Senate Healthcare: More Questions than Answers
source: http://bit.ly/8T1Z3a
-
-
- JonRaymond
- added this
Expansion of Medicare looks good. But mandated insurance will result in people opting for lowest cost plans with least coverage, which will do nothing for the current medical debt problem that so many face when confronted with serious illness. 51% of foreclosures are due to medical debt.
Rockefeller introduced a 90% rule that requires insurers to spend at least 90% of premiums on healthcare and not on administrative costs or profits. But there's nothing to stop them from raising premiums to make up the difference.
People from 27-55 are still out of luck in terms of high quality, affordable insurance. In the base bill, the basic, lowest level qualified program in the exchange has a very low actuarial level, 60%, which is worse than 99% of employer-based plans. What that basically means is that patients will have to pay, between premiums and out of pocket costs, 40% on average of their supposedly covered costs. Lots of people, mandated to buy insurance, are going to be choosing this lowest level program because it will be the least expensive. There will be some basic preventive care included in the package, but in the event of a serious illness or injury, the people in this plan will still face huge bills. The House bill sets that lowest level at 70%.
Medicaid eligibility expansion has been dropped, apparently confirming what Rockefeller said yesterday. He had been attempting to raise the eligibility to 150% of poverty, but it remains at the level in the base bill, 133%. The House bill sets Medicaid eligibility at 150% of poverty. http://bit.ly/8T1Z3a
Then there's the Ten Questions from Jon Cohn at The New Republic:
1. Would funds from the younger people on Medicare mix with the funds from the traditional, over-65 population?
2. Which older workers get to buy Medicare--and when?
3. Would the Medicare buy-in have some sort of risk adjustment?
4. Will there be subsidies or some other form of financial assistance before 2014?
5. Would the Medicare buy-in include supplemental benefits--or an option to buy them?
6. Would the Medicare buy-in pay Medicare rates?
7. Has somebody thought through the expansion and retooling of the Office of Personnel Management?
8. If there is a trigger mechanism, what conditions pull it?
9. If there is a trigger mechanism, what kind of plan appears if the trigger gets pulled?
10. How do you enforce the 90 percent rule?
Rockefeller introduced a 90% rule that requires insurers to spend at least 90% of premiums on healthcare and not on administrative costs or profits. But there's nothing to stop them from raising premiums to make up the difference.
People from 27-55 are still out of luck in terms of high quality, affordable insurance. In the base bill, the basic, lowest level qualified program in the exchange has a very low actuarial level, 60%, which is worse than 99% of employer-based plans. What that basically means is that patients will have to pay, between premiums and out of pocket costs, 40% on average of their supposedly covered costs. Lots of people, mandated to buy insurance, are going to be choosing this lowest level program because it will be the least expensive. There will be some basic preventive care included in the package, but in the event of a serious illness or injury, the people in this plan will still face huge bills. The House bill sets that lowest level at 70%.
Medicaid eligibility expansion has been dropped, apparently confirming what Rockefeller said yesterday. He had been attempting to raise the eligibility to 150% of poverty, but it remains at the level in the base bill, 133%. The House bill sets Medicaid eligibility at 150% of poverty. http://bit.ly/8T1Z3a
Then there's the Ten Questions from Jon Cohn at The New Republic:
1. Would funds from the younger people on Medicare mix with the funds from the traditional, over-65 population?
2. Which older workers get to buy Medicare--and when?
3. Would the Medicare buy-in have some sort of risk adjustment?
4. Will there be subsidies or some other form of financial assistance before 2014?
5. Would the Medicare buy-in include supplemental benefits--or an option to buy them?
6. Would the Medicare buy-in pay Medicare rates?
7. Has somebody thought through the expansion and retooling of the Office of Personnel Management?
8. If there is a trigger mechanism, what conditions pull it?
9. If there is a trigger mechanism, what kind of plan appears if the trigger gets pulled?
10. How do you enforce the 90 percent rule?
-
- groups:
- Community
-
- tags:
- Democrats, Healthcare, Senate, Public Option, 3 more
