The Newsroom News - Health reform Senator Baucus Issues Release to Push for Health Care Reform
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Senator Baucus Issues Release to Push for Health Care Reform
Written by David Norman
Last Wednesday, Senator Max Baucus of Minnesota – chair of the Senate Finance Committee – released a full framework of how health care reform would look under the current objectives. The primary and most significant information revolves around the health care exchange and the various programs that would be born, fostered and changed under it. In the period while new sources are being formed, it would begin with state-collected data of private and public options’ benefit packages and premiums, enabling consumers to make informed decisions about their plans. One universal and much-needed factor of the plan is standardization. All insurance applications as well as descriptions of benefits and options – private or public – would be completely standardized. Similarly, there would be a standard range of options in plan size with levels of minimum creditable coverage to range from 65-90% across four models. Many varieties of care including primary care, prescription drugs and mental health care would be required as fits into the creditable coverage.
The greater clarity of these programs would indeed provide information comparing private and public insurance options, but one newer idea is the invention and spread of health care cooperatives, or Consumer-Operated and Oriented Plans (CO-OP). What is unique about this model is that it would form entirely member-run, non-profit insurance ‘companies.’ In the realm of competition, these would compete with the non-group (individually purchased) and small-group (maximum 25 employees, average wages below $40,000) market. CO-OPs would be eligible for federal loans and grants to help with start-up and maintenance costs. This idea alone shows how the health care market will be turned around to focus on patients, giving the policyholder more power. Private insurers would get some updates and checks making them more consumer-friendly, as well. Under this layout, starting in 2013 all private insurance companies would be required to offer guaranteed care for enrollees with no life-time limits, no rescinding and no exclusion for pre-existing conditions. Likewise, employer-sponsored insurance would be subject to change. Employers would not be required to provide insurance for employees, but they would be fined a max of $400 per employee who receives a tax credit – such credits being awarded to those at the lowest income levels for whom all available options are unaffordable (totaling 10% or more of the household income). Small employers would be eligible for tax credits to make providing insurance more feasible. The most controversial aspect of this layout certainly is the ‘public option.’ This would look mostly like an expansion of Medicaid to all, targeted at those at the lowest levels of poverty. This would expand from individual state-wide coverage starting in 2011 to nation-wide coverage in 2014. Certainly, there are many directives consumers could follow under this plan – a drastic shift from the current market almost exclusively dominated by private insurance companies. These are only a few parts of the changes that would occur, but all would be aimed at making this a patient market, not a profit scheme.
Tuesday, 15 September 2009 13:22
Last Updated on Tuesday, 15 September 2009 15:12