Better By Inches
I should note that Max Baucus modified his chairman's mark to include some key elements sought mainly by Democrats, making the bill a bit better. The highlights:
• He increased the tax credits, as expected, so that they slide up to 12% of income instead of 13%, up to 400% of the poverty level. This makes the coverage subsidies a bit more generous and makes health insurance a bit more affordable. Emphasis on "bit". He also lowered maximum out-of-pocket costs.
• He reduced the "age band," lowering the difference between the cheapest policy and the most expensive based on age from 5:1 to 4:1. In other words, insurers will only be able to charge someone 4 times as high a price based on age, not 5 times as high. Again, this is a minor improvement, but an improvement nonetheless.
• He accepted Olympia Snowe's amendment lowering the threshold for affordability for employer-based insurance. If that costs someone more than 10% of their income, they can go to the exchange.
• He indexed the threshold where the insurance company excise tax comes in to the Consumer Price Index. This will limit the damage from average insurance policies getting hit with the tax as the years go on, but not completely. He also raised the initial threshold number up to $22,000 for a family plan, which isn't likely to satisfy the unions.
• The penalty for not getting insurance is now much smaller, down to $1,900 per family from $3,800.
• Anyone exempt from the individual mandate because of affordability can now buy the bare-bones catastrophic policy designed for "young invincibles."
Baucus did something sneaky, too. He delayed the coverage subsidies by six months:
Effective date of Health Care Affordability Tax Credits - The modified Chairman's Mark would set the effective date of the Health Care Affordability Tax Credits at July 1, 2013.
That's one way to save money in the overall bill - turn a ten-year bill down to 5 1/2, although Igor Volsky estimates that the cost has increased to $900 billion.
There are some other minor improvements outlined by Jon Walker.