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November 16, 2009
Hidden land mines in health care reform bill
Carrie Budoff Brown and Chris Frates of Politico have a good piece about some of the "hidden land mines" in the House health care reform bill.
This is in addition to the ticking time bombs in plain view I suppose. Nevertheless, they make a good point about what happens when the American people start to realize some of the bill's drawbacks:
Public option - not for everyone
The debate has placed disproportionate emphasis on the creation of a government insurance plan, raising the expectation that everyone could ditch their employer-provided coverage and enroll in the public option.
But that won't happen, at least not at the start. The reality is that only about 30 million Americans - 10 percent of the population - would even be eligible.
"People think they are going to get it - and they aren't," said Sen. Ron Wyden (D-Ore.), who has pushed for changes to provide consumers with more choices. "That's what they're going to flip out about."
The public option could be accessed only through a new insurance marketplace known as an exchange, where consumers would shop for plans. Only certain categories of people could use the exchange: the self-employed, small businesses, lower-income people who qualify for tax credits to purchase insurance and those who are otherwise unable to find affordable private coverage.
That means the vast majority of Americans - about 170 million - who get insurance through their employers won't have any new coverage options, say analyses by the Congressional Budget Office and the Centers for Medicare and Medicaid Services actuary.
It's a byproduct of Obama's desire to preserve the employer-based insurance system and not shock the system with too much change, too quickly. Wyden sees a different problem. "Folks are going to say what did you all do in health reform to give me some chances to get more affordable coverage?"
Voters may indeed begin to wonder what all the fuss was about - especially if a lot in the bill doesn't take effect until 2013 and they will still be stuck with their employer based insurance. Costs almost certainly won't come down and will just as certainly keep going up because the bill does nothing to address that problem.
Of course, the real deal is that the bill is a foot in the door. The argument will be advanced that the only way to "fix" all these problems is to go to a single payer, nationalized health care system. Thus, the "slippery slope" that the Democrats insist doesn't exist will be realized and the liberals will get their way.
All this is dependent on a bill getting through the senate. Not a done deal but the pressure will be enormous to pass something - anything - they can send to the House for conference. More pressure will be brought to get something both chambers will pass so it is still a likelihood that sometime in the next few months, a vote will take place in both the House and the Senate to pass some version of health care reform.
Landmines or no, the American people are in for a rude awakening.
Hat Tip: Ed Lasky