Saturday, December 26, 2009

More Stupidity In The Health Care Bill

There are many reasons that the health care "reform" bill passed by the Senate is not just a lousy bill, but will be an unmitigated disaster for the middle class and the working poor. Among them are:

  • A low that's too low - The minimum insurance required is almost no insurance at all, yet we will be required to buy it, or face fines of up to 2 percent of our income.

  • No provision for enforcement - Even given the ridiculously low standard that the Senate wants to hold health insurance companies to, they deliberately removed the enforcement mechanism in the House health care bill. Without an enforcement mechanism that includes the accountants, economists, and lawyers needed to evaluate insurance company policies, and the investigators needed to find violations, these regulations mean nothing.

  • No competition - The Senate bill does neither of the things generally assumed to be needed to provide competition among insurance plans. It neither removes the insurance companies' anti-trust exemption, nor does it provide a publicly financed alternative.

  • Drug prices unchanged - Despite the length of this bill, it does virtually nothing to make drug prices more reasonable, despite attempts to amend it by Sen. Byron Dorgan, among others.

But there is another thing about the bill that is even more deceptive than pretending to regulate insurance without providing regulation, as the New York Times reports:

The bill passed by the Senate on Thursday would move toward universal health insurance coverage in large part by expanding Medicaid, a program whose costs have traditionally been shared by the states and the federal government.

But the roughly 20 states that have already expanded coverage in some form will pay a greater proportion of their new Medicaid costs under the bill than those states, largely in the South, that until now have covered relatively few of their poorest residents.

States With Expanded Health Coverage Fight Bill

The bill mandates that anyone who earns up to 133 percent of the Federal Poverty Level (FPL) should be covered by Medicaid. Some states are already doing this, but others are not anywhere near it. The latter will get more support. Two states, Nebraska and Vermont, will get the entire amount subsidized by the Federal government.

To say that the states that have had more progressive programs in place are upset about this would be an understatement:

Wendy Saunders, New York’s deputy secretary for health, Medicaid and oversight, estimated that it would cost about $30 billion over 10 years to adjust the financing formula so that the Senate bill matches the more generous provisions of the House bill.

“Because it’s not a huge cost in the context of what is happening, we’re optimistic that it can be worked out,” Ms. Saunders said.

Massachusetts and Vermont, the states providing the broadest coverage, have already received some relief for the anticipated Medicaid costs in the negotiations that led to the passage of the Senate bill.

To secure the crucial 60th vote from Senator Ben Nelson, Democrat of Nebraska, Senate leaders permanently exempted his state from paying to expand Medicaid. But other states, many of them strong supporters of an overhaul, have been left in the lurch.

States With Expanded Health Coverage Fight Bill

The third largest state in the country, which is having budget problems just like every other state, is left on its own.

I'd ask just what would make supporters of this ridiculous bill reconsider passing it, but we're way past where that should have occurred to them already.

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