Senate Democrats emerged from intense negotiations last night with a compromise on health care reform.
TPM has the details:
If this trade-off carries the day, the opt out public option is gone.
In its place will be many of the alternatives we’ve been hearing about, including a Medicare expansion and a triggered, federally-based public option, the aide said.
As has been widely reported, one of the trade-offs will be to extend a version of the Federal Employees Health Benefits Plan to consumers in the exchanges. Insurance companies will have the option of creating nationally-based non-profit insurance plans that would offered on the exchanges in every state. However, according to the aide, if insurance companies don’t step up to the plate to offer such plans, that will trigger a national public option.
Beyond that, the group agreed–contingent upon CBO analysis–to a Medicare buy in.
That buy-in option would initially be made available to some uninsured people aged 55-64 in 2011, three years before the exchanges open. For the period between 2011 and 2014, when the exchanges do open, the Medicare option will not be subsidized–people will have to pay in without federal premium assistance–and so will likely be quite expensive, the aide noted. However, after the exchanges launch, the Medicare option would be offered in the exchanges, where people could pay into it with their subsidies.
Health care reform is extremely important. Our current system is broken; anything that moves us toward a better system is the step in the right direction.
But this compromise gives too much to the insurance companies. Health care reform requires a viable, competitive public option that is accessible to most, if not all, of the uninsured or underinsured. Lacking that, there won’t be enough competitive pressure on insurance companies to provide better coverage at lower prices, thus perpetuating our current system of high costs for little care.
Other provisions of health care reform are highly important and progressive, such as preventing insurance companies from denying coverage due to preexisting conditions. But both covering the uninsured and improving coverage for the rest of us are key, and I doubt this compromise–if it becomes law–goes far enough.
Of course, this is hardly the final step toward health care reform. There’s a chance this compromise itself could be reworked depending on what the CBO says and whether conservative Democrats are satisfied with it. And, in the end, whatever the Senate passes will have to be reconciled with what the House passed and the whole shebang has to once again get voted on.
So, while I’m not entirely happy with this compromise, there are a lot of steps left before we get health care reform anywhere near becoming law.