Senate's Tax on High-Cost Health Plans: Democratic Suicide Pact?

[eridani]

http://www.truthout.org/article/senates-tax-high-cost-health-plans-democratic-suicide-pact

A much-vaunted Senate proposal to tax high-cost health plans, once seen as all but inevitable, came under new attacks Wednesday from House Speaker Nancy Pelosi, members of the Democratic caucus and influential health policy experts - even as President Obama was reported as pressing Pelosi to accept the Senate version. The Senate bill would impose a 40 percent excise tax on plans worth more than $23,000 for families and $8,500 for individuals, with the purported aim of raising $150 billion in revenues and reducing health care costs from these so-called "Cadillac" plans.

But something new has entered into the political equation, even in the face of the near consensus among Washington insiders in favor of the Senate excise tax: political panic. Democrats, especially in the House, are justifiably worried how this issue will play out in the 2010 election, although the Senate provision wouldn’t kick in until 2013. One labor lobbyist told Truthout bluntly, "Freshman and sophomore representatives, the front-line Democrats who are most vulnerable, are freaking out about this."

Indeed, despite the public posture of White House officials that they're backing the excise tax 100 percent, there's a growing realization of its political dangers spurring a quiet, back-channel search for compromises that might mollify critics in the House and in unions, while keeping 60 Senators on board. According to a well-connected, knowledgeable labor source, these could include such steps as drastically raising the minimum value of health plans that could be taxed, increasing the inflationary index covering the taxed plans so middle-class families don't get ensnared and ending the discrimination based on age that's now permitted. "The White House knows that improvements have to be made," this source told Truthout. So far, there's been no public horse-trading over how to reconcile the differences between the House version, which taxes millionaire families, and the Senate version that critics say burdens middle-class families rather than the rich who've fared so well over the decade.

[ixion]

1. there are numerous suicide pacts in that horrid bill

the most serious of which is the mandate, IMO.

[Phoebe Loosinhouse]

2. The bill is indefensible on many levels.

* The deal with Pharma that is no deal

* No drug importation _ killed off specifically by the White House to preserve the Pharma deal

* The hidden war on generic drugs in the deal

* Mandates with no public option

* No ability to control costs (the Medical Loss Ratio DOES NOT control costs)

* Excise taxes (by the way, the panic noted above PROVES that costs will continue to rise since they are admitting that tying the taxes to inflation alone will not work, because rates will CONTINUE to outpace inflation. Ergo - this whole stupid reform effort has essentially solved NOTHING since the purported goal was to rein in costs and bring them in line with the rest of the world. Yet we refuse to use the methods which make the rest of the world so much more affordable - tight regulation and oversight and/or single payer)

*Out of pocket spending of 17-24% of income on premiums, co-pays and out-of-pockets AFTER reform and WITH subsidies

*Age discrimination lowered but maintained


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Republicans can successfully bash Democrats over the head for the reform which is not reform for the next several election cycles. They can say it was a misguided effort based on the corrupting influence of political payola, which in my view is an accurate summation. It will NOT reduce costs for middle class America. The poor will definitely be helped and it will matter little to the wealthy as long as they aren't taxed (which is how President Obama said he would finance reform initially. Oh, I forgot, that was just empty campaign rhetoric.)

Yes, the increase in community health clinics is great - that is probably the single best actual accomplishment in the bill and I guess we can thank Bernie Sanders for that one, although I am unclear if it is just Vermont that benefits. If that is the case, then I think it sucks - just another payoff to a specific politican in a specific area - like the one to Nelson. We were supposed to get NATIONAL reform. The Senate bill set up state exchanges, while the House bill had national exchanges. Again, I thought one of the points of reform was to get away from the uneven patchwork of care available throughout the country. Why should someone in Massachusetts have a better or worse package available than someone in Oklahoma?

I hate everything about the bill except for the fact that some people who need it may get immediate relief (we think).I wonder if the National High Risk pool makes it in to the end. I am also mad about the fact that once again, children with pre-existing conditions get covered immediately, while their parents have to wait years (so far as I understand it) for the immoral prior conditions clauses to be finally dropped for everyone. Again, wasn't that one of the most BASIC things that was supposed to happen right away?

Why is the House bill so much better than the Senates and yet we have to have the Senate Bill essentially shoved down our throats with almost no improvements? Why did they waste the time and energy of the House and the people by raising expectations that they then focused on watering down and dashing? Why are the Senate and the White House so openly craven to vested interests?

[eridani]

3. The high risk pool is not "relief'

--except for possibly a few very sick and very wealthy people. It's catastrophic-only overpriced shit--at least if it's like what similar state pools are like.

[Phoebe Loosinhouse]

4. I don't recall ever seeing the actual particulars of the mechanics of the

National High Risk Pool - what the costs would be, subsidies, etc. Which is one reason that I am wondering if it makes it to the final bill. I thought the White House flack for Health Care Nancy De Par. . .something mentioned it recently in one of her releases which is the only sign I've seen recently of its survival.

[eridani]

5. I'm expecting a total screw job n/t