meet targets for providing affordable insurance coverage to a specified number of people.

    The agreement would also allow Americans between age 55 and 64 to buy coverage through Medicare, beginning in 2011.

    The new details – there some kind of triggered P.O. B.S. and the Medicare buy-in begins in 2011. I don’t understand why this can’t happen immediately?

  5. cassandra_m says:

    I predicted that the PO wouldn’t make it altho it isn’t over. This compromise is not bad, but need to see details. Being able to buy into medicare will help those out of work or very underemployed — those better off financially will be able to buy somewhat better insurance on the exchange.

  6. Delaware Dem says:

    I am updating the post with more details. It would appear that the public option is not dead, although I am not sure how it gets 60 votes if it is not dead. I would love to think that the Grinch who stole healthcare reform, i.e. Joe Lieberman, found that he had a Democratic heart after all.

  7. pandora says:

    I’m so confused, and obviously so is everyone else.

    Psst… DD, I’m so glad this is your post and you’re on top of it! My head already hurts. 😉

  8. Delaware Dem says:

    Read my update to the post Pandora….

  9. I’d like to see details about this triggered public option. Is it a strong public option? What is the trigger? Those details will be important. We could actually end up with something better than the weak, watered-down option if it was done right (which I doubt).

    One of the arguments for the public option was that the FEHB plan failed to do anything about rising rates. Will having more people in it help? Perhaps.

    I’d still like to see the FEHB opened to anyone, so people can shop around and perhaps we can break the job = health care paradigm.

  10. Here’s a good article on the compromise. It’s being scored by the CBO right now and physicians groups are NOT happy. Perhaps physicians groups should have spent more money paying off Nelson and Lieberman. Insurance groups are very, very happy. They gets lots of new customers and sweet government money.

  11. Joanne Christian says:

    FEHB would be fine if they let you buy in at the level you want, and not some of the VERY lousy levels that are issued. Having processed FEHB, each “job category” has a whole different value of coverage–comes down to “are you an air marshal”, or a “postal worker”, in every conversation of processing..and then there is this absolute great coverage…..there is no one set FEHB coverage package as far as I have ever seen to grasp their coverage tables as a whole industry.

  12. Joanne Christian says:

    UI–I can see why physician groups may not be happy. I have been on that end of a $7 reimbursement for a 90 minute visit–that FEHB covered. But like I said, on the flip side, every now and then a full $133 reimbursement comes through..it’s a crap shoot every time. For the most part it’s more the low end reimbursement.

  13. Joanne,

    It looks like there will be some regulations imposed on the plans offered through FEHB. We haven’t seen the details yet but it sounds like they will standardize the plans so that it won’t differ from state to state.

  14. Howard Dean support the deal:

    And this morning he was on The Early Show on CBS reiterating his support for this deal.

    He called it a “positive step forward” that “makes a lot of sense” and described it as “what should have been done in the first place.”

    He asked and answered the most important question about this compromise (apart from the obvious political advantage, that it makes passage of health care reform more likely):
    “Whatever we call it is irrelevant. Is it going to work? Yes, it is.”

    Dr. Dean also called the deal “real reform.”

  15. pandora says:

    Here’s an interesting tidbit from WaPo

    And private insurance companies would face stringent new regulations, including a requirement that they spend at least 90 cents of every dollar they collect in premiums on medical services for their customers.

    Seems like that’s gonna hurt.

  16. anon says:

    So are they keeping the individual mandate? If there is no robust public option they had better remove the individual mandate.

    At this point I am looking forward to Harry Reid being replaced by a Republican in 2010.

  17. anon says:

    Is there some conspiracy among Dem leaders to keep smiling and act like this is victory, because to wail and gnash their teeth would be even worse?

  18. xstryker says:

    Did they ban recision?

  19. donviti says:

    amusing,

    I am a liberal and I am a pragmatist.

    How about you change that to say, “loyal democrat that has his party in power and knows his guys are almost as bad as the other guys, but at least I was given a peace of bread to eat this time in stead of the shit sandwich I was eating for the past 8 years” that would read better and be more honest. Pragmatist? Are you kidding? You settled is what you did. You aren’t liberal. You are a democrat.

    I am not one of those liberal purists who, like the current fringe of the right wing, scream like petulant children when they do not get 100% of what they want.

    I’m trying to digest this sentence and I am perplexed with the combative tone you take to the folks that Obama catered to and that got him elected. Aren’t you concerned that you making an apples to oranges comparison? DD, I am one of those people that screams and I know god damned well this bill doesn’t give us 30% of what we want. How many people still aren’t covered? What costs were curbed? Are you saying we should be happy with this steaming pile of shit called a “health care bill” That has triggers in it, give aways to urgent care centers, what about subsidies? Hmmmmm, really changing the way we do business there.

    I hardly think I’m fringe. I don’t want a war. I want a public option. I don’t believe Jesus is coming again. the world is over 5000 years old. Climate change is real. i don’t want to drill baby drill. I don’t think torture is right. I don’t think spying on amaericans is ok to make me safe. I belive in gun control and I don’t think Obama is Kenyan.

    Way to go all CNN on us and make the extremes of both party become equal in their extremism.

    So I will take this deal despite my disappointment in the lack of a robust public option.

    Yes you will (patting your bald head) You will take it and like it and stfu. Because it’s your party in power. and your a “pragmatist” 🙂

    In the end, we want to forbid insurance companies from rescinding coverage when you get sick, and denying coverage for preexisting conditions, and we want to lower costs across the board for everyone so that premiums for everyone stop rising 10-20% each year, and we want to make insurance available to those who do not have it and cannot afford it. This compromise accomplishes at least three of the four goals there, and makes significant inroads on the fourth. So I will take it for now.

    And the insurance companies still make fucktons of money because the government gave them a 50% off coupon that says they will pay for my half of the insurance. And it doesn’t lower jack shit. It might as well be cash for clunkers or an indefinite TARP that allows them to rape tax payers for decades to come.

    this is a total give away to the health care companies that will still have a state by state monopoly. Nothing changes, 10million people still won’ be covered. they got subsidies. the triggers are a joke and of course the loopholes would make a tom Delay proud.

    I guess I’m semi-intelligent and petulant now because I thought it was going to be different with a supermajority in both the house and the Senate.

    Way to march to the middle DD.

  20. Delaware Dem says:

    So the better idea is to reject all the good the bill does just because, like banning rescission and denial of coverage based on preexisting conditions and the 90% regulation on insurance companies, forcing them to actually spend money on healthcare instead of executive pay and advertisements. Yeah, let’s just through all that out because we didn’t get all of what we wanted.

    Donviti, you are the petulant purist I was talking about. You would reject this bill, and have Congress pass nothing unless they pass exactly what you want. I would rather them get something done than nothing. And actually, the expansion of Medicare is better than a Public Option. Indeed, the most progressive option for universal healthcare, other than single payer, was the Medicare for all. The expansion down to 55 does not go far enough yet, but I will take it for now.

  21. donviti says:

    I know who you were talking about don’t worry 🙂

    It’s not what I want. It’s what the country wants. It’s what is fair. You know what fair is right? It’s not not doing something because it impacts a corporations bottom line.

    which is exactly what this is. A bill catered to big business and ensuring we don’t hurt their precious profit margins.

    I will take it for now and still complain. and in 10 years when we are right back where we are now, we can start this kabuki dance all over.

    (still patting bald head) 🙂

  22. pandora says:

    The more I think about it, the more I like the expansion of Medicare idea. Would I like it to be Medicare for all? Hell yeah! But Medicare for all, like single-payer and universal healthcare didn’t stand a chance. This step seems like an opening that could lead to further expansion. We’ll see.

    But, before I fall in love or go on a rant, I’d actually like to, you know, read the plan.

  23. Delaware Dem says:

    Indeed, Donviti, maybe you should spend some time reading up on what some progressives have to say about the deal, like Anthony Weiner.

    http://tpmdc.talkingpointsmemo.com/2009/12/weiner-on-medicare-buy-in-this-is-one-idea-i-like-a-lot.php

    And Howard Dean likes it too.

    If progressives do accept the compromise, where does that leave you or others like you?

    It is very easy “keeping it real” and being pure in ideology when you are in the opposition. But we are actually trying to govern now, Donviti. I understand you have no interest in that, and you will always be on the sidelines screaming at what you do not like, but some of us are in politics to get things done. Winning election after election means nothing if nothing is done. You want nothing done right now. I do.

  24. just kiddin says:

    What is wrong with Howard Dean. Let me count the ways. He was absolutely opposed to the single payer system while Governor of Vt. He likes to say currently that “we have a single payer system in Vt for everyone “under” the age of 18. It is his brother Jim that is the real progressive. Howard Dean has finally come round to his brothers thinking and most of the progressive thinkers. He is a liberal after all and therefore is willing to accept “any” compromise and call it a “win”. This is no win. Not for the under 55 year olds. Why not put them into the current Medicaid system so people could begin accessing as early as June 2010. Because this is a sham and a scam brought to us by none other than Carpetbagger Carper. Carper designed this “exchange” to be run by people who have never run a health care system before! It will cost millions of dollars to start up this system and none that money is going to “HEALTH CARE”. Its another raft of bureacratic redtape, with less coverage. In fact the coverage may even be less than medicaid and they hope to “establish health care clinics” to handle these cases. ARe your fricking kidding us? This is another ponzi scheme that will steal dollars from the system before it begins to apply a bandaid to real health care.
    try this: http://wwww.antemedius.com/content/fake-liberals-why-they-deserve-our-scorn

    See liberals will accept ANY compromise. It is the REAL progressives who fought this battle and are fighting tonight as we speak…not libs like Howard Dean ready to cave in.

  25. just kiddin says:

    THE FIX IS IN!

    The Senate Health care deal will put Joe Leiberman in charge of regulating your health insurance. Thats right! Joe Leiberman the biggest prostitute for the insurance industry would be Chair of the National Office Of Personel Mgt. (OPM). This “exchange” for national non profit insurance plans, ( a replacement for the Public Option)and its operation is unclear.

    Rumors that if non profit companies fail to offer good enough Plans on the “exchange”, would trigger the creation of a real Public Option.

    Joe Leiberman the mouthpiece for the insurance companies will
    CHAIR the committee that overseas the “alternative” to the public option. It puts Leibermans finger on the public option and the trigger.

    The idea of putting Leiberman in charge of keeping the insurance companies honest…is putting the biggest fox in the woods inside the hen house.

    This is the deal Leiberman will get from Reid and the demorats to get Leibermans vote. Its an outrage. Of course, you can be assured that Senator Tom Carpetbagger Carper will be on that committee, the man who has consistently exposed the ridiculous exchange program since day one.

    Our only hope now is that Houe Progressives refuse to vote for this bill by rejecting the corrupt bought out corporate owned Senate bill.

  26. A. price says:

    i have to agree with JK here. I told you live in thw world of fantasy regarding Afghanistan… and you still do….. but, you are absolutely correct here. This is INSANE. If this goes through, the driving force should be to get Leibby out. The leadership in the Senate is horrible.
    *disclaimer.. this is an awful stereotype about Mormons*… but what is it about Mormons with the last name Reid? We REALLY want our team to win, but they cant seem to clinch anything. (yeah, im a bitter Eagles fan)
    Anyway, It is clear that electing Obama isn’t enough. The wave of progressive awesomeness that elected him needs to turn it’t attentions to the congress and if democrats like Reid, and Carpetbag fail to see the mandate of Obama, they need to be replaced.
    I know i sound purist, but we still have an opportunity to have a truly progressive agenda for at least 14 years. (i wont count the first 2 years of the Obama administration because the Repukes have made a VERY good last stand)
    Leiberman’s appointment only shows us that the revolution isn’t over.