Excellent side-by-side comparison of the health bills

[ProSense]

Congressional Health Reform Bills: Coverage, as of 3/3/2010

Congressional Health Reform Bills: System Reform, as of 3/3/2010


The Health Insurance Provisions of the 2009 Congressional Health Reform Bills: Implications for Coverage, Affordability, and Costs:

[ProSense]

1. Who's afraid of the facts? Democrats? n/t

[Clio the Leo]

2. thanky! NT

[nightrain]

3. that subsidies are needed indicates that the premiums are too high.

Just a transfer of the peoples' wealth to the disease management corporations. More corporate welfare. Not sufficient. Terrible policy. Unaffordable to middle income people.

[ProSense]

4. Those premiums are significantly lower than current premiums.

The subsidies are on top of that.

[nightrain]

5. still unaffordable.

[ProSense]

6. It will never be free. n/t

[nightrain]

9. not looking for free, looking for affordable.

[ProSense]

12. There will be various ways that Americans enduring hardships will benefit.

They cannot and do not get such relief now.

[nightrain]

15. unaffordable for middle income people. Terrible policy to transfer

peoples' wealth to private disease management corporations. Most middle income people don't have thousands sitting around for disease management insurance.

[HughMoran]

17. Ummm, this is what we have now, but without subsidies!

You're not making a lick of sense.

[Cleobulus]

24. My employer provides for (crap) insurance, I won't get a subsidy...

and I won't be able to afford the premiums either, isn't that wonderful?

[HughMoran]

27. can't use the exchanges?

I had $10000/year family coverage at my large company

$36,000/year at my new small company (identical BCBS PPOs)

The exchange will get me to $15,000/yr - much much much better, but still not the $10k my large company was offering.

What situation are you in where you can't get decent rates using the different options offered by this plan?

[Cleobulus]

28. I used the subsidy calculator...

When I mention that I have an employer that offers medical insurance benefits, I get no subsidy(squeaks by just below the threshold for premium costs) and as far as I know there is no option to just NOT take my employer's insurance and choose the exchange. Oddly enough, under the house plan, if I say my employer doesn't offer insurance, I qualify for Medicaid.

[ProSense]

29. The chart in the OP reflects the information from the calculator

Premiums drop significantly. Not only that, you will have choices, which include getting a voucher from your employer to shop for other coverage.

[HughMoran]

30. I don't qualify for a subsidy either

but, as noted in my post, the rates are still significantly lower. My employer will qualify for subsidies which may make the coverage more affordable, if not she'll drop the insurance and she'll subsidize our exchange obtained insurance. Is Medicade similar to a subsidy?

[nightrain]

37. for those middle income people who buy their own insurance

these proposals are STILL unaffordable, and leave people without care, STILL.

[ProSense]

19. Really,

your complaints are ridiculous. The system is expensive and millions are uninsured. This bill changes that significantly.

When some people will see their premiums drop by 80 percent, what are you complaining about?

[HughMoran]

20. My small business is charged $36,000/year for a family plan

You think this is a good system?

This is what we'd be stuck with using your intransigent thinking.

:think:

[HughMoran]

7. Thanks or sharing. Apparently even easy to read charts provide facts the miserable rotten haters

don't want people to know about. Who'd have thought that the arrogant 'truth tellers' would be doing anything and everything they can to prevent people from promoting actual facts WRT health reform. A similar post promoting a summary of the HCR bills is being equally unrecced by the 'truth-killers' over in GD. Truth hurts, baby, the truth hurts. Keep posting facts - it kills the vampires.

[ProSense]

8. Some people are

expecting Democrats to create policy based on misinformation. That's why they're at a loss for why everyone from Al Franken to Bernie Sanders in the Senate and Alan Grayson to Anthony Weiner in the House support the bill.

The facts are clear.

[nightrain]

10. spewing....

[HughMoran]

11. Should I do the Heimlich maneuver?

I hope you don't choke too bad - can you breath?


;)

[nightrain]

13. clarification-- your post is spewing

[HughMoran]

14. Oh, shit! I misunderstood. I hope my post doesn't create a tsunami when it fully erupts!

OMG!!

What about the children!

[nightrain]

16. your projection onto others is quite massive.

[HughMoran]

18. I do have a large projector

I'm embarrassed to admit it (blushes).

[WillYourVoteBCounted]

21. what about the Grayson Medicare Bill comparison

it would make the other ones look like shyte.

[HughMoran]

23. Let's hope so

I hope he can get it passed and that it is indeed accessible to all and for a good premium and benefits. We'll see soon enough (don't get your hopes up.)

[vaberella]

58. Not at all. Since Grayson's Medicare Bill is in conjunction with the others.

Grayson's Bill still ignores the entire mess Medicare is in. It's in serious, serious need of reform which the HCR is trying to minimize if not eliminate. It's not something that runs on itself. Medicare has serious fraud cases and people are being ripped off. You add more people paying into that system and you get more people being ripped off and wasteful spending. So it doesn't address that. HCR does. Lastly, this came out before Grayson's bill so it's a moot point.

[bornskeptic]

59. Medicare costs are about $10,000 per enrollee.

President Obama's 2011 budget allocates $489 billion, which provides coverage for about 48 million enrollees. The premium costs under Grayson's plan would be very similar to those in the OP's chart this year, and somewhat higher in 2014.

[Cleobulus]

22. From reading the articles this applies to those who get insurance through the exchange...

not through their employers.

[Supersedeas]

72. there are plenty of implications to be drawn

[zalinda]

25. Look at all the subsidies

This looks like Health Insurance Companies are getting on the same government gravy train as "farmers" who get paid to not grow crops.

zalinda

[Cleobulus]

26. The subsidies aren't even the problem I want to be able to CHOOSE to get on the exchange...

and take advantage of the subsidies offered without going through my employers health insurance plan.

[ProSense]

31. Solution:

Free choice vouchers. Workers who qualify for an affordability exemption to the individual responsibility policy but do not qualify for tax credits can take their employer contribution and join an exchange plan.

more

[Cleobulus]

32. What is the affordability exemption and how do you qualify...

why should such an exemption be needed in the first place?

[ProSense]

33. It will be based on several factors, but

let's say your employer's plan is more than 8 percent of your income, you will be exempt from the mandate and also eligible to opt out.

This will also change over time to allow more people to opt out.

[Cleobulus]

34. I saw 9.8% and 12% respectively on the subsidy calculator...

I think the house bill is on a sliding scale of 8%-12% but I could be wrong. As I said, the premiums squeak by just under the 9.8% limit(Senate bill).

[ProSense]

38. No:

Note: In general, full-time employees with employer coverage available that meets specified requirements are not eligible for premium subsidies, unless the employee would have to pay more than 9.8% of income for the employer-provided coverage.

Which is actually a max based on a family plan. If you scroll down, it's explained:

For income up to: 400% of poverty
Maximum family payment of: 9.8% of income

It has nothing to do with the 8 percent limit for exemption on an individual income.

And even so, people will still be able to buy as much insurance as they want to.

[nightrain]

35. so, what do those exempt get out of this "reform"??

[ProSense]

40. A lot more than they get under the current system

Read the links at the OP. It's chock full of information.

[nightrain]

41. no. If the cost of the premium is too high of a percentage of

income and leads to being exempt, they're still without care.

[ProSense]

44. You don't know what you're talking about

Being exempt from the mandate means you don't have to pay a penalty.

You are still able to get voucher to purchase your own coverage on the exchange.

[nightrain]

45. the premiums are unaffordable, the voucher is essentially worthless

if a person cannot afford the premium, copays, deductibles etc.

stop with the nasty ad hominems. You're acting like a jerk.

[ProSense]

47. Pure nonsense.

"You're acting like a jerk." You're being obtuse.

The vouchers are not worthless.

You're complaining about a plan that will make things a lot better for many people, and what is the alternative: nothing or wishing.

[nightrain]

49. I'm not being obtuse. I think you're not willing to see the problems

with these plans. They don't work for people. It's a huge transfer of wealth from people to private corporations, just on a larger scale than the current mess.

"a lot better for many people"? Grayson and Kucinich's proposals are MUCH better, cost-effective and with universal availability.

[ProSense]

51. No, it just that some people are so locked into misinformation they can't see

the big picture. If health care reform could be contained in a four-page bill, they would have passed it instead of SCHIP after the Clinton bill failed.

There is a reason Congressman Grayson supports the current bill.

What is going to control prescription drug costs that are going up under Medicare?

What about the age rating and other discriminatory practices built into the system?

What about dental coverage, which Medicare doesn't cover, but is usual offered in conjuction with private plans?

Hacker...explained that Medicare was not designed “to provide health security to a younger than 65 population.” “There are a lot of holes in the Medicare program that should be fixed but which aren’t going to be fixed immediately. One of the important reasons to have a separate insurance plan is to make sure you’re providing the kind of good coverage that you know younger Americans need,” Hacker said.

link

Comprehensive Reform

[bornskeptic]

60. Premiums would not be lower under Grayson's plan.

Without the subsidies in the main bill, Grayson's proposal would be almost worthless. It only makes sense as a supplement to the main plan. The amount the government spends on Medicare is public record. You can check it here:

http://www.whitehouse.gov/omb/budget/fy2011/assets/health.pdf

$425 billion in 2009
$451 billion in 2010
$489 billion in 2011

Medicare enrollment has not yet reached 50 million. Do the math.

[Mass]

71. The waiver in the individual market allows you to get an insurance with a lower actuarial market

or stay without insurance without penalty.

Otherwise said, if you cant pay your insurance, tough luck for you. We all know it is not a solution, and could have been avoided with a real public option, where premium was based on income rather than on age.

It may be better than what exists, but it is an extremely disappointing bill, and we should say so.

[Cleobulus]

36. Wait a second, I don't want to opt out of the mandate, I want to choose a subsidized plan...

on the exchange, or get Medicaid, depending on which version of which bill is finally passed, I don't want to opt out completely if I can find affordable coverage that I can actually use.

[ProSense]

39. Opt out of the mandate?

What are you talking about? It's an opt out of employer coverage to be able to purchase a plan on the exchange.

[Cleobulus]

52. No you said I would opt out of the mandate and not be penalized...

due to cost. My question is can I still get on the exchange, will it still be subsidized for premiums and will I get subsidies for the deduct and copays(coinsurance) so I can get affordable treatment?

[denimgirly]

42. Wow..be an Insurance Company (Gold Rush!) -- Lots of Subsidies.

[Nite Owl]

43. Read the fine print

It's at 70% acturarial value, this is a Basic Plan which won't cover everything for someone who is actually sick. The subsidies are for the premiums at the Basic Level, if you need more than you have to pay the full value yourself. The subsidies do not cover the deductibles, that has to be paid by the individual. Many will be forced to pay for the premium and not be able to afford to use the plan. The insurance companies cannot afford to give the proper coverage, they need to go. It's all about saving them not helping us.

[ProSense]

46. For Medicare

it's 76 percent. The plans go as high as 90 percent.

[Nite Owl]

54. But the subsidies only cover

the Basic plan after that we have to pay the difference. Many cannot afford the difference, this is classism. People who can afford the better healthcare can get a decent plan but many can't and they are caught with the same problems we have now when they get sick and then face bankruptcy for the deductibles. The Basic plan becomes useless if you can't afford to use it.

[ProSense]

56. This is inaccurate.

The chart isn't based on the basic plan. Also, people need to stop viewing reform through the prism of the current failed system and understand that there are variables beyond the anecdotes that will impact the actual cost to individuals.

[nightrain]

61. if we could only pick which diseases/conditions we were to get, then

we could pick the level of insurance we could afford and/or need. But, since we can't it's far
better to have universal comprehensive affordable accessible health CARE. I object on principle to paying private insurance extortionists whose purpose is to deny care so as to maximize profits for shareholders and to provide exhorbitant compensation for execs. Private insurance corps provide not one exam, one pill, one home health RN visit, one psychotherapy session. Their function is to minimize provision of service. There's no way to control/regulate private insurance corps, they will, and do, evade regulation.

ProSense, perhaps you are affiliated with insurance, you seem to promote it over other more effective options. I find disease management insurance to be the wrong approach and reprehensible to transfer more of the public's wealth to Cigna, BC, United etc.

[ProSense]

64. Again with the flawed arguments.

There are many people with excellent low-cost health care coverage who have encountered significant health problems (cancer, heart disease, etc.) and have received the excellent care needed with little to nothing out of pocket. That is what everyone should enjoy. The obstacles have been the predators in the health insurance industry. This bill will remove those obstacles.

[nightrain]

67. LOL. It's extremely doubtful that the current bill will actually touch the disease

management insurance corporations in any significant way. ProSense, you have blinders on and are definitely out of touch with real peoples' issues, you ignore and minimize our concerns. Try some empathizing rather than attacking.

[nightrain]

48. great plans, huh? Scrape up the money for the premiums, then

can't afford the copays, deductibles, etc. Nice. But the corporations got your money! (sarcasm off)

[Nite Owl]

55. It's a big fat gift

wrapped in a pretty bow for the insurance industry. I love when they say that since they now have to cover everyone all must be mandated to buy in or be fined or they couldn't afford it. (They meaning the healthcare corps). What we can't afford isn't really considered! If these companies can't manage within a framework they should go bankrupt, cease to exist. That is capitalism. The burden is instead put on us. Reverse socialism, just like the banks.

[Cleobulus]

50. Will the Government subsidize the 30% because I sure as hell can't afford to pay that.

[Nite Owl]

53. The subsidies are for

the premium part. Copays and deductibles are all ours. There is a limit on out of pocket amount but it's not what a normal working person can afford. Something like 7k. To those in Congress I guess that's pocket change but to us it's all the bills and food on the table.

[bornskeptic]

62. So you probably prefer Medicare, which has no out-of-pocket max.

The max in the Senate bill is $5950 for an individual, and $11,950 for a family. For most people without major chronic health problems the out-of-pocket max will seldom, if ever, come into play. All preventive care would be covered without cost sharing, and in a plan with 70% actuarial value an individual would typically have to acumulate well over $20,000 in medical bills to reach the out-of-pocket max. You might have a $1000 deductible and 30% coinsurance, but that's all based on the insurer's negotiated provider reimbursements, which are considerably lower than the amount you would be billed if you didn't have insurance. Under Medicare with its 20% uncapped coinsurance, you would have to reach about $30,000 in covered expenses to have $6000 in out-of-pocket expenses, but $100,000 in covered expenses would mean $20,000 in out-of-pocket costs, whereas with insurance from the exchange it would still only be $5950.

[zalinda]

63. That may be true now

but, we will lose control of insurance companies once this bill is through. In other words, they will be able to decide on fees and caps and out of pocket expenses. With Medicare, the government will run it, which means that the government can tweak the weak spots like they did with social security.

zalinda

[ProSense]

65. "they will be able to decide on fees and caps and out of pocket expenses." Nonsense

People will have more choice and will not be locked into a plan that doesn't serve their needs. Also, new regulations will significantly curbed or eliminate the current practices of insurers.

[bornskeptic]

66. No policy could be sold on an exchange without approval from HHS,

and since subsidies could only be applied to policies sold on exchange, the government would have almost total control over policy details.

Medicare enrollees deal with the problem of out-of-pocket costs by purchasing supplemental policies from private companies.

[Cleobulus]

69. I have a condition that requires surgery, I'll hit that max immediately upon trying to get...

treatment, and that 5950 is well over a quarter of my income, in other words I'm screwed.

[vaberella]

57. The link to the site is great. Worth a rec. n/t

[robinblue]

68. Why compare with the House bill? Its DEAD!

[Mass]

70. Otherwise said, don[t get old.(why do we see the House plan. It is dead).