What Does The Senate Bill Do?
Jonathan Cohn sums up the how the Senate health care reform bill will do for people. Basically it helps lower your risk if you get sick and need health care. Most people will save money with this bill. Costs would only be higher if you currently don’t buy insurance and don’t get sick.
So what happens if reform does pass? For starters–and this is no small thing–the insurance company will have to sell you a policy, no matter what pre-existing conditions your family brings to the table. And you’ll know from the start that the policy will cover basic services because the government will be defining a basic benefits package. That package is going to include a broader range of services than the typical non-group policy would without reform. So when your doctor recommends a standard test or procedure, you won’t have to panic it falls into some hidden policy loophole.
But what will that coverage cost? The basic premium is roughly the same, according to Gruber’s calculations that he extrapolated from official Congressional Budget Office estimates. But that $50,000 income means you’re also eligible for federal subsidies. Large federal subsidies. In fact, the government will cover about two-thirds of the price, so that you’re left owing just $3,600.
Now, you could end up spending a lot more on medical care if you or someone in your family gets sick. But here, too, the federal government would step in to help. Under the reforms, the government would limit out-of-pocket spending to around $6,000 per year. Combined with the premium, you’re on the hook for around $10,000 total, or about a fifth of your income.
That’s not pocket change, for sure. A family making $50,000 will have to make serious sacrifices to find $10,000. But it’s better–light years better–than finding $25,000 or more. It’s potentially the difference between having to give up your home, get an extra job or declare bankruptcy. Just knowing the bills that could come will be the difference between getting care you need–and skipping it, at grave risk to your health.
Ultimately the bill will be judged on whether it helps people and whether insurance is affordable. My judgment on whether to support the bill was whether more people would be able to get health care. In my judgement that is the ultimate outcome.
Tags: Health Care Reform
answer to your question is simple…pork to the Senators that held out, raises taxes, increases deficit & does little to improve health care- no matter which side of the aisle you’re on.
60 votes ends the myth of the “blue dog democrat”.
Will someone please explain to me:
1) How we can afford to give “large federal subsidies” to people making $50,000 per year? $60,000 per year? $80,000 per year? I understand helping people who can’t afford insurance, but $50K?! $75K?!
2) Where will that money really come from? Honestly, where will it come from? We’re bankrupt.
So much idiocy, so little time. anonny –the subsidies listed in the table are not for “people” making that much money, it’s for a FAMILY OF FOUR. Assuming they mean two adults and two kids, $50k means each adult making $25k. That’s not much when you’re raising two kids. And remember, the subsidies phase down as income goes up. The whole point of this exercise is to make health care more affordable, in a world where it is becoming increasingly unaffordable to even middle class families. And to you and genius Tom S, it will reduce, not increase, the deficit. Every part of this bill will help with the “we’re bankrupt” thing.
And lizzie — if blue dogs really were a myth, we would have gotten a really good bill, not the half decent (but still much better than nothing) one that we are getting.
Scott rocks, and has much more patience for idiocy than I.
We do just fine on $50,000 with two kids, including paying for health care. But I’m glad to know that’s “not much.”
Are you willing to bet your house that the deficit will go down? Just because Harry Reid pulled an Enron on the CBO doesn’t mean it will be so. Not to mention that the whole thing is predicated on a massive cut in payouts to physicians for Medicare. Good luck with that.
I’d be very comfortable betting that the deficit will go down more than the CBO says. The CBO is notoriously conservative in scoring new, money-saving items. I think there are probably things in the bill that will save more than the CBO is willing to score.
And I’m happy for you that you’re willing to keep paying more and more for your insurance while making less and less each year. Me…I’d rather not. If you don’t want your savings on your premiums, maybe I’ll set up a PayPal account and you can just forward them to me. 🙂
Really? You do just fine on 50,000 with a family of four? I find that hard to believe. I’ve been there, done that, and it ain’t easy. I’ve also, many moons ago, paid for our individual health insurance, which, for decent care cost us more per month than our mortgage. If you have “affordable” health insurance I’d read the fine print.
“And I’m happy for you that you’re willing to keep paying more and more for your insurance while making less and less each year. Me…I’d rather not.”
Right. So I should just take the handout. But before I do, I’ll just, for the hell of it, ask: where do you think that money comes from?
And besides, what’s so damn sacrosanct about payouts to doctors? The root reason for our astronomically high health care costs is not the insurance companies (although they have no incentive to help), it’s the high cost of health care! That means doctors and hospitals. At some point either they will have to learn to make do with less, or we all go broke. No other choice.
My judgment on whether to support the bill was whether more people would be able to get health care
Apparently regardless of the costs such as losing the freedom to choose how to spend one’s own money and the Federal government becoming a collection agency for the profits of insurance monopolies.
This bill represents such a fundamental loss of freedom and naked alignment of corporate and government interests against the wealth and welfare of its citizens that it is unfathomable.
Yeah. I’m sure doctors are going to be lining up to take Medicare patients when that goes down.
“That means doctors and hospitals.”
Yea because doctors are waaay over paid for their services. We’re all rich and enjoy a lifestyle where we hardly ever have to take call or go without sleep for >24hours.
Next up massive doctor shortage.
The Senate bill is unconstitutional. First, the federal government cannot mandate anything. States can mandate car insurance but not the feds they have no such power. Social Security, Medicare and Medicaid come under the Commerce language. The Senators must have known this could be challenged easily, which means they are toying with the american people on a daily basis. States could mandate a single payer system, but if the final bill takes out the Kucinich, Sanders amendment permitting states to enact their own legislation, this Senate bill will be doomed in the House conference segment.
How can Nelson get free medicaid for Nebraska for forever, while other small and large states like California and Mass are going bankrupt over the cost of health care. Why cant the Nelson deal be challenged by other states. Why didnt the carpetbagger Tom Carper hold out so Delaware could get free medicaid paid for by the feds? Cuz Carper so deeply embedded with the insurance companies would never think of helping out the workers and middle class in Delaware.
The idea that taxing union workers for health care rather than taxing the filthy rich is another reason why working people should say, No Hell No, We wont buy it, You can put us in jail, but we refuse your federal mandate on the grounds that you have no power to force us to buy from the greedy corporations. There is nothing in this bill that keeps insurance companies from upping your premium the very day Obama signs this piece of crap.
Ultimately the bill will be judged on whether it helps people and whether insurance is affordable. My judgment on whether to support the bill was whether more people would be able to get health care. In my judgement that is the ultimate outcome.
I disagree with your ultimatum. Why does the meme on this site keep making it sound like healthcare is going to be affordable? this reeks of Medicare Part D and yet the Dems are in favor of this sell out to Big Business b/c more people are going to be insured? That’s such a cop out and a lazy defense.
Ultimately this bill will be judged on the dollars spent by lobbyists to get what they wanted. It will be judged on not getting a public option. It will be judged on not getting EVERYONE covered. It will be judged on the creation of an entirely new Subsidy program for Companies THAT DON’T NEED IT!
And who pays for their increase profits? Ultimately WE DO and they still get rich.
It won’t make insurance affordable in the long run, which people on this site also don’t like to acknowledge.
UI, I hear you and respect your opinion that it should only matter that we are helping Americans that aren’t covered. But this isn’t the way to do it. It’s wrong and it is serving the Narrow Interests Obama told us he wasn’t going to serve in his inaugural speech.
the tax payers are going to make the health Co’s even richer.
Ultimately this is wrong.
The numbers I’m using are 2% of income, 8% of income and 20% of income. You are mandated to buy health insurance and pay up to 8% of income for it, otherwise you’re fined 2% of income. If you get sick, you’ll be on the hook for 20% of your income. Now you’d probably go bankrupt. 20% is certainly a lot of money but it’s doable.
There are some big reforms in the bill – an end to uninsurable people and an end to kicking you off of insurance if you get sick which are the worst and most immoral practices of the current system. The price for that is that everyone must have insurance.
I don’t like it that there is no government option but under the bill we had before most of us would not have had that option anyway. I also think the left has set itself up as a fierce critic of for-profit insurance. That means that we’ll get an “I told you so” if they fail to live up to their promises. I really do believe that we’ll get a public option or Medicare buy-in. Those ideas are out there now and they’re popular.
Ultimately the bill will be judged on whether it helps people and whether insurance is affordable.
Insurance is affordable for the poor right now, if you consider Medicaid. If that’s not satisfactory, then maybe “affordability for the poor” is the wrong goal, or at least not the only goal.
For the long-term poor there is Medicaid. IIRC, 40% of births are paid for by Medicaid.
Just as important as affordability is health care security. The health care of the middle and upper middle class is hostage to the hell of corporate mergers, bankruptcies, and offshoring. The Senate bill won’t fix that. If you make good money and are “between jobs” for some months, you have to go apply for a whole new policy that is subsidy-eligible, then pray that your family can still go to the same doctors. And then when you get a new job, back on a new insurance plan with new doctors and different forms to fill out.
If you are a highly paid professional with a secure career, none of this means anything to you. But if you are part of the insecure middle/upper middle class you will know exactly what I am talking about.
COBRA is a nod in the right direction, but it is a cruel joke to give laid-off people the “right” to buy health care with paychecks that are no longer coming, even with subsidies.
And even if you aren’t laid off, there is still job lock-in. If you are offered a better job, even if the job would advance your career, the first thing you have to do isanalyze their health care plan to see if your family can go to the same doctors, or what the hidden trap doors are that would wipe out the raise you are being offered.
And conservatives will tell you that between jobs, you are supposed to spend down your savings to buy health care. This is basically a structural cash-flow restriction that the current patchwork private system imposes on the labor force to keep it from ever gaining wealth.
Health care lock-in is part of the corporate cheap labor policy in effect for 30 years. They want people too afraid to ask for a raise or switch for a better job.
Ultimately, this bill will be judged for destroying the freedom of American citizens to choose where to spend their money. Having the government extort money for the profits of private companies without offering a non-profit government-run alternative is a crime against freedom and liberty.
But, you say, more people will be insured! While that goal is laudable, the price being extracted is way too high. Millions of people have died defending the freedom that is about to be thrown away because people supporting this bill either don’t understand the freedom being lost or simply don’t care. To paraphrase Franklin” “Those Who Sacrifice Liberty For Security Deserve Neither.”
Government extortion of money from its citizens for the profits of private companies is the way of dictatorships, not free countries.
Okay… so the status quo is better than this bill? I’m really having a hard time debating this with you, A1, well… because there seems to be no debate on your side. I’m willing to admit the bill has flaws. I’m also willing to fight on improving it. What are you willing to do? This “my way or the highway” approach and we need to “kill the bill” even though the odds of getting anything else are pretty much nil is frustrating. It’s also frustrating in that there was a time in my life when I would have killed to have this bill – a time when we were paying way more than 8% of our salary for crappy, high-deductible insurance because we didn’t want to lose our house.
This good and evil/all or nothing approach is disheartening.
I’m willing to admit the bill has flaws.
When it’s time to fix the bill as you say – which parts would you fight to keep?
I’m just trying to picture a future “fix” that wouldn’t require us to undo things we are putting in the bill now. Why put them in in the first place?
pandora, supporters of this bill seem to think that if this bill fails, there won’t be another chance, yet at the same time they think that if this passes, it will be “fixed” later. I think that those positions are contradictory.
I think that if this bill fails, a new and better bill that actually reforms healthcare will begin to be worked on very quickly. People want real healthcare reform, not government extortion of people’s money to guarantee profits for insurance companies.
It isn’t republicans that are responsible for this bill, either. It is liberals and progressives that are willing to accept crumbs of benefits and pay for them with their freedom.
It isn’t a question of “good and evil/all or nothing.” It is a question of real reform versus an illusion of reform and at what cost. My position is that this is a bad bill with way too high a price.
We, as liberals and progressives, should demand more and not settle for crumbs.
As Jon Walker wrote this morning in “Reforms Don’t Always Magically Get Fixed Over Time”:
“Many are championing this bill as an imperfect step toward greater reform, and claim it is built on a strong foundation. Say what you will about the benefits of the bill, but I refuse to accept that funneling trillions of dollars, and forcing millions of new customers, into the private health insurance system that got us into this mess is a smart foundation.”
http://fdlaction.firedoglake.com/2009/12/22/reforms-dont-always-magically-get-fixed-over-time/
By the way, the AJAX comment editing has stopped working for me.
I can go along with the “fix it later” crowd if that means we introduce a single bill each for adding the robust public option, Medicare expansion, and drug price negotiation before November. Even if they all fail, it is time to draw bright lines and take names.
I wonder if “fix it later” crowd thinks that the insurance companies with billions of dollars in government-extorted new profits are just going to send all their lobbyists home if the Senate bill becomes law.
This is basically the difference: The people who want to kill the bill believe this congress can and will produce a better bill. The people who want to pass this bill believe this congress can and will improve it.
Okay, that’s lacking nuance, but cut me some slack.
No one is happy with the status quo, so it’s really a difference of what path we take. Truth is… it’s all a crap shoot. No one knows what congress will, or won’t, do.
Can we all agree that the outcome of killing the bill or passing the bill is an unknown, and cut out the crap like… people for the bill are for insurance companies and people against the bill are for letting uninsured people die. It really isn’t productive.
No, we can’t, pandora. We KNOW what the consequences of passing this bill are.
Can we all agree that the outcome of killing the bill or passing the bill is an unknown…
I can go along with that. I think either way would alter politics in a way that I cannot foresee. Whether it passes or fails the bill is probably another step toward the end game, but whose I cannot tell. I’d like to think the new health care system will cause people to wish for single-payer in an unstoppable surge.
Killing bill would hurt real people:
http://www.tnr.com/article/health-care/recognizing-reform
Thanks, anon. And I like the way you think!
I’ve struggled with this bill, and I haven’t reached my conclusion lightly. I basically agree with everyone, but will admit that having someone 🙂 constantly tell me I’m dead wrong and they’re 100% right get’s my hackles up.
Passing the senate bill takes freedom away from everybody.
So Pandora what are your fixes, and when do you want to get started? Can we start by opposing candidates who don’t support fixing this HCR bill? Or will we keep voting for them and sending them money?
First on my list would be removing the individual mandate. On that one we are just digging our hole deeper that we say we will climb out of later.
Next, add a public option. I’d be willing to give up the 85% cost ratio in exchange for a robust public option.
Then, Medicare 55+. No “buy-in,” just plain old Medicare. You pays your taxes and you goes to the doctor. Adjust taxes as necessary.
What else can be fixed?
Well, since you say so, it must be so. And I’m an idiot. So… if we kill this bill then you can guarantee that we’ll get something better?
Anon, I love those fixes, and am willing to fight for them. I stopped giving to the DNC a while ago. I now choose individual candidates and donate directly to them.
Passing the senate bill takes freedom away from everybody.
After we pass the bill, I’m up for inviting teabaggers to join us on a single bill that does nothing but strip the individual mandate on exactly the grounds that it takes freedom away.
I happen to agree that the individual mandate takes freedom away. But I think the subsidies push the net benefit of the bill just shy of the “neutral” mark.
We have honest people here arguing about whether the net benefit is just over or just under neutral. Not something to stir up the base exactly.
After we pass the bill, I’m up for inviting teabaggers to join us on a single bill that does nothing but strip the individual mandate on exactly the grounds that it takes freedom away.
Think about that for a minute. Repubs are already designing their 2010 ads about Dems sending people to jail and fining them if they don’t buy insurance. But if we put a bill on the floor that does nothing but strip the individual mandate out of the new HCR law, Repubs will have to vote against it and all those ads will have to go into the garbage can.
I’m up for inviting teabaggers to join us on a single bill that does nothing but strip the individual mandate on exactly the grounds that it takes freedom away.
So much unfocused libertarian fog. You can’t prevent denial of coverage for preexisting conditions unless everyone has to get into the pool.
So much unfocused libertarian fog. You can’t prevent denial of coverage for preexisting conditions unless everyone has to get into the pool.
Exactly. So then let Repubs vote against it and STFU about freedom.
Good point.
You can’t prevent denial of coverage for preexisting conditions unless everyone has to get into the pool.
So John M., does this put you in the “Don’t fix it later, it’s fine the way it is” crowd?
Assuming the Senate HCR passes as expected…
If Repubs want to campaign against Dems for the individual mandate, then give them an upperdown vote on it next year. That will change their tune quick, and cut the legs out from under the summer teabag protests going into the mid-term elections.
If against all odds the mandate is removed, then the chess table is overturned and the insurance industry becomes an ally in finding a better solution.
…unless everyone has to get into the pool and we can profit from them.
– The pool owners
If against all odds the mandate is removed, then the chess table is overturned and the insurance industry becomes an ally in finding a better solution.
And here is the nut of the delusion here. The insurance industry will NOT be an ally in finding a solution. Certainly not a just one. They will be looking out for themselves and will look to dismantle the regulatory scheme that this current bill provides and they will wipe the floor with progressives.
Either these insurance companies are complete evil and not to be trusted or you think that you can get them to be allies to get something better. You can’t get both. Because everything that you want to make this better will definitively NOT be in the interests of insurance companies.
Everyone who supports passage also wants ameliorating changes, either next year or next session.
The insurance industry will NOT be an ally in finding a solution.
If they faced the threat or the reality of accepting the new terms without an individual mandate – they would not accept that. Like I said, the chess table would be overturned and we would get our opportunity to improve the bill.
Everyone who supports passage also wants ameliorating changes, either next year or next session.
I can find dozens of formerly liberal bloggers urging passage of this bill.
But I can’t find any with a list of changes, a timeline, a legislative strategy, a list of candidates to support or oppose in 2010, primary challenges based on HCR positions,etc. It makes me wonder about the sincerity of the “fix it later” proposition.
We still haven’t fixed Medicare Part C or D and we are now talking about filling the donut hole with more money for private industry. (Hint: the progressive “fix” is drug price negotiation, not throwing more money at the problem).
I can’t find any elected officials vowing to introduce “fix” bills either. Maybe I just missed them.
Uh no.
They would not accept that and work at ridding themselves of the regulatory scheme they agreed to. Period.
The Public Option died because insurance companies could buy 4 votes. They’ll buy more to dismantle the rest of this that they don’t want. There are simply no reasons for insurance companies to just ramp up what they do already — buy off pols. And progressives will have fewer voices, not more, working at stopping them. But there is NO magic that cam be had that gets insurance companies and progressives on the same side.
We still haven’t fixed Medicare Part C or D and we are now talking about filling the donut hole with more money for private industry
Then you missed that Medicare Part D — as unpaid for as it is — was actually an improvement itself on the original Medicare.
And that donut hole is being partially filled by the pharmaceutical companies? That is what their 80B is meant for.
One more time — although you won’t acknowledge this, either — Social Security, Medicare, Medicaid as they exist TODAY are a far cry from the programs originally passed. Each of these programs has gone through hundreds of improvements — a few major and many minor — to get to where they are today. And not one of these programs are perfect, either. But dismantling these programs is currently political suicide. Unless you are a repub. This is why repubs are dead set against anything that gets done in this arena. You can’t give people something that starts benefiting them in a real way and then take it back.
Each of these programs has gone through hundreds of improvements — a few major and many minor — to get to where they are today.
The last modification that is recognizable as “social insurance” was the 1965 Medicare act. It has been downhill ever since. The low point was perhaps Reagan making Social Security benefits taxable. The public/private approach we have been taking ever since is why we have the highest health care costs in the world, which is why we are having a health care crisis now.
And that donut hole is being partially filled by the pharmaceutical companies? That is what their 80B is meant for.
And where do you think they are getting that money from?
The Public Option died because insurance companies could buy 4 votes. They’ll buy more to dismantle the rest of this that they don’t want.
These people need to be defunded.
The low point was perhaps Reagan making Social Security benefits taxable.
Reagan signed legislation supported by both parties to remove the exemption for Social Security received by higher-income taxpayers. One may argue that the threshold should be higher – it has not been raised since 1993 – but the concept of taxing high-income taxpayers’ Social Security benefits was enacted with broad-based support.
formerly liberal bloggers urging passage of this bill.
Nate: “Debating the kill-billers on the policy merits of their position has become a bit like debating the global warming denialists.”
http://www.fivethirtyeight.com/2009/12/another-left-right-convergence.html
Reagan signed legislation supported by both parties…
We never learn…
the concept of taxing high-income taxpayers’ Social Security benefits
“High-income” being $32K
Your problem with taxing high-income SS recipients? $32K in 1993 was extraordinarily high income for a retired couple.
$32K has been less than median income for a while now… remember wage inflation has been proceeding at a lower pace than commodity inflation.
http://en.wikipedia.org/wiki/File:Household_income_65_to_05.png
Maybe OK for a retired couple back then, but I don’t think you can call anyone under the median “high income.”