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    More problems with the Senate health care bill

    by: desmoinesdem

    Tue Dec 15, 2009 at 09:56:35 AM CST


    Nate Silver thinks that thinks any Democrat who opposes it is "batflippin' crazy." He posts a chart showing how a family of four earning $54,000 a year would get much more in subsidies if the bill goes through than if no bill passes.

    I discuss a few problems with the bill and Silver's analysis after the jump.

    desmoinesdem :: More problems with the Senate health care bill
    Silver tacitly admits that this bill won't do anything to contain health care costs. His graph shows that the overall cost of health insurance will increase just as fast with the bill as without it. The only difference is, taxpayers will be covering a greater portion of the cost.

    I think most families earning $54,000 per year won't find it particularly affordable to spend more than $8,500 out of pocket for premiums either.

    Silver ignores other problems with the bill too. Remember President Obama's promise that we can all keep the insurance we have? The Senate bill contains an excise tax on employer-provided insurance, which is likely to encourage employers to change the policies they offer. Writing at Firedoglake, Jon Walker summarized conclusions reached by The Centers for Medicare & Medicaid Services:

    To translate, your employer will reduce what your current insurance plan and put in place high co-pays and deductibles. The result is that many people with employer-provided health insurance will see their insurance get much worse. For younger, healthier employees, possibly getting less comprehensive insurance but maybe higher wages (I think it is very doubtful that there is a pure dollar for dollar passthrough), this might be a decent deal. For older, less healthy employees this is a very bad deal. They will be forced to pay much more out-of-pocket for their health care.

    Republicans won't stop screaming about a "government takeover of health care" just because the Senate dropped the public health insurance option. They will pin all the failures of this bill on the government. Democrats may pass a shoddy bill and declare victory this year, but the results won't be pretty if many people see their employer-provided health insurance getting worse.

    Medical bankruptcies won't go away either. Writing for the Consumer Reports health blog, Kevin McCarthy discusses the preservation of annual caps on coverage, which I wrote about here, and brings up an additional problem the current bill won't solve:

    Another problem with the Senate bill is that it doesn't plug a loophole that a lot of junk insurance plans use: not counting deductibles or co-payments for doctor's visits or prescription drug payments toward a plan's annual out-of-pocket maximum. That can be a catastrophe for people who are seriously ill. And it's one of the things we recommended legislators fix.

    The Senate bill does say that the stingiest plans must cap consumer's out-of-pocket payments at around $6,000 (at least in the first year after reform goes into effect; the cap could go up in succeeding years based on inflation). But it fails to specify that ALL out-of-pocket expenses-- deductibles, coinsurance, co-payments, and similar charges--would count against that out-of-pocket-maximum. The House bill does. It's not too late for the Senate to follow suit.

    Those who keep defending compromises made in the Senate need to explain why Democrats won't take a hit for these and other flaws in the bill.

    I wouldn't mind Democrats paying a political price for sound policy, but taking heat for a bill that's little more than corporate welfare is a different story.  

    Tags: , , , , , , , , , (All Tags)
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    Simple questions that I have (0.00 / 0)
    I am just asking two basic questions about the bill that have been a part of Republican talking points.  I am not saying I either agree or disagree with their talking points, just trying to get straight answers.

    1.  Does the bill give a subsidy to people making eighty nine thousand dollars a year to help pay for their health care?

    2.  Does the bill create eighty eight new federal bureaucracies to oversee the health care system, if no how many new bureaucracies are involved?

    Thank you for your time.  


    no one knows the final shape of the bill (0.00 / 0)
    or how the subsidies will be structured, so I can't answer the first question.

    88 new federal bureaucracies sounds like a willful misreading of something in the bill. I would have to know more about where the GOP is getting that "information" before I could check it.

    Obviously, Lieberman, Nelson et al are making sure there will be no new public health insurance option whatsoever on any level. So I don't know what "federal bureaucracies" are being created other than the national health insurance exchange.

    Invite other Iowa political junkies to join us at Bleeding Heartland.


    [ Parent ]
    ModerateIADem, (4.00 / 1)
    1.  Does the bill give a subsidy to people making eighty nine thousand dollars a year to help pay for their health care?

    Just under 89K (lower 48) if (1) subsidies are available up to 400% FPL and (2) assume family of 4 or greater. (1) is currently true both for House-passed as Senate bills. Obviously, this applies to exchange policies only.

    Here are the fed poverty level thresholds, defined for the lower 48, Alaska & Hawaii.

    So, a family of 4 w/ 88K income would be at 399% FPL. Now you factor in age of head of household & regional cost factors ...

    A. If the policyholder is 30, w/ two young children, medium cost area:

    %premium paid by family: 100%
    payment as percent of income: %9.7  

    B. Policyholder is 50:

    %premium paid by family: 80%
    payment as percent of income: 12.0%

    So the "older" of the two families receives a subsidy but is paying a larger %income for premiums.

    The real joke is when you just exceed 400% FPL. At 89K, a family of 4 w/ a 50 yo HOH in a higher cost area gets no subsidy and pays 17.7% of income for health insurance in the exchange. Now, in the Wash DC metro statistical area, the median family income for a family of four is $102,700. This means that this hypothetical family is lower-middle class and is paying almost 20% of GROSS income in the exchange? Good grief.

    My father was already 60 when I was 12. So, if we'd been this $89K family of four in the DC area, then no subsidy and 23% of gross income to health insurance! Unbelievable.

    Anyway, if you are so inclined, you can play around with different scenarios here.

    NOTE: this does not factor in anticipated premiums hikes, the premium inflation that is guaranteed to take place before 2014, the lack of COLA for subsidies, err, need I say more?  


    [ Parent ]
    federal bureaucracies (4.00 / 1)
    what is your definition of new bureaucracy?

    I think they arrive at the 88 by including new grant programs.  


    [ Parent ]
    Thanks (4.00 / 1)
    I usually define it as something with public employees who have an administrator who hires, fires and delegates.

    Thank you as well for telling your story and putting a real face on a various serious matter where good people seem to have been lost in the numbers.  


    [ Parent ]
    They were house members (4.00 / 1)
    They were reading from the House legislation, obviously the Senate bill will be watered down or whatever phrase you want to use.  I heard the eighty nine thousand number come from Steve King's mouth so that is probably a mis-truth, if not an outright lie.  

    well, look (4.00 / 2)
    Republicans won't stop screaming about a "government takeover of health care"

    now look at

    Remember President Obama's promise that we can all keep the insurance we have? The Senate bill contains an excise tax on employer-provided insurance

    Nothing new here. Remember the big fuss about Whole Foods?

    I use the same system to cover ppl. I purchase high-deductible catastrophic plans which I couple to a reimbursement acct that transforms the policy into a reasonable deductible for the employee.

    These plans will be phased out in this legislation. I've estimated that my insurance rates will triple.

    Yes, it's a government takeover. The government is not allowing me to use my risk management skills to maximize my profits.

    Second, as long as that excise tax is in there, the govt is  saying that I shouldn't hire anyone older.

    The CBO has protected the insurance industry from the heavy hand of govt (and I don't disagree w/ their decision). Problem: the rest of us don't have a CBO.



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