Tuesday, December 29, 2009

House GOP health care plan is filled with loop holes

Jun. 17, 2009

House Republicans have released a two-page summary of their proposal, which CNN Radio obtained.

Some highlights include:

·~"Pools" of insurance. It would let states, small businesses and others group together to offer lower-cost, health care plans. Such pools would have to offer, at a minimum, any coverage that is provided in a majority of states.

This sounds suspiciously like a coop, a health care idea that never really caught on. One of the problems with this idea is that the 'pools' cannot cross state lines,. In addition, Blue Cross was once a cost effective non-profit coop, but to make more money it became a profit making health care corporation.

·~Medicaid transfer. It would allow Medicaid users to take the value of their Medicaid benefits and transfer/apply those to a private health care plan instead.

Wow! All this would do is weaken Medicare and make it more expensive. This is a really bad idea, but it is not surprising that the GOP would propose it with its support of corporatism.

·~Boosting of health care savings accounts. It would increase incentives for people, especially those in lower income brackets or over 55, to build up HSAs.

Again, this proposal would help people in the top tax brackets but would do little for the average American. Some of these plans require any money left over in them be turned into the federal government. 

·~Automatic insurance. It would encourage employers to sign up their workers for health insurance automatically, so that employees would have to "opt out" of coverage if they didn't want it.

Finally, a good idea. But, what about employee choice?

This Republican alternative bill also contains several ideas that are increasingly championed by both parties.

·~Longer coverage for youths. It would allow dependent children to stay on their parents' policies until they are 25.

The Democrats support the same provision, but extend the benefit to age 26.

·~Promotion of wellness at the workplace. It would encourage employers to reward employees for improved health.

No argument here. The Democratic plan wants doctors to be reimbursed for wellness medical care.

·~Expansion of community health centers.

·~Mobile health care. It would allow Americans to maintain their specific health insurance policies when they lose or leave jobs.

·~In-home care. It would provide financial help and encourage more in-home care over institutions.

·~Limitations on malpractice lawsuits. There is general agreement over limiting such lawsuits, but a deep divide exists over exactly how much.

In Texas, they put a $250,000 cap on noneconomic damages makes most claims unprofitable for trial lawyers to pursue. Statewide, malpractice lawsuits have fallen by half. But the cost of medical insurance has not fallen.

The CBO found that under the Republican plan, insurance coverage would increase by about 3 million and that the percentage of insured non-elderly adults would remain at about 83 percent after ten years. The House bill would increase coverage to an additional 36 million people, raising the number of insured to 96 percent. The GOP plan is cheaper because it only insures 10 per cent of Americans the Democratic plan would cover.

In a press release from the Democratic National Committee, Vice Chair Wasserman Schultz said the GOP plan, "would allow health insurance companies to continue engaging in unfair and discriminatory practices like denying coverage to people because of a pre-existing medical condition."

Politfact agrees that Wasserman Schultz's analysis is mostly true. The GOP wants to put people with pre-exisitng conditions into high risk pools.
The GOP want to  "limit the pool premiums to no more than 150 percent of the average premium for applicable standard risk rates in that state." In other words, it might cost people with pre-existing conditions to pay 50 percent more than average premiums paid by healthy people.

-- CNN's Lisa Desjardins contributed to this report. To top of page



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