Wyden Free Choice amendment added to Senate health bill

[ProSense]

Sen. Wyden wins big healthcare concession

By Jeffrey Young - 11/20/09 02:25 PM ET

Senate Majority Leader Harry Reid (D-Nev.) and Senate Finance Committee Chairman Max Baucus (D-Mont.) have taken a long stride toward locking down the support of Sen. Ron Wyden (D-Ore.).

The three senators announced an agreement Friday on an amendment that would allow many more people who get health insurance at work to opt out and instead purchase coverage on the new health insurance exchanges the bill would create

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The Wyden-Reid-Baucus amendment does not got that far but it would open up the health insurance exchanges to considerably more people than the bill as currently written. Under Reid's version of the Senate bill and under the House-passed bill, the vast majority of people who receive health benefits from their jobs would be ineligible to shop for insurance on the exchanges, which instead would primarily be accessed by individuals and workers at small businesses.

The agreement between Wyden, Reid and Baucus would change that."The agreed to amendment will make it possible for these individuals to convert their tax-free employer health subsidies into vouchers that they can use to choose a health insurance plan in the new health insurance exchanges. The Congressional Budget Office estimates a previous version of this provision will expand coverage to more than a million Americans," according to a statement from Wyden's office.

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[Taverner]

1. Is this good or bad?

Pardon my ignorance on that...

[ProSense]

2. Quite a few people argued that it would significantly improve the bill.

I don't think it makes a huge difference.

[Taverner]

3. How would it help? How would it hurt?

[ProSense]

4. Unions don't like the idea that it may weaken the employer negotiating pool.

Others like it because it gives more people access to the exchange, see the last paragraph in the OP.

[OregonBlue]

16. They are only going to allow him to offer the amendment I believe. I think it would be great

since it would allow everyone to choose their plan, even those that already have plans but don't like the ones offered by their employer. It would create REAL competition. My understanding is that it will only be offered as an amendment and I doubt they will get 60 votes. Bennett of Utah was the co-sponsor so it may bet a few PUB votes but lots of Dems oppose it precisely BECAUSE it creates real competition!!

[Cant trust em]

7. It's great.

In its previous incarnation, the public option would only be available to those who had no insurance. If you had insurance, but wanted to opt for the public option, you were barred from doing this.

This amendment will allow more people to get into the PO, thus creating a larger negotiating pool and driving down costs further.

At least that's what I've pieced together through my understandings.

[ProSense]

9. "If you had insurance, but wanted to opt for the public option, you were barred from doing this" No

(2) OPT-OUT.—In no case may an employer automatically enroll an employee in a plan under paragraph (1) if such employee makes an affirmative election to opt out of such plan or to elect coverage under an employment-based health benefits plan offered by such employer. An employer shall provide an employee with a 30-day period to make such an affirmative election before the employer may automatically enroll the employee in such a plan.

On edit: A difference with the Wyden bill is that instead of the employer funds going directly to the exchange, the employee gets a voucher.

[Cant trust em]

10. Is that from the new amendment?

[ProSense]

13. No, actually that's the House bill. Here is the pertinent language from the Senate bill

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.’’.

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‘‘(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.

[Clio the Leo]

5. And Mary Landrieu apparently got a little gifty as well...

.... which I am about to address in a separate OP.

[ProSense]

6. Interesting. n/t

[Clio the Leo]

8. I know.........

.... it's crazy how things start to come together and make sense.

(But then again, I operate under the basic premise that the hold outs are holding out for a reason .... not because they are inherently evil. lol)

[Cant trust em]

11. They're waiting for their carrot.

It's a little like a hostage negotiation.

[Clio the Leo]

12. lol yep. NT

[Cha]

15. Oh yeah, I always figured

they wanted something like a canary.

Especially lieberman..wonder wtf he wants?

[Clio the Leo]

18. His own TV show I think.

A movie about his life perhaps?

[ProSense]

14. Think Progress explains

Why Rush Wyden’s Choices Amendment?

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Under this compromise, a small sliver of the population — individuals and families under 400% of the federal poverty line who receive employer-sponsored coverage and spend 8-9.8% of their income on premiums — could “convert their tax-free employer health subsidies into vouchers that they can use to choose a health insurance plan in the new health insurance exchanges.” Currently, individuals in employer-based coverage who have to spend more than 9.8% of the incomes on premiums aren’t required to purchase health insurance and don’t quality for affordability credits if they enter an Exchange:

“As I have long said, empowering Americans to choose the health insurance that works best for them and their family is the single best way to hold health insurance companies accountable,” Wyden said in a statement. “While this is just one step in the direction of guaranteeing choices for all Americans, it is a major step because – for the first time – it introduces the concept of individual choice to a marketplace where it has long been foreign. This is a significant step toward real reform.”

The theory of instantly “empowering Americans to choose the health insurance that works best for them” is sweeter than the reality. The merged senate bill establishes a time line that more or less allows everyone to choose a plan from an exchange by 2017. In this way, the legislation builds on the current structure but also sows the seeds for an eventual transition to a more ‘individualistic’ system — or what Wyden calls “real” reform.

This ‘time release’ approach — to borrow a pharmaceutical term — is intentional. Opening the exchanges only to small businesses, individuals and the self-insured for a limited period preserves the employer contribution in the health care system and allows the exchanges to build a capacity for covering more people over time. It helps the Exchanges find their footing without being overrun by millions and millions of new applicants from the employer market. Care continuity is also better preserved.

In short, the existing legislation accomplishes the main goals of Wyden amendment on a more realistic timetable. Wyden was concerned that it didn’t have his name stamped all over it. Now it does.

[Oregone]

17. Now, do you perceive this as devastating to the bill?

Being that you have argued strongly against it?

Since I like this concept, I imagine that you have got to hate it.

[MarjorieG]

19. True that Nelson got anti-trust removed for allowing cloture; reinstate later and pass?