As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."

Friday, May 29, 2009

HELP's Health Care Bill

Ted Kennedy's committee will try and influence the debate on health care with the release of their comprehensive legislation, which includes some pretty solid proposals.

Sen. Edward M. Kennedy (D-Mass.) is circulating the outlines of sweeping health-care legislation that would require every American to have insurance and would mandate that employers contribute to workers' coverage.

The plan in the summary document, provided by two Democrats who do not work for Kennedy, closely resembles extensive changes enacted in the senator's home state three years ago.

In many respects it adopts the most liberal approaches to health reform being discussed in Washington. Kennedy, for example, embraces a proposal to create a government-sponsored insurance program to compete directly with existing private insurance plans, according to one senior adviser who was not authorized to talk to reporters.

The draft summary also calls for opening Medicaid to those whose incomes are 500 percent of the federal poverty level, or $110,250 a year for a family of four.

If you're looking for the left-most counterpart to whatever happens in Max Baucus' Senate Finance Committee, this is it. MassCare is doing decently, but not getting the job done on its subsidies because a small state has no chance to drive down costs in any meaningful way. The cost controls - and how to pay for the subsidies - are the two keys here.

But it's notable that Kennedy includes a robust public option. Howard Dean today painted Chuck Schumer's compromise public option as the limits of where he would allow the conversation to go.

As a sticking point, he's insistent that any reform effort include a public plan. The public entity would provide insurance that, by avoiding the demands of the private market, could help control cost and expand coverage. Cognizant that such a proposal will engender stiff -- if not universal -- opposition from Republicans in the Senate, Dean said he had no objection to Schumer's modified version.

"If we can get Schumer's proposal out of the Senate, I think that would be a very good thing," he told the Huffington Post. "It can't be any weaker than that though. We don't want what would be a fake public option."

As one of the leading progressive voices on health care reform, Dean's endorsement of the Schumer proposal is no small thing. The New York Democrat has envisioned a plan for insurance coverage that, while run on public funds, is self-sustaining and subject to private market rules. Money would come from the payments and premiums of consumers. The same officials who ran the plan would be forbidden from regulating it. And a reserve fund would be set up to handle a potential influx of claims.

The stipulations, Dean said, would assuage critics without actually diminishing the public option itself.

"[Schumer's proposal] is still run by the public," he added. "But it is subjected to insurance rules that are there in order to protect the public from for-profit institutions, which is obviously not necessary if you are running your plan on the public side. Because the consumer needs the protection because of the profit-motive, but they don't need protections from a non-profit or the government. So Chuck has those things in there to level the playing field. I understand that. And I don't think we need to be doctrinaire about this. But I think, the bottom line is a public option is run by the public and financed by the public, it is not administered by the private sector."

I'm not quite as sanguine as Dean about Schumer's public option because it would act much like a nonprofit, without getting the Medicare bargaining rates needed to drive down costs. It would represent an improvement, but only a slight one. However, framing the conversation as a choice between Schumer's version or Kennedy's, not Schumer's version or nothing, is crucial. That's the importance of the Kennedy bill.

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