
If this amendment passes, it could significantly change--and most experts would say improve--the Senate health care reform bill.
As part of an agreement hashed out at the end of the Finance Committee mark up process, Sen. Max Baucus (D-MT) and Sen. Ron Wyden (D-OR) will join forces to amend the Senate health care bill with Wyden's "Free Choice Act." If it can attract 60 votes, it would give low- and middle-class Americans with employer-provided insurance the option of purchasing subsidized insurance in the exchanges.
Baucus and Wyden have the support of Senate Majority Leader Harry Reid (D-NV).
"Senator Wyden has worked tirelessly to reform our health system, and I am pleased to have his support for the Patient Protection and Affordable Care Act," Senator Reid said. "I will support the inclusion of his proposal for workers whose employer coverage is unaffordable but are not able to access the exchange."
Sixty is a tough climb. It would have likely been impossible under the original terms of the Wyden amendment, which would have opened the exchanges up to everybody. This is a scaled down version of that, and it will be a hard amendment for Democrats to vote against.
PeninsulaMatt
November 20, 2009 2:41 PM
It really feels like the Senate is going to pass a decent bill. I'm optimistic (and surprised!)
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Progressive Party
November 20, 2009 2:42 PM
This is really good news. I would love to opt out of my employer based plan. I hate sending my money to any health insurance company!
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Odel Roo
November 20, 2009 6:45 PM in reply to Progressive Party
LMAO... what do you think... you are going to one of the 6 mill that might get the PO where I might add it will cost you more.
Yer tooo much!
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Cal Gal
November 22, 2009 1:16 PM in reply to Odel Roo
Huh? Learn to think, then learn to write, OK?
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mans_best_friend
November 20, 2009 2:46 PM
What, exactly, are the arguments AGAINST this? If you're going to have a PO, why prohibit people from choosing it if they want?
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Schmed
November 20, 2009 2:53 PM in reply to mans_best_friend
It removes the notion that the PO is just for people who don't have insurance because they can't afford it. While giving everyone a better range of choice is great in my book, it'll just amp up the Repug argument that the PO is just a way to start the Single Payer snowball rolling.
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geofu54
November 20, 2009 3:28 PM in reply to Schmed
That was exactly my first thought.
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Lestatdelc
November 20, 2009 4:44 PM in reply to Schmed
If only.
The amendment is a good step in the right direction, but the PO should be open to anyone to buy into. Not just those making 400% of the poverty line and below. It (the PO) should also be open to employers to buy into for their employees. That would be a huge cost saver and vastly expand the size of the PO pool. Getting business that are not in the health industry out of the healthcare business (GM was basically a health insurance provider that happened to make cars) would be huge. It would be a massive shot in the arm to American businesses to be able to effectively move healthcare costs off their books and make them competitive once again in the global market because unlike companies in every other industrial country, they would not be shouldering healthcare costs on their books.
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Odel Roo
November 20, 2009 6:57 PM in reply to Lestatdelc
"they would not be shouldering healthcare costs on their books."
Of course they would... do you think this is a free ride from the health care fairy ? It is called higher taxes - both business and personal.
There are 44 million people on Medicare I would say that is a pretty significant number and they cant get costs under control with that buying power.
This like the other bills again does NOTHING to address escalating costs and still leaves 12-18 million without coverage. All they are doing is putting paint on a Jalopy and calling it new and improved. It's a big fat pile of crap that make no sense. Were all gonna get good and fucked and with less money and no kiss.
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Tanjaoui
November 20, 2009 8:11 PM in reply to Lestatdelc
Right. Ian Welsh has some other good suggestions:
http://www.ianwelsh.net/what-the-public-option-must-have-to-work/
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Cal Gal
November 22, 2009 1:23 PM in reply to Lestatdelc
I basically agree. I never like the "public option" only being available to certain limited groups.
And I DO think that tying health care to employment is a historic anomaly that distorts the economy of both health care and employment.
I would like to see a "Medicare for all" program compete with private insurance through state-based exchanges available to anyone.
I would also like to see health insurance deductible to people the same way it is deductible to employers -- without any b.s. 2%-of-AGI floor.
If employers want to jump in, fine, but if they don't have to provide insurance, they'll be less likely to discriminate against people with sick family members in their hiring decisions. (This is one form of discrimination that's still legal.)
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Indie Pro
November 20, 2009 4:01 PM in reply to mans_best_friend
it could affect the CBO score.
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Indie Pro
November 20, 2009 4:04 PM in reply to Indie Pro
though, usually a bigger pool in the exchanges is good for the exchange, and a bigger pool of healthy people in the PO reduces costs overall, according to previous CBO scores.
Increased subsidies, that's my guess what the arguement would be. Though govt takeover is most likely.
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jimbomoron
November 20, 2009 4:28 PM in reply to mans_best_friend
The problems? Adverse selection -- that employers could game the system.
Take a hypothetical company. Let's call it Cheney & Rumsfeld Associates. If you have equal tax treatment of employer-based and individual health insurance, and don't have the firewalls, what is there to prevent C&R from encouraging employee Hank Healthy to stay on its plan while encouraging employee Sally Sick employees to buy on the Exchange? Years from now, for example, it could easily be implicitly understood that new hires have shorter probation periods if they select the plan favorable to their employer. And how would plans on the Exchange be affordable if the population on the Exchange was much older and sicker than that of those in employer-based health insurance? So that's why the firewalls exist -- to protect employees from employers gaming the system.
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Cal Gal
November 22, 2009 1:25 PM in reply to jimbomoron
I think Congress would have to amend ERISA (not a bad idea, BTW) for employers to be able to give different benefits to some employees.
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holyhandgrenaid
November 20, 2009 2:47 PM
If this passes, then by some fluke the Senate bill would stand a chance of being better than the House bill. Now that would be somethin' else.
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Maritza
November 20, 2009 2:54 PM
If this is true this is GREAT news!
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Walter Mitty
November 20, 2009 3:00 PM
I think this is destined not to get 60 votes. I think it's giving conservadems stuff to vote against so they can say "look what I kept out of the bill" to their anti-reform constituents.
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FlownOver
November 20, 2009 4:09 PM in reply to Walter Mitty
Sure – you can count on Joe Lieberman (LyingSack-CT) allowing this to jeopardize his pimps' bottom line. Right.
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mcc
November 20, 2009 4:20 PM in reply to FlownOver
Worth noting, Lieberman actually is a previous cosponsor of Wyden's bill! Surely Lieberman would not vote against his own interests and stated positions just to be inexplicably difficult, right?
*laughs, then cries*
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creo13
November 20, 2009 6:55 PM in reply to mcc
Don't be so sure. We was for it. Now he can be against it. You know Joe ;-)
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FlownOver
November 20, 2009 4:10 PM in reply to Walter Mitty
Sure – you can count on Joe Lieberman (LyingSack-CT) allowing this to jeopardize his pimps' bottom line. Right.
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FlownOver
November 20, 2009 4:11 PM in reply to Walter Mitty
Sure – you can count on Joe Lieberman (LyingSack-CT) allowing this to jeopardize his pimps' bottom line. Right.
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CT Voter
November 20, 2009 3:13 PM
I can't believe I'm probably going to be watching C-Span on a Saturday night. . .
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geofu54
November 20, 2009 3:24 PM
And the naming of the amendment ("Free Choice") is uncharacteristically good for Democrats.
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mcc
November 20, 2009 3:32 PM
Sixty is a tough climb. But it will be a hard amendment for Democrats to vote against.
Didn't Wyden's amendment, back when it was a standalone bill, have an unusually large amount of support from Republicans? It seems like unless Republicans suddenly start opposing Wyden just because Harry Reid seems to be supporting it, it ought to be possible for the Wyden bill to pass.
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mcc
November 20, 2009 3:53 PM in reply to mcc
Yeah here we go. S.391. Cosponsors:
Sen Alexander, Lamar [TN] (R)
Sen Bennett, Robert F. [UT] (R)
Sen Cantwell, Maria [WA] (D)
Sen Crapo, Mike [ID] (R)
Sen Graham, Lindsey [SC] (R)
Sen Gregg, Judd [NH] (R)
Sen Inouye, Daniel K. [HI] (D)
Sen Kaufman, Edward E. [DE] (D)
Sen Landrieu, Mary L. [LA] (D)
Sen Lieberman, Joseph I. [CT] (CFL)
Sen Merkley, Jeff [OR] (D)
Sen Nelson, Bill [FL] (D)
Sen Specter, Arlen [PA] (D)
Sen Stabenow, Debbie [MI] (D)
That's some significant Republican support (plus two or three conservadems), and I don't think these are even what I'd call "moderates" really. If Lamar Alexander cosponsored this this seems to imply a couple of other Rs would vote for it. It seems like unless these Rs chicken out and decide supporting doing anything positive at all is political suicide for a modern Republican (in other words: if Judd Gregg "pulls a Judd Gregg"), or unless liberal Democrats inexplicably vote against this en masse, the Wyden amendment should pass.
If nothing else if the Rs that previously cosponsored this bill suddenly decide to vote against it they will have a very hard time explaining their votes.
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CT Voter
November 20, 2009 3:58 PM in reply to mcc
they will have a very hard time explaining their votes
Only if they're asked to.
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Xantar
November 20, 2009 4:00 PM in reply to mcc
Baucus is co-sponsoring this bill, and as we all know, he is obsessed with getting bills and provisions that can receive bipartisan support. So if he puts his name on this bill, I have to believe that he believes there's a chance that some Republicans will vote for it. Of course, the Republican caucus will vote against cloture in the final tally, but they may still support this amendment.
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tosh
November 20, 2009 5:08 PM in reply to mcc
None of the GOP'ers will support the cloture vote on the amendment, not the amendment if it gets by cloture. Wyden's amendment is DOA and we all know it.
Baucus is simply co-sponsoring it to play nice for killing it off in Committee. That was the moment of risk: if it passed Baucus's committee, it's something that Dodd and Harkin would have agreed to in Merger, and then it would have taken 60 votes to strip it *out*. Now it's 60 to put it in, and we know that there will take only 1 Dem to kill it.
Dead. Wyden knows it, but wants his vote. One suspects that he wants people to take stand on it to use in the future. But I think we all know that means little.
John
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Indie Pro
November 20, 2009 3:58 PM
very cool, at face value.
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Indie Pro
November 20, 2009 3:59 PM in reply to Indie Pro
though wouldn't it screw that CBO with the increased subsidies? Still, pretty cool at face value.
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mcc
November 20, 2009 4:11 PM in reply to Indie Pro
I think there may be some confusion about the use of the word "subsidy" here. What the press release says is:
I interpret this as meaning either that the "subsidized" insurance is employer-subsidized insurance (this was my previous impression of how the Wyden bill worked, that the employer is required on demand to take the money they were going to use to buy you insurance and just hand you a voucher for 75% of that amount, or something)-- or else if I'm confused and there actually are some government subsidies involved, the vouchers are at least deficit-neutral because they are paid for using something that otherwise would have been a tax credit to your employer. I guess one would have to read the actual bill to be sure.
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Indie Pro
November 20, 2009 4:26 PM in reply to mcc
that's why I kept the "at face value" on my comment.
people, especially around here, are quick to applaud and back any measure without reading it, or even having a basic understanding.
If it widens the availability of the exchanges and the Public Option, it'll increase the worth of both in my eyes.
Not to mention, I believe it could have a positive effect on business.
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Indie Pro
November 20, 2009 5:08 PM in reply to Indie Pro
other worrisome parts of the Senate bill, are the 2 exchanges for each state
and of course, keeping the inustry exempt from anti-trust laws
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Tanjaoui
November 20, 2009 8:04 PM in reply to Indie Pro
I have heard it risks allowing companies to circumvent state insurance regulations (as did the credit card companies when they were allowed to go national). If a state has stringent insurance regulations assuring quality and cost, insurers stop offering insurance in that state, move to a place like Mississippi or Texas, with lax regulations, and offer their national plan in the original state. As someone else has pointed out, it also means they are no longer subject to risk adjustment mechanisms. This would enable them to cherry pick without constraints.
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Tanjaoui
November 21, 2009 1:59 AM in reply to Tanjaoui
My bad...that's another provision in the Senate bill, not this. This looks OK. Good, not great (+1m people in the exchange). Slightly bigger risk pool.
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Tanjaoui
November 21, 2009 8:04 AM in reply to Tanjaoui
This is what I meant to refer to:
4) Nationwide Plans Gutting State Regulation – The merged bill still has the “nationwide plans” (formerly “national plans”) from the Senate Finance Committee bill. They are a top priority of the health insurance lobby. National plans would not be required to follow the minimum benefit laws in the states in which the policies are sold. These “nationwide plans” effectively gut state law regulating insurance coverage.
This is not, apparently, the Wyden Amendment. But it's worrisome. Again, it's exactly what credit card companies did, and amounts to deregulation.
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JohnMcCSF
November 20, 2009 4:08 PM
Sixy votes
To consider an amendment to a bill already on the Floor?
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EastWest
November 20, 2009 6:33 PM
Sixty!!!!!! Fucking pussy-crats. They'd have an 80-seat majority and roll over for the rethugs.
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theone718
November 20, 2009 6:40 PM
THIS IS CHANGE. This is what we need to get our way towards real reform. Let's hope Wyden can get the votes he needs for this.
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Andreams
November 21, 2009 9:55 AM
I love the Wyden amendment but it's been changed by one very important provision. In the original, individuals who don't have employer coverage would be able to buy in the exchange. This leaves them out unless the article left out something. Very small employers are exempted from offering employees insurance. Additionally, what happens if the employer goes out of business? Under current law, there is no COBRA in that situation. Will this bill address that by allowing those people to keep their policies if they have purchased them through the exchange or will they be dumped?
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sulimari
November 22, 2009 3:00 AM
This article is misleading. You guys are in for a RUDE shock. Andreams- the original Wyden choice expands the exchange to everyone who DOES have employer coverage; it allows them to opt out of their company plan and convert the employer subsidy into a voucher that they can use on the exchange. In this compromise only those whose employer coverage costs between 8-10% of their income would qualify. That's a tiny, tiny slice of the employer-based pool--granted, any expansion of the exchange is worthy (bigger risk pool->lower costs), but its not what most people would expect from reading about a "Free Choice" amendment. This is exactly what Wyden has been warning about all along. Most people will not get to even choose the PO.
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JadeZ
November 22, 2009 10:07 AM
this bill is a disgrace and might i add i have been spot on for months predicting all this.
now what you will see finally passed is a bill mandating coverage (a major win for the drug and insurance industries)because that deal was cut in obams office long ago and has been the driving force behind this entire fiasco.
and finally you will see NO PO , only the so called 'trigger".
then you will get all the hacks claiming because they have "forced" the insurance industry to not drop people it s a big reform.
and thats all you will get from this bill.
mandated insurance , no cost containment and another 35 million customers for the insurance and drug killers.
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