So What Were They Waving, Anyway?

Friday, 18 September 2009, 11:17 | Category : Healthcare, Politics
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During the President’s speech on health care, we were treated to the sight of several Republican congresspersons and senators standing and waving what was purportedly their health care “plan”, in response to Obama’s claim that the Republicans were offering no alternative. It turns out, they do have an alternative. It’s H.R 2520/S. 1099, the Patient’s Choice Act of 2009. And what do they offer us, the health-care-abused citizens and lawful resident aliens (yes, the Republicans include non-citizens in their plan) of these United States? Well, it’s not radical change, for sure…

  • They would require the Secretary of Health and Human Services to immediately form a commission to conduct a study! To develop a national strategy for prevention! (all those medical schools and health policy groups have been wasting their time and resources doing their own studies the past 20 years, I guess)
  • the Centers for Disease Control will implement a science-based media campaign on health promotion and disease prevention! It may even “include the use of humor”! (I kid you not, the language is right there in Section 101(b)(1)(B)(v)). It will even have a website! In all fairness, the plan submitted by Senator Baucus might also call for a media plan and website – I didn’t see it reading through his proposal, but I could have missed it. But the Ryan-Coburn bill puts it right at the beginning.
  • the bill would change the Food Stamp Program so that the government would come up with lists of approved, healthy foods that would be the only things you could spend your food stamps on. This sounds good, but wait until the snack-food lobby gets done with your senators and representatives before getting too excited.
  • It would create health care insurance exchanges. So do the Democratic proposals that aren’t willing to just trash the entire thing and go single-payer.
  • The bill forbids states from determining (or limiting) the costs of premiums.
  • “With respect to health insurance issuers offering health insurance coverage through the State Exchange, the State shall not impose any requirement that such issuers provide coverage that includes benefits different than requirements on plans offered to Members of Congress under chapter 89 of title 5, United States Code.”
  • It does not do away with the pre-existing condition exclusion. Under their plan, you can still be denied coverage for a pre-existing condition for up to 12 months.
  • The plan will allow citizens “or an alien lawfully admitted to the United States for permanent residence or otherwise residing in the United States under color of law” to be covered. That doesn’t bother me, but I’ve heard some Tea-Party folk screaming about the Democrats allowing coverage for people who aren’t citizens.
  • You can get a tax credit for up to $2290 for an individual, or $5710 for a family, to help pay for your privately-obtained insurance. Which sounds nice, until you realize that private insurance costs, on average, about $4500 yearly for an individual, and over $12,000 for family coverage. So families would still have to come up with nearly $7000 to pay for insurance. And to claim the credit, married couples would be required to file a joint return
  • For those who would continue to receive health insurance through their employer, this bill would remove the income-tax exclusion, so you’ll pay taxes on the amount of that coverage, so you would be paying income taxes on an additional $5,000-12,000. And you wouldn’t get the tax credit, obviously.
  • For those unable to obtain private health insurance, and not covered by an employee-provided plan, the government would provide a debit card to offset some of the cost. The total amount of this debit card would not exceed $5000, and would be less for some. To be eligible to receive the card, your family (and only families are eligible, not individuals) must meet these criteria:
    • consist of 2 or more individuals living together who are related by marriage, birth, adoption, or guardianship (cohabitators need not apply, apparently, nor gay couples, obviously)
    • have a gross income that does not exceed 200 percent of the poverty line. This is calculated by adding up the incomes of everyone between the ages of 21 and 65.
    • include at least 1 individual who is a dependent under the age of 19
    • the amount of the card would be $5000 for those under the 100% poverty line, and would decrease in stages to $2000 for those between 180% and 200% of the poverty line. You can get an extra $1000 for being pregnant, but only once every 12 months. And you can get an extra $500 for each child under the age of 1. States can use their own funds to increase the amounts, but cannot use any Federal funds to do so.

There is more in the bill, including language about tort reform (surprise!), but these seem to be the “high points” (“low points”?). You can read the bill for yourself here.

So, the Republicans do have a plan, of sorts. It seems to me that it’s much friendlier to the insurance companies and others with their hands in the health-care dollar trough than it is to actual real human people needing health care, but after all, it’s not like we have some vested interest in having a healthier America.

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