Nebraska gets a free pass for voting for health care

[IndyColtsFan]

I thought the original purpose of Health Care Reform was to provide lower cost health care to all Americans.

Why the talk/concern of the insurance companies. The government feels that they do the job better and cheaper.

Or is the government again blowing smoke?

Throughout the debate, the left has kept shifting its argument based on being proven wrong as more data was released. At first, all we heard was "Health care is too expensive! People can't afford it! The government needs to take over!" Then, when the initial Congressional proposal hit in the summer and the left was cheering, the CBO burst their bubble by showing that no cost containment would happen if that bill were enacted into law.

When faced with that argument, many on the left shifted to "Costs don't matter -- it is quality of care that does!" After that shift and all of the ensuing arguments, I lost track of any other shifts between then and now.

Now, it seems that there are two camps in the Democratic party:

1. The first camp consists of the people voting for the current bill who will do their best to claim that they have achieved a monumental victory with the passage of this bill when, in fact, everyone knows they're trying to pass something, ANYTHING, to save face and to back up all the rhetoric and tough talk we've heard since the election.

2. The second camp consists of the people disappointed in the legislation and who are trying their best to blame Republicans for "obstructionism" with only a token mention of the Blue Dogs and their role in defeating the previous provisions. Of course, we all know solely blaming this on Republicans is absolute BS.

 

[woolfe9999]

Appropos of what this bill does and does not do with respect to the insurance industry bottom line, I got around to reading the CBO report on the Reid version of the bill, and the supplemental report on the manager's amendment to that bill. BTW, if you really want to understand legislation, CBO reports are online and they are a better source of information than pundit soundbites or internet commentary.

Bottom line is that this bill has the following net projected effects on health insurance costs:

For those not in employer group plans, it will raise them substantially, to about 20% above their current level (some of this is due to expanded benefits). Subsidies will pay for about 2/3's of the premium costs, so people can buy them for about half of what they cost now, but the insurance industry will gain about 15 million new customers, the vast majority purchasing these very expensive policies. The other half of the new insureds will be under Medicaid, which will not benefit the industry. So the insurance industry is getting a big windfall here, but those saying they are getting 30 million new customers are not correct since the Medicaid expansion accounts for about half of the newly insured under the bill.

With respect to employer based plans, there are numerous small provisions which either slightly raise or lower premium costs. For small group insurance, the net is about a 1% reduction in premium costs, and about 2% for large group. This isn't going to affect the insurance industry much. It will probably be a slight hit to their profits for existing, employer based insurance, not really offsetting the massive windfall of new customers buying premiums which will be higher than they are now, and using subsidies to purchase them.

Just thought I'd inject some...information into this discussion.

- wolf

 

[CycloWizard]

Appropos of what this bill does and does not do with respect to the insurance industry bottom line, I got around to reading the CBO report on the Reid version of the bill, and the supplemental report on the manager's amendment to that bill. BTW, if you really want to understand legislation, CBO reports are online and they are a better source of information than pundit soundbites or internet commentary.

Bottom line is that this bill has the following net projected effects on health insurance costs:

For those not in employer group plans, it will raise them substantially, to about 20% above their current level (some of this is due to expanded benefits). Subsidies will pay for about 2/3's of the premium costs, so people can buy them for about half of what they cost now, but the insurance industry will gain about 15 million new customers, the vast majority purchasing these very expensive policies. The other half of the new insureds will be under Medicaid, which will not benefit the industry. So the insurance industry is getting a big windfall here, but those saying they are getting 30 million new customers are not correct since the Medicaid expansion accounts for about half of the newly insured under the bill.

With respect to employer based plans, there are numerous small provisions which either slightly raise or lower premium costs. For small group insurance, the net is about a 1% reduction in premium costs, and about 2% for large group. This isn't going to affect the insurance industry much. It will probably be a slight hit to their profits for existing, employer based insurance, not really offsetting the massive windfall of new customers buying premiums which will be higher than they are now, and using subsidies to purchase them.

Just thought I'd inject some...information into this discussion.

- wolf

Convenient that most articles describing the latest form of the bill leave out the fact that it mandates health coverage. This will cause the bill to fail horribly such that little of the rest of its contents matter. The only equivalent mandate I can conceive of that is already in place is the draft, but even that doesn't take money out of peoples' wallets. If this bill passes, things will take a turn for the worse very, very quickly.

 

[blackangst1]

I thought the original purpose of Health Care Reform was to provide lower cost health care to all Americans.

Why the talk/concern of the insurance companies. The government feels that they do the job better and cheaper.

Or is the government again blowing smoke?

I dont think that was EVER the goal, TBO. I believe the goal (sorry to sound like a cliche) was to (to put it crudely) tax those who have, and pay for coverage for those that dont, using the existing insurance model we already have, meanwhilke doing NOTHING to actually reduce cost. The reason I say that is two-fold.

First, as has been proven um-teen million times, the highest part of cost is internal administration, not the actual mark-up of the product itself. Now, to address that, congress would then need to mandate administration of insurance. Sorry, that isnt gonna happen. (Again to put it crudely) We arent at a place in this country to where our government can mandate how to run your internal administration. Of course there are some things that are governed, but there's not gonna be a mandate that says your admin costs must be below x%. Aint gonna happen. Nor should it.

Second, I always thought the cries from some on the right of government "taking over" privatized insurance were a joke. In a very real way that would mean the removal of not only insurance comanies, but the entire industry from the private sector. It aint gonna happen any time soon. It is a 2-4 TRILLION dollar industry that would need to be yanked off Wall Street. That move would affect almost EVERY American who has ANY kind of retirement account. Go ahead and look at your IRA or 401k. See how much of it is invested in health care. Its just...unrealistic.

And finally, as evidenced by the all time high $$$ amounts going to the Dems this year from the health care industry, well....they arent going to bite the hand that feeds them. They just arent. So, as a result, we get the mangled POS that is struggling to pass. Which isnt reform at all.

 

[boomerang]

Just thought I'd inject some...information into this discussion.

- wolf

Since you have it right there in front of you, what does the CBO say about the front load? You know the 4 years of taxes, fees and the like that will be collected to fatten up the coffers? The revenue that will be collected prior to the vast majority of any benefits kicking in that the CBO is duty bound to include in their calculations?

I'm certain that this money will be put in a lock box somewhere to be drawn upon when the health plan actually kicks in right? I mean, there's just no way that the fine upstanding members of Congress would ever tap into that money for other purposes - right?

I wish, I truly wish, that I could go through life with rose colored glasses on ignoring the bad while only seeing what I deem to be good. Fat, dumb and happy! That's the American way baby!

 

[woolfe9999]

Since you have it right there in front of you, what does the CBO say about the front load? You know the 4 years of taxes, fees and the like that will be collected to fatten up the coffers? The revenue that will be collected prior to the vast majority of any benefits kicking in that the CBO is duty bound to include in their calculations?

I'm certain that this money will be put in a lock box somewhere to be drawn upon when the health plan actually kicks in right? I mean, there's just no way that the fine upstanding members of Congress would ever tap into that money for other purposes - right?

I wish, I truly wish, that I could go through life with rose colored glasses on ignoring the bad while only seeing what I deem to be good. Fat, dumb and happy! That's the American way baby!

Do you want the information or are you just trying to make a point here? I'll give you the information in case you do want to know. It isn't the answer you think it is.

The bill's major tax provision, which is a tax on high-premium plans, doesn't kick in until 2013, which is when the main benefits of the legislation also kick in. And they start very low and increase from year to year thereafter. This tax is actually very backloaded, with most of the revenues coming in toward the end of the next decade.

There is only one signficant tax provision which kicks in right away: the relatively small tax on insurance companies, which starts out miniscule and ramps up over the next decade.

This is offset by the tax credit for small businesses which was moved up to 2010 in the manager's amendment.

Accordingly, the net revenue generated by the bill in 2010 is MINUS one billion dollars. In 2011, 2012, 2013 (the major benefit year), and 2014, the net revenue, respecitvely: one billion, four billion, 22 billion, 43 billion, and increasing from there.

You can check these CBO figure on cbo.gov, loading the PDF of the CBO's 12/19/09 report on the bill plus the manager's amendment, which is the latest version of the bill. Look at the table under "changes in revenue," and feel free to correct me if I am misreading it.

The revenue provisions in this bill are, in fact, extremely backloaded, not the other way around.

This is what I mean when I say that people need to read at least portions of the bill and/or the CBO reporting on the bill. You cannot trust anything that anyone in Congress says about the bill either while on the floor or in the media. You cannot trust anything the press says about the bill. You cannot trust any pundits, whether left, right or center.

My suggestion is to bypass all media and ideological commentary and go straight to the source.

- wolf

 

[Hayabusa Rider]

The mandated purchase of insurance is a rather interesting concept. The claim by Dems has been that most of the people who do not have insurance is because of cost. So what happens? They mandate that people buy it or the government will punish them. Now the Dems say that they are covered. Yeah, because they were effectively forced to buy something they couldn't afford or the benevolent government will punish them.

It's like countries which say there are no gays withing their borders. Well of course not. They were all executed.

Ahh, the power of guns and badges.

 

[woolfe9999]

The mandated purchase of insurance is a rather interesting concept. The claim by Dems has been that most of the people who do not have insurance is because of cost. So what happens? They mandate that people buy it or the government will punish them. Now the Dems say that they are covered. Yeah, because they were effectively forced to buy something they couldn't afford or the benevolent government will punish them.

It's like countries which say there are no gays withing their borders. Well of course not. They were all executed.

Ahh, the power of guns and badges.

I suppose I agree with this criticism in concept. However, I will point out some facts about the bill to put this mandate in perspective, which I think underscores that this criticism is more on principle than practicality.

Anyone who gets insurance through his or her employer is not covered by the mandate, obviously.

Anyone up to 133% of Federal Poverty Line (FPL) is under Medicaid and not covered by the mandate.

Anyone between 133% and rough 300% of FPL is exempted from the mandate (roughly).

Certain types of workers like firefighters are exempted from the mandate.

Finally, and most importantly, in the Senate version of the bill, the tax penalty for those covered by the mandate but opting to not purchase insurance is $95 for the year in 2013, going up to $750 per year by 2016. Subsidies will pay for 2/3's of the premiums for those who opt to buy the insurance.

In the House version, BTW, the penalties are steeper, which is why that bill would cover about 36 million more people versus the senate version covering about 31 million more.

Not saying I particularly care for the idea of a mandate, but given the size of the penalty and the fact that it only affects people at 300%+ of FPL, it doesn't actually seem all that burdensome.

- wolf

 

[sciwizam]

I don't think people <300&#37; are exempted, they are provided subsidies to help pay for it.

 

[woolfe9999]

I don't think people <300% are exempted, they are provided subsidies to help pay for it.

They are provided subsidies if they want to purchase, but not mandated to purchase. Actually, the number 300% FPL is not exactly right. The exemption from the mandate applies if the premium cost would be 8% or more of your income, so it isn't based on percent of FPL directly. On average, that comes to approximately 300% FPL, depending on where you are located and other variables.

- wolf

 

[EagleKeeper]

Is the insurance companies going to quote at $100/month for you and $300/month for myself.

Or both of us get $300/month and you have to request a check from Uncle?

With a different rate; how would the insurance companies determine who gets what quote?
Does one get a letter from Uncle stating what their rate or discount should be?

If a family has to wait for a check from Uncle; what will be the frequency and time lag?
A family maybe able to pay the $100/month but can not afford the $300 and wait for Uncle.

 

[boomerang]

<snip>
My suggestion is to bypass all media and ideological commentary and go straight to the source.

- wolf

Thanks for your reply. Thanks too, for having a calm and level head. Yes, I was trying to make a point, but I very much want good information to base my decisions on.

I have to take the CBO report with a grain of salt at this point however. Mostly because this is not the final version of the bill. After it goes back to the House and winds it's way back is the time to get serious. I, as well as many, get caught up in the thick of all this at a point in time that is mostly meaningless.

I have extremely serious issues with this bill. For several reasons that I consider to be very important.

I don't like it being crafted behind closed doors. I don't like the lack of transparency - transparency we were promised. When my grandkids are behind closed doors whispering they're usually up to no good. This is exactly what I see going on now in the Senate. It went on in the House too. These actions make me very suspicious. No one will be able to convince me otherwise. No way, no how.

Contrary to those blinded by their parties rhetoric, I have major, major problems with a bill that is crafted by one side only. Major problems. This legislation is too big, too far reaching, it takes over 1/6 of the economy and it should have input from both sides.

I may add more later, but I'm unusually busy right now. I just wanted to thank you for your post before the thread progressed too far. Sorry for grammer and spelling errors - I just don't have time right now.

 

[Hayabusa Rider]

They are provided subsidies if they want to purchase, but not mandated to purchase. Actually, the number 300% FPL is not exactly right. The exemption from the mandate applies if the premium cost would be 8% or more of your income, so it isn't based on percent of FPL directly. On average, that comes to approximately 300% FPL, depending on where you are located and other variables.

- wolf

If true I have less of a problem with how it works. It's inherently unfair to penalize someone because they can't afford the financial penalty.

One thing which I would insist on is calculating in debt. Suppose someone has a financial disaster which cripples them? Having a good income doesn't prevent such a thing. That ought to be taken into account as well.

Thanks for presenting a rational argument

Hearing what sounds as if government running health care fixes all woes for cheap is about as silly as Palin's Death Panels.

 

[woolfe9999]

Thanks for your reply. Thanks too, for having a calm and level head. Yes, I was trying to make a point, but I very much want good information to base my decisions on.

I have to take the CBO report with a grain of salt at this point however. Mostly because this is not the final version of the bill. After it goes back to the House and winds it's way back is the time to get serious. I, as well as many, get caught up in the thick of all this at a point in time that is mostly meaningless.

I have extremely serious issues with this bill. For several reasons that I consider to be very important.

I don't like it being crafted behind closed doors. I don't like the lack of transparency - transparency we were promised. When my grandkids are behind closed doors whispering they're usually up to no good. This is exactly what I see going on now in the Senate. It went on in the House too. These actions make me very suspicious. No one will be able to convince me otherwise. No way, no how.

Contrary to those blinded by their parties rhetoric, I have major, major problems with a bill that is crafted by one side only. Major problems. This legislation is too big, too far reaching, it takes over 1/6 of the economy and it should have input from both sides.

I may add more later, but I'm unusually busy right now. I just wanted to thank you for your post before the thread progressed too far. Sorry for grammer and spelling errors - I just don't have time right now.

I would take the CBO estimate with a grain of salt because the bill isn't final as well. In particular, the revenue (i.e. tax) provisions in the bill are one area that might get changed when the bill goes to conference committee.

Everyone should keep an eye on the main revenue provision in the Senate bill, the one that taxes "cadillac" plans. It is a very under-reported portion of the bill, one that is mentioned but not often analyzed by media. While the house version is a generic tax on the weathly that is easy to analyze, the senate tax has potientially huge implications that are hard to predict. It could lower healthcare premiums by a lot. It could lessen the benefits that people with higher end policies receive. It could force insurance companies to be more efficient and take less profit. While its its short term effects are minimal, it's effects way down the road could be massive, for good or ill.

On the issue of transparency, I'm not really sure. The texts of these bills and the CBO reports have been online as soon as they come down. The problem is the media and political filtration of all of it. It's a massively complex bill that is not being explained very well by anyone, for a variety of reasons, which include such nefarious things as outright political bias, and such banal things as time compression on news reports.

Regarding the backroom dealings, this is an ugly part of the political process that goes on all the time, and is receiving more publicity here due to the high profile of this bill. The real problem on that score IMO is less with the bill in particular and more with the system in general.

Don't worry about spelling and grammar. Mine is never perfect either.

- wolf

 

[woolfe9999]

If true I have less of a problem with how it works. It's inherently unfair to penalize someone because they can't afford the financial penalty.

One thing which I would insist on is calculating in debt. Suppose someone has a financial disaster which cripples them? Having a good income doesn't prevent such a thing. That ought to be taken into account as well.

Thanks for presenting a rational argument

Hearing what sounds as if government running health care fixes all woes for cheap is about as silly as Palin's Death Panels.

I think, but don't quote me here, that there is a "hardship" exemption that you can apply for based on financial circumstances. If not, then I agree with you that there should be.

This bill will not cure all woes. That is for sure. The issues are almost insanely complicated and it is a headache to even analyze it all.

- wolf