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CBO: Health Care Reform Will Lower Out-Of-Pocket Burden For Most Consumers

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A new CBO report, requested by Sen. Evan Bayh (D-IN) contains some helpful, though not unexpected information about the impact of Senate health care legislation on insurance premiums, particularly in the individual market.

According to CBO, average premiums in the individual market would increase 10 to 13 percent because of provisions in the Senate health care bill, but, crucially, most people (about 57 percent) would actually find themselves paying significantly less money for insurance, thanks to federal subsidies for low- and middle-class consumers, than they would under current law.

Those are two separate findings, but it seems likely that Republicans will use the former finding to attack reform, claiming it will raise people's premiums, and leave people confused about the second finding, which is actually the one that impacts people's pocket books.

The report finds that for the minority of consumers in the individual market who receive no federal assistance, premiums (and therefore out-of-pocket costs) will increase slightly--on the order of 10 percent--which could prove politically difficult in the years after health care reform takes effect.

Separately, for those who have high-end employer-provided insurance, CBO finds that a new excise tax on high-end policies will have disparate effects on premiums. Those who keep their "cadillac" insurance would end up paying higher premiums than they do today, and those who choose instead to choose less luxurious policies would pay lower premiums.

"[P]eople who remained in high-premium plans would pay higher premiums under the excise tax than under current law, and people who shifted to lower-premium plans would pay lower premiums under the excise tax than under current law," the report reads.

But CBO also finds that on average, people who have plans susceptible to the 40-percent tax will ultimately be paying less in premiums than they would without health care reform: "On net, CBO and JCT estimate that the excise tax and the resulting behavioral changes...would reduce average premiums among the 19 percent of policies affected by the tax by about 9 percent to 12 percent in 2016."

You can read the entire report here (PDF).

Comments (21) | Join the Conversation!

Recommend Recommend (1)

November 30, 2009 12:30 PM   

Meanwhile, Monday morning quarterback Dr. Krauthammer recycles the same old GOP talking points: Scrap the whole thing and start over. Tort reform would save half a trillion (!), allow people to buy insurance across state lines, which he compares to buying oranges from Florida, and taxing employer provided health insurance benefits.
Did he run that last one by the GOP leadership? They are allergic to any tax increase, no matter how justified.

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November 30, 2009 12:35 PM    in reply to jeffgee

did he also say we should scrap domestic funding and put all our money into the war?

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November 30, 2009 12:48 PM    in reply to jeffgee

50 billion = 500 billion?!

Amazing!

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November 30, 2009 4:05 PM    in reply to Stroszek

CK, like most of the conservative 'thinkers' is a proponent of the 'illions theory'.

As long as the number is in the m/b/trillions -- you can swap 'tr', 'b', and 'm' in front of illions as your point requires.

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November 30, 2009 12:47 PM   

The reason premiums will increase on average is because the plans will offer more coverage with less of a cost-sharing burden on the consumer. Eliminate all the high deductible, catastrophic illness junk policies and the "average" is going to rise with reform or without it.

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November 30, 2009 12:51 PM   

projections for 2016? Hilarious. 2 year projections.

People who get subsidies will pay less, news at 11.

and then those who get less insurance will pay less as well. Priceless.

Anything on this:

Until 2014, insurance companies could continue to deny coverage or charge higher premiums based on people's medical history. Another highly touted reform -- banning annual and lifetime limits on coverage -- would take effect in 2010, but it would permit significant exceptions.

Even with those rules in place, "there's no power to really hold the insurance companies accountable," said consumer advocate Betty Ahrens, executive director of the Iowa Citizen Action Network. "It's toothless."

Jim Manley, a spokesman for Senate Majority Leader Harry M. Reid (D-Nev.), said the bill was a compromise. "This is not the legislation we would have written in a perfect world, but Senator Reid believes that this bill has the best chance possible to get the 60 votes necessary to overcome a Republican filibuster," Manley said.

...and...

A close reading of the bill reveals other surprises, like the section titled "No lifetime or annual limits," which is intended to protect people from huge out-of-pocket expenses.

Where annual benefits are concerned, the Senate bill bans only "unreasonable" limits. What that means is not spelled out; a Senate aide said the Treasury Department would set the standard.

In addition, the bill says that certain health plans could continue to use annual and lifetime limits. As Timothy Stoltzfus Jost, a law professor at Washington and Lee University, interprets it, those potentially exempt from the ban include companies that self-insure, meaning they pay employee health benefits out of their own coffers, and businesses with more than 100 employees.

Further, the prohibition on lifetime and annual limits applies only to limits "on the dollar value of benefits."

In the past, health plans have gotten around restrictions measured in dollars. In 1996, Congress passed a law that said employers could not set lower dollar limits on mental health coverage than on medical and surgical coverage.


the whole article is worth a read
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/29/AR2009112902425.html

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November 30, 2009 1:03 PM    in reply to Indie Pro

An MIT study released over the weekend estimated that premiums for comparable coverage would be lower. In addition to the cost-sharing standards, that's quite a bit of money saved for those unsubsidized consumers who need more than catastrophic plans.

You may now proceed with your frantic nay-saying.

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November 30, 2009 1:24 PM    in reply to Stroszek

haha. You're a tool.

I read Gruber's memo. It's a nice memo. It's much like this CBO report, as a matter of fact. Especially since it relies on the CBO anyway. Which is to say, it kinda glosses over the people who get insurance through their employer and concentrates on people in the exchanges. Fails to talk about the two exchanges in the senate bill.

BUT

I am fairly certain that you will continue to shake your pom-poms for anything you are told to shake your poms-poms for.

But if, and at that I laugh, if you are truly concerned:

http://www.kaiserhealthnews.org/Daily-Reports/2009/November/30/Senate-health-bill-cost-issues.aspx

"But many experts, including some who signed the letter, said Orszag is only partly right. Parts of the Senate bill could control costs but no one knows how much. Nearly everyone agrees that the bill's cost controls have been weakened and may grow weaker. And all agree that the House bill would do even less."


my fav quote from Gruber on the Seante bill:

Gruber says he's a "big believer" in the concept that people should pay more for their health care so they'll know what it really costs and have an incentive to save money. "I'm a believer in consumer skin in the game," he says. "But a $2,500 deductible is a lot to ask for someone making $22,000 a year."


Then there is this, which I've said to you many times over:

There is nothing in the Senate bill, or the House, that ensures any savings will be passed along to "mandated" consumers. That is what makes this a truly industry tongue kiss of a bill.

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November 30, 2009 1:29 PM    in reply to Indie Pro

not to mention the lack of bringing the industry under anti-trust laws allows them to collude in any manner they wish

plus allowing the selling of insurance across state lines will mean a weakening in consumer laws, but hey, Rah! Rah! Rah!

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November 30, 2009 1:40 PM    in reply to Indie Pro

I'm with you. It seems apparent that the Senate is going to abandon the public option, which likely means it won't make it into the final bill. Without a public option, this bill is just an insurance mandate that will force millions more to become customers of the health insurers. Yes, there are more regulations but, you know what, regulations are made to be avoided, amended, and repealed. Since there will be no systemic change, I have very low expectations for HCR. In fact, I wouldn't even care if the bill dies. Let the system go into complete collapse. Maybe then we'll get real reform. In any case, this will be the breaking point for me as to Obama and Democrats. Sure, they're not as bad as the Republicans and, yes, maybe I'll even vote Democratic as the least worst option. But I am done donating money and proselytizing. The Democrats simply can't get things done. If a Progressive third-party emerges, count me in.

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November 30, 2009 3:08 PM    in reply to wbgonne

As it stands right now there is no chance of a progressive third party becoming a viable threat to the Democrats or the Republicans. You can join the Greens or the Socialist Party right now. But first you'll probably want to go change the ballot access laws, redesign the entire federal government, and rewrite campaign finance laws at the federal, state, and local levels.

Or, you can donate to or work for progressive Democrats, or give money to organizations like Progressive Majority, so that the conservatives don't end up controlling the entire Democratic party.

By the way, how many people do you think would die in that "real collapse" of the health care system you mentioned? Do you think you would know any of them?


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November 30, 2009 3:59 PM    in reply to Skybolt

no bill will ever stop death.

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rwc

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November 30, 2009 4:11 PM    in reply to Skybolt

I go back and forth between you and wbgonne on this.

On the one hand the deck is totally stacked against another party and, of course, the immediate result of a progressive third party making any headway would be to empower the GOP which has become increasingly fascistic.

On the other hand, the way it is set up now, the Democratic Party always seems have enough corporate conservadems among its ranks to just about always prevent any real change from happening when the party gets in control.

I'm convinced (and, indeed, if you read Republican strategy memos, they are convinced as well) that if somehow we got a Congress full of Kuciniches and Sanders and created a real social democratic government like those in Europe, with real national health care, free university education, strong union rights, a more equitable distribution of wealth, etc. etc., that the public would respond overwhelmingly in favor.

But the generally disengaged public only sees that little really changes under Dem rule and just swings back to the GOP in disgust.

You know, 38 years ago I debated staying in Europe where I had gone to study abroad because I saw how the U.S. supported fascistic regimes around the world and feared if the ruling elite was willing to do that to protect their economic interests abroad then they would surely do the same if domestic forces threatened their control at home. I really feared getting married and raising a family in a nation with such a strong rightwing.

But then I decided it was my duty as a U.S. citizen to do what I could to make it a better nation, especially since it has such an outsized power over the rest of the world.

But now that I have a son about to enter college, and a daughter a few years behind, I'm not so sure of my decision. And I'm not at all sure I won't urge them to leave when they become adults.

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November 30, 2009 6:11 PM    in reply to rwc

"the Democratic Party always seems have enough corporate conservadems among its ranks to just about always prevent any real change from happening when the party gets in control."

Methinks this ain't no accident.

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November 30, 2009 1:17 PM   

My question is what would the premiums be if there were no reform? Will republicans say it will be less under their plan?

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November 30, 2009 1:22 PM    in reply to creo13

Probably, because the GOP plan would permit low premium, high deductible policies that offer little coverage. Other studies, including comparisons of estimates from earlier CBO reports, have indicated that premiums for a policy similar to the Dems' "basic" package would be higher without reform.

Of course, regardless of what actually does or doesn't do, Republicans will say it's gonna rape your hamster.

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November 30, 2009 1:25 PM    in reply to Stroszek

At which point the Democratic bill will knock up your hamster, and the GOP will force it to carry the baby to term.

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November 30, 2009 2:44 PM   

The same substantial degree of uncertainty that surrounds CBO and JCT’s estimates of the impact that the proposal would have on insurance coverage rates and the federal budget also accompanies this analysis of the proposal’s effects on premiums.

Nuff said. And still no kiss!

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December 1, 2009 1:34 AM   

Without a public option, the bill is a joke.
But here is a public option that is less expensive and maybe more sensible:
For a relatively low fee - say $500/year - the government could furnish "semi-catastrophic insurance". This would provide 100% coverage for all medical expenses over, say, $50,000. Only a small % of the population exceeds that amount (although a few exceed it by 10-fold) so the actual payout would be quite small. The government should invest in case managers and invest heavily in fraud detection (?perhaps with a bounty system??) to help manage expenses.
Meanwhile, Aetna, Health Net, Anthem, etc could sell policies which cover costs between $1000 - $50,000. The costs of these policies should be quite low; if they're not, then it should "trigger" anti-trust legislation. Throw in a little tort reform, and... problem solved. The general unpopularity od attorney and insurance companies should make this a slam-dunk if their republican shills can't claim that the plan will bankrupt the country. Of course, they'll claim ANYTHING, won't they!

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December 1, 2009 1:38 PM   

So, basically, I either have to pay a higher premium to get the same amount of coverage I have now or choose a health care plan that provides less coverage.

No matter how you spin it, that is forcing me to cut my coverage or increasing my costs.

And if I can't afford the increase, that means I have to put my health at risk to ensure coverage for others while insurance companies continue to rake in outrageous profits and medicare and medicaid scammers continue to make out like bandits.

Additional coverage for more Americans should mostly come out of the gold-lined pockets of the insurance companies and from a crackdown on healthcare fraud.

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December 1, 2009 8:39 PM   

Krauthammer has more intellect than all of the commenters here combined, including me. Of tort reform is essential. Those who support the status quo are generally those who are enriched by the current unfair system. For some balance, see www.MDWhistleblower.blogspot.com under Legal Quality category.

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