
The soon-to-be amended Senate health care bill will cost $871 billion over 10 years according to a new, long-awaited report by the Congressional Budget Office.
That's about $22 billion more than the bill was originally expected to cost, before the new changes--including nixing the public option--were offered to the bill. Democrats replaced the public option with a new plan to allow national or multi-state, non-profit insurance plans, regulated by the federal government, to sell insurance on state exchanges.
The CBO has concluded that, on average, premiums will be the same as they would have been if the Senate had the public option, but that the public option saved the federal government more money by putting downward pressure on the premiums of low-cost private plans, which will be heavily subsidized.
The bill remains a big deficit slayer--$132 billion in the first 10 years. Over the next 10 years, CBO warns all estimates are very uncertain. But here's a key conclusion: "CBO expects that the legislation, if enacted, would reduce federal budget deficits over the ensuing decade relative to those projected under current law--with a total effect during that decade that is in a broad range around one-half percent of GDP."
Senior Democratic aides are suggesting that the bill could reduce the deficit, compared to deficits projected under current law, by as much as $1.3 trillion.
You can read the report here (PDF), and a summary on the CBO's blog here.
converse
December 19, 2009 12:59 PM
So compromises to satisfy the conservative Dems' demands cost us another $22 billion. Hope that any more progressive primary challengers use that against them in their next election.
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wbgonne
December 19, 2009 1:12 PM in reply to converse
So the public option has to come back in to contain costs. Right?
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AJM
December 19, 2009 4:00 PM in reply to wbgonne
Dream on. Hyde is still here and expanded 30 years later.
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Docb
December 20, 2009 9:54 AM in reply to wbgonne
PUSH HOUSE LEADERSHIP on the PO..this mess has to go thru 'Conference' and the House had more gonads...Chide the leaders in the Senate about the Nelson/Leibermutt ?insurance Cos giveaway!
Local office calls are best now but the 1.800.828.0498 will work if you get the names of the people you talk to!
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Barbyrah
December 20, 2009 10:25 AM in reply to wbgonne
From the New England Journal of Medicine re: the Massachusetts mandate:
"There is little doubt that the high cost of care in Massachusetts is causing major strains. From 2006 to 2008, the average price of a family insurance premium increased by more than 12%, and premiums increased by about 10% statewide this autumn."
Just a little more info to the discussion...
P.S. I think the public option that was analyzed by the CBO was the vastly watered-down version, where it would be available only to a small number of people, and those people would be the medically-higher-risk pool. Might be worth looking into. Translate: There can be many versions/iterations of "public option."
Best wishes.
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Stroszek
December 19, 2009 1:37 PM
Good news:
The annual caps are out.
The medical loss ratio is in at .85 cents for every dollar. If an insurer goes under, it must provide rebates to policy holders.
People can trade high cost employer plans for a voucher to use on the exchange.
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Bruce Webb
December 19, 2009 8:00 PM in reply to Stroszek
Sweet.
I'll have to read the language but if that 85% MLR requirement applies to private plans in the exchange almost all the doomsday scenarios become moot, it makes it almost impossible to continue the current predatory model of shoving people who make claims off the role while seeking out customers ho are less likely. Doing so just elevates the risk of rebates.
This provision was in the Tri Committee and HELP bills but was effectively eliminated in non SFC and the Speaker/Majority Leader verisions.It's reinsertion by the Team of 10 is potentially huge and the for-profit insurers their worst nightmare. So people shouldn't write off Franken until the actually read the languag.
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cawleybo
December 19, 2009 9:33 PM in reply to Stroszek
85% for large group plans. 80% for small group and individual plans. The Secretary can lower the percentage if they feel it is causing disruption in the market.
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Barbyrah
December 20, 2009 9:25 AM in reply to Stroszek
The .85 cent figure is for large group plans only; for small groups or individuals, it's .80.
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tiowally
December 19, 2009 1:37 PM
Epic FAIL.
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Eric Spiegelman
December 19, 2009 1:56 PM
So, let me get this straight. Joe Lieberman objected to the public option because it's too expensive.
"With our debt heading over $21 trillion within the next 10 years...we've got to start saying no to some things like this."
(that's what he said.)
Yet, the health care bill is more expensive without the public option?
Ugh.
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wbgonne
December 19, 2009 2:00 PM in reply to Eric Spiegelman
Rank doubletalk accepted at face value by his own partisans. Hmmmm. Somebody might get suspicious that the fix was in all along.
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converse
December 19, 2009 2:36 PM in reply to wbgonne
Name one partisan who "accepted" what Lieberman said. In case you have trouble with math, his vote was needed to get to 60. That is the only reason the compromise was made. Accusing others of a "fix" simply accentuates your obvious unwillingness to accept reality.
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Barbyrah
December 20, 2009 9:56 AM in reply to converse
I encourage you to view this Bill Moyers interview, and pay special attention to what Robert Kuttner (co-founder, The American Prospect and former columnist for Business Week) has to say about how this whole health insurance "reform" got started. In a nutshell: Rahm led the way by doing backroom deals with the insurance companies and pharma...last spring. I repeat: Rahm started setting this thing up last spring. And what was jettisoned to get those companies on board, so they wouldn't put up a stink: No public option. Period.
http://www.pbs.org/moyers/journal/12182009/profile.html
In some worlds...me thinks this might be referred to as the "fix."
Regards.
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Stroszek
December 19, 2009 3:58 PM in reply to wbgonne
Huh?
The one thing every Democrat has been able to agree on in the last couple of weeks is that Lieberman is a spiteful, lying asshole. In fact, people like Ezra Klein and Nate Silver have been among the most harsh and vigilant in pointing this out and actually getting some somewhat decent fact-checking done in the mainstream media.
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mcc
December 19, 2009 5:31 PM in reply to Eric Spiegelman
Lieberman isn't really trying very hard anymore to make his lies believable.
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ohyeathatsright
December 20, 2009 10:36 AM in reply to mcc
He realized he doesn't have to. No consequences.
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TaosJohn
December 19, 2009 2:02 PM
The Democrats have no idea how much these bills jump the shark. Neither does TPM. "Remember what the Fight is About"??? WTF? There IS no fight, only capitulation to our corporate masters.
Things are really different now. We ARE the change we've been waiting for, and the Democrats can go to hell. I'm 64, and they're not getting me back. No more compromising with evil. I am finally free, brothers and sisters, and it feels wonderful.
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Eric Spiegelman
December 19, 2009 2:17 PM in reply to TaosJohn
You're my favorite.
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Cy Guy
December 19, 2009 2:30 PM in reply to TaosJohn
I think the abortions provisions go too far, but it's important that the regulatory changes and controls (I'm very pleased the 85% minimum health expenditure clause made it) get passed and really they can not be done through Reconciliation. So pass this even if it means holding your nose, and then come back after the 2010 elections and pass whatever we can through reconciliation in a lame duck session. I think we'll be able to hold at least a simple majority after the 2010 midterms, but the best time to push through reconciliation items is during the appropriations process when there are so many must pass bills and there is already pork laid out on the table for those more concerned about their tenure than they are about their constituents.
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AJM
December 19, 2009 4:02 PM in reply to Cy Guy
Doubt it. How big do you think the Democratic margin with women is going to be? What about pro-choice turn out? Dream on.
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hollywood
December 19, 2009 2:37 PM in reply to TaosJohn
Well enjoy the feeling while it lasts ......
The only other option in a zero sum game is to give power back to the Republicans ..... I am heartened to know now that we have at least 55 Democratic Senators who would do the right thing. If the Senate were not such a rigged and hobbled institution that would have gotten us what a democracy is supposed to get a majority ..... the votes to win the day. My new talking point is how undemocratic the Senate really is. Wyoming has less citizens than DC yet we get TWO SENATORS from fucking Wyoming and none from DC. ALABAMA AND MISSISSIPPI GET THE SAME VOTE AS CALIFORNIA AND NEW YORK! Plus you need 60 votes to wipe your ass now that the Republicans have lost all shame whatsoever.
The United States Senate is killing our Democracy!
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ohyeathatsright
December 20, 2009 10:39 AM in reply to hollywood
We don't have a democracy. It's a democratic republic.
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converse
December 19, 2009 2:39 PM in reply to TaosJohn
Maybe if people like you and Lieberman hadn't "compromised with evil" to begin with, the world would be a better place and a better bill could have been created.
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garp
December 19, 2009 6:45 PM in reply to TaosJohn
Free of what?
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Cool Blue Reason
December 19, 2009 3:27 PM
Does anyone have a link to the actual bill / manager's amendment? Is it out?
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Cool Blue Reason
December 19, 2009 3:28 PM in reply to Cool Blue Reason
http://democrats.senate.gov/reform/managers-amendment.pdf
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Barbyrah
December 20, 2009 10:11 AM
From PBS, September 2009 re: the mandate and fines:
"Under the Senate version being hashed out in Senator Max Baucus' Finance Committee this week, uninsured individuals with incomes of between 100 percent and 300 percent of the federal poverty level -- up to about $32,000 a year -- would be subject to up to $750 a year in penalties. Families of four earning up to roughly $66,000 could be fined up to $1,500 a year, if they remain uncovered. Higher earners could be fined $950 a year for individuals or up to $3,800 a year for families.
The House version would penalize uninsured individuals and families 2.5 percent of their adjusted gross income, topping out at about $4,800 for an individual. Both measures would offer subsidies to low- and moderate-income Americans to offset the cost."
Note: As of yesterday, the senate bill increased its fine structure.
http://www.pbs.org/newshour/bb/health/july-dec09/healthcare_09-21.html
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ohyeathatsright
December 20, 2009 10:42 AM in reply to Barbyrah
Anyone know what marginal rate increase would have had to been enacted to support Single Payer and Sanders' amendment?
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Barbyrah
December 20, 2009 12:09 PM in reply to ohyeathatsright
Had to do some digging...lots of conjecture/spin out there, depending on what's being advocated. And sleight-of-hand stuff all over the place with numbers.
The "cleanest" thing I found...admittedly, from an organization that champions single payer (Physicians for a National Health Care Program). But after I read through, it makes pretty good sense:
"A universal public system would be financed in the following way: The public funds already funneled to Medicare and Medicaid would be retained. The difference, or the gap between current public funding and what we would need for a universal health care system, would be financed by a payroll tax on employers (about 7%) and an income tax on individuals (about 2%). The payroll tax would replace all other employer expenses for employees’ health care, which would be eliminated. The income tax would take the place of all current insurance premiums, co-pays, deductibles, and other out-of-pocket payments. For the vast majority of people, a 2% income tax is less than what they now pay for insurance premiums and out-of-pocket payments such as co-pays and deductibles, particularly if a family member has a serious illness. It is also a fair and sustainable contribution."
http://www.pnhp.org/facts/single-payer-faq#raise_taxes
(What I find most interesting...is the 2% figure for individuals is actually less than the fine we're gonna pay if we don't purchase private insurance, courtesy of the House of Representatives.)
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Tanjaoui
December 20, 2009 1:15 PM in reply to Barbyrah
Baffling. And Canada, right next door. It couldn't be that hard to sell to the public if there were a nucleus of Senators and Representatives - politicians with the courage of their convictions - prepared to take it on in a serious way. I guess that's too much to ask.
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ohyeathatsright
December 21, 2009 12:04 PM in reply to Barbyrah
Thank you! I appreciate your synopsis. For comparison, my company (IT, ~80 Employees) pays on average around 10% in payroll taxes for health insurance. I pay approximately 2.5% additionally per year (after having my HI paid for) in other medical expenses. Single payer comes out WAY ahead.
But no, instead of sensible economics playing a part here, we're stuck with this ridiculous 'guvmint will kill granny' rhetoric already. The thing I don't understand is that it's the same people are going to be pissed off if single payer was on the table; if we can't get 1 GOP vote for healthcare that's basically an industry giveaway, why not go for the glory and revamp everything! The Democrats are already in the tank for the mid-terms even if they pass this atrocious bill; they need to take a political risk to recapture their base.
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