The HCR bill passed the House and, since it is identical to the Senate bill (which was an amendment by substitution of another House bill), it will go to the president for his signature. The “Reconciliation” bill will probably die in the Senate. What now ?
First comes the election. I don’t think the anger and determination to punish the Democrats will die down. I think they could lose 100 seats this fall. The Senators were less visible in the health care debate but there are a number of small scandals that will doom a number of members’ chances for re-election.
The first provisions to become effective in the bill will be the “shall issue” provision which prevents health insurance companies from turning down applicants for “pre-existing conditions.” Thus, we now have the case of the man whose house is burning down, buying fire insurance. This will have several effects. It will remove the motivation to buy insurance from all but the most conservative. The “mandate” does not take effect initially and the penalties are weak, so it will have little effect. Worse, it requires the purchaser to buy a product larded up with coverage for low probability events and unnecessary treatment types. This is a lobbyists dream, as it is in most states.
The taxes apply to income and investments, so there will be more drain on the economy. Take a look at a leftist’s account of the myths and fallacies in the bill which will become law tomorrow.
1. Myth This is a universal health care bill.
Truth The bill is neither universal health care nor universal health insurance.
Per the CBO:
Total uninsured in 2019 with no bill: 54 million
Total uninsured in 2019 with Senate bill: 24 million (44%)
2. Myth Insurance companies hate this bill
Truth This bill is almost identical to the plan written by AHIP, the insurance company trade association, in 2009. The original Senate Finance Committee bill was authored by a former Wellpoint VP. Since Congress released the first of its health care bills on October 30, 2009, health care stocks have risen 28.35%.
3. Myth The bill will significantly bring down insurance premiums for most Americans.
Truth The bill will not bring down premiums significantly, and certainly not the $2,500/year that the President promised.
Annual premiums in 2016, status quo / with bill:
Small group market, single: $7,800 / $7,800
Small group market, family: $19,300 / $19,200
Large Group market, single: $7,400 / $7,300
Large group market, family: $21,100 / $21,300
Individual market, single: $5,500 / $5,800*
Individual market, family: $13,100 / $15,200*
4. Myth The bill will make health care affordable for middle class Americans.
Truth The bill will impose a financial hardship on middle class Americans who will be forced to buy a product that they can’t afford to use.
A family of four making $66,370 will be forced to pay $5,243 per year for insurance. After basic necessities, this leaves them with $8,307 in discretionary income — out of which they would have to cover clothing, credit card and other debt, child care and education costs, in addition to $5,882 in annual out-of-pocket medical expenses for which families will be responsible.
5. Myth This plan is similar to the Massachusetts plan, which makes health care affordable.
Truth Many Massachusetts residents forgo health care because they can’t afford it.
A 2009 study by the state of Massachusetts found that: 21% of residents forgo medical treatment because they can’t afford it, including 12% of children. 18% have health insurance but can’t afford to use it
Read the rest of it at the link. Jane Hamsher favors single payer on the model of Canada or the NHS and I disagree but this is an interesting picture of the bill from an intelligent leftist. I don’t understand some of her numbers. I don’t know why individual policies would be cheaper than individuals in the large and small group markets unless the policies are not the same in provisions. For example, many individual policies are high deductible. Her description of the early provisions is a bit different from what I understand but I have not made a detailed study of the bills.
Six months from the date of passage, children could not be excluded from coverage due to pre-existing conditions, though insurance companies could charge more to cover them. Children would also be allowed to stay on their parents’ plans until age 26. There will be an elimination of lifetime coverage limits, a high risk pool for those who have been uninsured for more than 6 months, and community health centers will start receiving money.
I thought the ban on pre-existing condition exclusion applied to all ages.
Long term effects, assuming the bill stands, would erode the level of reimbursement to providers, would not reduce the number of people going to ERs, and would result in waits for care, especially primary care, as doctors retire and drop out of the system to practice for cash.
I also think the bill could be amended to remove most of the objectionable provisions and leave the few helpful ones, like insurance exchanges. We have to get some market structures in place if there is to be any effort at reducing costs. None of this will happen unless the political culture ion Washington changes. That is what we have to do in November.
Here is more on Obamacare’s early provisions.
Tags: health care
Doc,
I’ve gotta be honest… I don’t have a firm handle on exactly what the House/Senate/President did in terms of constitutional law making.
Of course… I’ve been drinking quite heavily since last Wednesday (St. Paddy’s Day) and am only now returning to news gathering/processing, so that’s where my uncertainty lies.
I wouldn’t be at all surprised if one or more Democrat Members of the House and/or Senate are assassinated prior to Election Day.
HEY… I’m not calling for violence or law breaking… I’m just guessing that the governmental activities of the last week will prove the straw that breaks the camel’s back for some individuals.
We’ll see…
BILL
Bill, I think we are a ways from violence but it is a possibility when this all falls apart. I will be up in the mountains with plenty of ammo. I remember when we were all storing dried food and getting ready for armageddon. That was Jimmy Carter. Jimmy Carter now seems like a patriot.
This all seems superlatively dysfunctional: the Democrat’s celebrations, the promises to “save money, make health care affordable”. This is beyond gagging, it is absolute throat necrosis.
I thought the ban on pre-existing condition exclusion applied to all ages.
I think it goes into effect for adults in four years. Not entirely sure about that, but that’s my recollection.
Obama is giving speeches saying that that is one feature of the bill that is going into effect immediately. He used children as an example but that feature seems to be omitted. It could be an error or they might have eliminated children because any problem that children have that would fit the “pre-existing condition” definition is likely to be catastrophic. Blue babies, for example, are the most common major childhood heart defect. Atrial septal defect is more common later but is rarely diagnosed early unless massive.
Maybe they omitted them to game the CBO score.
The Star-Telgram is reporting it <a href='http://www.star-telegram.com/2010/03/25/2068267/crowley-newborn-with-heart-defect.html#tvg'the pre-existing condition clause for children goes into effect in September.
New federal legislation that will prevent insurance companies from denying children coverage based on a pre-existing condition comes too late for the Tracys. The legislation, passed by Congress and signed by President Barack Obama this week, won’t go into effect until September.
Sorry about the bad link. I’m getting rusty! Let me give it another go. Link is here.
Wait a minute–Tom Maguire is saying something else entirely:
But the guaranteed issue and no discrimination clauses were not accelerated! Legally, Congress spoke quite clearly – kids currently covered must soon have any restrictions based on pre-existing coverage lifted from their contract. But no insurer has an obligation to issue until 2014.
First, the baby had the surgery. In California all these cases are covered by CCS which is like Medi-Cal. Texas probably has a similar situation because the Crippled Children’s Foundation was national.
Also, the parents were uninsured so they couldn’t add the child to a family policy which might make a difference. In the old days, you couldn’t get health insurance for children until 15 days past birth.
I still don’t know what the law actually says. These drafting errors are very common in rushed legislation, which is usually politically hot. Early in the AIDS epidemic, the CA legislature passed a law that did not let anybody know the results of an AIDS test.