Orszag Calls Senate Health Care Bill Biggest Cost-Container Ever Considered

[ProSense]

Sam Stein

Orszag Calls Senate Health Care Bill Biggest Cost-Container Ever Considered

The health care bill before the Senate would cut costs and reform health-care delivery more than any piece of legislation in American history, White House budget director Peter Orszag declared on Wednesday.

"The bottom line is the bill that is currently on the Senate floor contains more cost containment and delivery system reforms in its current form than any bill that has ever been considered on the Senate floor period," the Office of Management and Budget director told reporters during a conference organized by the publication Health Affairs.

Orszag's assertion of historic budget savings ups the ante a bit as the Senate moves through the critical stage of debating and amending its version of the legislation. At the very least, it makes it a bit harder for fiscally conservative Democrats to attack.

The OMB director cited four key aspects of the bill: its deficit neutrality and the inclusion of a commission that would restrain Medicare spending, an excise tax on high-cost insurance plans, and delivery system reforms.

Budget observers say Orszag is technically correct, at least when it comes to health care related legislation. While the Balanced Budget Act of 1997 included a 12 percent cut in Medicare spending, it would have saved fewer nominal dollars overall than the legislation being debated right now. It also lacked the "delivery system reforms" that Orszag conspicuously included as a clause.

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[AllentownJake]

1. The White House budget director said this?

The dickens you say.

[ProSense]

3. Anyone

can challenge his assertion, but he is obviously correct. From the article:

Budget observers say Orszag is technically correct, at least when it comes to health care related legislation. While the Balanced Budget Act of 1997 included a 12 percent cut in Medicare spending, it would have saved fewer nominal dollars overall than the legislation being debated right now. It also lacked the "delivery system reforms" that Orszag conspicuously included as a clause.

"It depends what you mean by cost containment. If you are talking about attempts at reform of the overall healthcare system, not just government system but the overall healthcare system I think that's true," said Josh Gordon, policy coordinator at the Concord Coalition, a non-partisan federal budget analysis organization. "Congress has never done anything to try and restrain the growth of healthcare costs. We've never tried to change the healthcare delivery system from fee for service -- the Congress has never considered that."

"If you're looking at cost containment as being lowering healthcare inflation through delivery system reform, this bill reforms that more than any other bill prior," Gordon added. "Though relatively few bills ever make it onto the floor of the Senate, so this jumps to the top of the pack just for that procedural reason."

[jefferson_dem]

2. He's right.

It's obvious at this point that those who oppose reform do so for their own shallow political reasons.

[Clio the Leo]

4. Kick. NT

[eridani]

5. Yes--by fucking over sick people

The deficit hawks insist that we will be making up the difference.

[ProSense]

6. Sheer nonsense

Video: Hundreds and hundreds of people will die if this bill doesn't pass .

The House Health Care Bill Makes Progress For Gay Rights.

Krugman: new CBO estimate is good news

SUMMARY OF MANAGER’S AMENDMENT

Building on the legislation House Democrats introduced last week, the manager’s amendment provides for several changes to the bill, including the following:

• Establishes a process for the review and public disclosure of health insurance premium increases and justifications for those increases by the Secretary of Health and Human Services and states beginning in 2010. Permits the Commissioner of the Health Insurance Exchange, beginning in 2013, to take into consideration excessive and unjustified premium increases in making decisions regarding which insurance companies will be permitted into the exchange and how quickly to open the exchange to employers for the purchase of insurance for their employees. Provides a total of $1 billion in funding for states for this process over the period 2010 to 2014.
  
  
• Repeals the McCarran-Ferguson Act insurance antitrust exemption with respect to health insurance and medical malpractice insurance.
  
  
• Authorizes the Federal Trade Commission to investigate insurance companies that are registered as not-for-profit companies.
  
  
• Directs the HHS Secretary to work with states that have alternative programs to state high risk pools as a part of the new National High Risk Pool program for people who can’t get health insurance in today’s marketplace.
  
  
• Amends the National High-Risk Pool to make those early retirees whose premium increases are excessive eligible for the new program.
  
  
• Prohibits undocumented individuals from accessing financial assistance from the national high risk pool program with requirements for verification of citizenship or lawful presence.
  
  
• Requires that the Medicare fraud and abuse phone number be printed prominently on beneficiaries’ Explanation of Benefits forms.
  
  
• Imposes a 90-day waiting period for new durable medical equipment suppliers to be paid if the HHS Secretary believes there is a risk for fraud.
  
  
• Establishes a new public health program on mental health and substance abuse screening, intervention, referral, and recovery services.
  
  
• Provides for the development of quality indicators for Alzheimer’s care.
  
  
• Provides for diabetes screening collaboration and outreach through the Department of Health and Human Services in collaboration with the Centers for Disease Control and Prevention.
  
  
• Codifies the Office of Minority Health within the Office of the HHS Secretary and establishes satellite minority health offices in various HHS agencies.
  
  
• Clarifies that states may reimburse nursing homes for costs incurred in conducting background checks on potential employees.
  
  
• Provides a special rule for the expansion of certain physician-owned hospitals that consistently treat the highest percentage of Medicaid patients in their communities.
  
  
• Changes the effective date for a payment change for skilled nursing facilities from January 1, 2010 to April 1, 2010.
  
  
• Imposes performance assessment and accountability measures on the Health Choices Administration, including requirements for improving customer service and streamlining redundant rules, regulations, and procedures.
  
  
• Permits a qualified health benefits plan to provide coverage through a qualified direct primary care medical home plan.
  
  
• Repeals the worldwide interest allocation rules.
  
  
• Closes down the loophole that allows unprocessed fuels (like black liquor) to claim the $1.01 producers credit.
  
  
• Makes clarifications to the interstate insurance compacts that require the Secretary of Health and Human Services to develop model guidelines for compacting states, ensures that the interstate insurance compacts do not override state laws governing rate review and fraud, and makes clear that the compacting states determine which of the compacting state’s laws serve as primary for the insurance company.
  
  
• Delays implementation of the provision that would eliminate the ability of employers to deduct Federal subsidies with respect to prescription drug benefits provided to retirees by two years.
  
  
• Clarifies that the business/consumer purchasing collaborative provided for in the early access health grants is a non-profit business collaborative.
  
  
• Requires HHS Secretary to conduct a study to determine the existence of duplicative HHS programs and establishes a process for the elimination of any such program.

Text of amendments: PDF

Any automatic enrollment program shall include adequate notice and the opportunity for an employee to opt out of any coverage the individual or employee were automatically enrolled in. Nothing in this section shall be construed to supersede any State law which establishes, implements, or continues in effect any standard or requirement relating to employers in connection with payroll except to the extent that such standard or requirement prevents an employer from instituting the automatic enrollment program under this section.’’.

<...>

‘‘(2) if the employer plan’s share of the total allowed costs of benefits provided under the plan is less than 60 percent of such costs, that the employee may be eligible for a premium tax credit under section 36B of the Internal Revenue Code of 1986 and a cost sharing reduction under section 1402 of the Patient Protection and Affordable Care Act if the employee purchases a qualified health plan through the Exchange; and

‘‘(3) if the employee purchases a qualified health plan through the Exchange, the employee will lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes.

PDF

There is also the Wyden Amendment here.

[eridani]

7. The high risk pool, if similar to those provided by the state is just another piece of shit

Why not just allow high risk people into Medicare, like we do with disabled people?

"Review and disclosure" is more bullshit. Just another way of saying that they don't intend to exert direct control on costs--just have a list of Very Naughty Boys and Girls who face no consequences other than being on the list.

The bottom line is that the legislation forces people to buy crappy insurance that is not any better than catastrophic, which means that all regular expenses will still be paid out of pocket. Can't afford both? Gee--too bad. Just wait a year for some extra money ony your tax return. Or opt to go with paying for ongoing care over paying for shitty insurance and become a criminal.