Health Care: HELP Bill Released During Public Option Call With Sens. Dodd, Brown and Whitehouse

Impatience via mdezemery.

Just got off a call with Sens. Dodd, Whitehouse and Brown on the HELP (Health, Education, Labor, and Pensions) committee health care bill. They have finally released a full copy of the proposed bill along with the most recent CBO scoring of it:

CBO’s new score of the bill – which would reduce health costs, allow Americans to keep the coverage they have if they want it, and make health insurance affordable to those who do not have it today – would be $611 billion over 10 years, a significant reduction from earlier, incomplete estimates. The new estimate includes a provision on employer responsibility and a strong, national public option, the Community Health Insurance Option.

Click Links for:Bill Text, Public Insurance Option, Employer Responsibility, CBO Score (all PDFs)

According to Sen. Dodd, the $611 billion figure comes from CBO, but does not include the numbers for any Medicaid expansion, which is under the Finance committee’s jurisdiction and their bill is not yet completed so it couldn’t be scored.

Small businesses, NOT TO INCLUDE businesses with fewer than 25 employees who would be exempted (PDF), would have an annual fee of $750 per employee for participation in the public option plan that would be assessed directly through HHS if they aren’t already providing insurance for employees. There would be a cost of a little over $300 per person for individual coverage on an annual basis. Both these numbers come from CBO scoring as well, and are contained within the CBO information link above.

Sen. Whitehouse was very specific about the need for a strong public option: "The public needs an honest, nonprofit federal option as competition to keep the insurance industry honest. . . we need a better business model for the insurance industry."

According to Sen. Dodd, the benefits would be determined by the Secretary of HHS, with premiums and provider rates set as consistent with local rates. This would be done in a way to make costs and payments competitive, putting the full strength of the federal government’s broad buying power behind negotiations while meeting reform and costs standards of state and local considerations.

As Sen. Whitehouse put it, the goal is to take the direct focus away from perks, profit and management and move it toward health care for the consumer.

They emphasized several times that 14,000 Americans a day are losing their health insurance.

For consumers to buy into the public plan, there is a firewall built-in if you are already part of an employer-based health plan. If your plan costs more than 12 1/2% of your annual salary, then you can contemplate switching to the public option. If not, then you are stuck with your employer-based plan, whether or not you are satisfied with it. It’s a cost containment decision, with the hope that competition from the public plan will, over time, shift the operations of private insurers.

Sen. Brown emphasized that this plan is designed to reward "best practices" for insurers — and that each state will have an advisory council to monitor local competition in an effort to keep insurers more competitive and, hence, he says, more honest. He used the student loan industry as an example. I’m not certain that was the best example, frankly, given the profit-grubbing nature of any number of lenders in that industry, but there you are.

I asked about the Blue Dog assault on reproductive freedom, but the staffers and Senators on the call had not heard about that issue, and could not comment.

I followed up with a question about pre-existing conditions and coverage under the bill. I was told that the bill contains protections for people who have had to deal with recission issues and/or who have pre-exisiting conditions which make it difficult to find or switch coverage. Insurers will be barred from refusing coverage for pre-existing conditions going forward under this bill — there is a requirement for coverage for all, and a ban on insurance ratings for pre-existing conditions as well. This was done to ensure that people who most need the health coverage actually get care.

It’s going to take a while to digest the full text of the bill, the CBO scoring and everything else. But I wanted to get the info out to everyone as soon as I got off the call. So have at it in the reading — please let us know what you find in the comments.

UPDATE:  Forgot one thing: Whitehouse also emphasized that the cost control measures that could occur through better preventative care, quality reforms within the health care system itself, reduction in paperwork costs, etc., could not be scored by CBO — but that recent studies on GDP consideration and through the President’s Economic Council of Advisers show a substantial potential savings in costs that could occur.

UPDATE #2:  Also, all three Senators emphasized that all 13 Democratic Senators on the HELP committee had committed to voting FOR the bill.

UPDATE #3:  I made an error in the initial draft on this: small businesses with fewer than 25 employees will be exempted from the fee.  See above for link.