Ezra Klein provides a helpful summary and assessment of Olympia Snowe’s proposed amendments to the Baucus health bill. Given how important her vote is, folks should read through that list to see where she’s going.
On several key issues, Snowe is asking for improvements compatible with those offered by various Democrats — Rockefeller, Wyden, Kerry, Bingaman, Cantwell, et al. Think Progress’ Igor Volsky summarizes those here. What does Snowe want?
1. She wants to expand access to the exchange(s) to employees of more employers:
– Lower the threshhold of "affordability" so that when employers don’t or can’t offer "affordable" plans, they get access to the exchange (Snowe [coverage] #C1 on Ezra’s list);
– Increase the size of firms — from 50 to 100 employees — whose employees can choose from the exchange (Snowe #C3);
– Even allow larger employers to access the exchange under state plans (Snowe #C8)
2. She would require better coverage from employer-based plans, which will tend to move more towards the exchange:
– Don’t allow employer-based plans to have deductibles higher than $2,000 (individuals) or $4000 (family) without offsetting contributions (Snowe #6);
3. She would speed up the dates by which employers must meet the insurance reforms, thus pushing more towards the exchange: (under Baucus, employer-based plans get a 5-year delay before having to meet the same standards as plans offered in the exchange)(Snowe #C7)
4. She would soften the Baucus excise tax on high-end insurance.
– Slow down the rate at which the tax applies to more and more plans and permanently raise the cap for those between 55 and 65; (Snowe [Financial] #F1)
– This means the revenues have to come from somewhere/someone else.
5. She would reduce the penalty for those who don’t purchase insurance under the mandate. So revenues have to come from somewhere/someone else. (Snowe #F4)
– Alternatively, replace the penalty with a lower "defined minimum contribution." (Snowe #F5)
If you step back and sum it all up, what Snowe is telling us is that she sees that many more people and businesses than Baucus allows for will need to get access to the exchange. Since employer-based plans should comply with insurance reforms sooner (thus increasing premiums), the number of people who will need to get access to a better individual market will increase even faster.
If more people will be looking to the exchange, and if we impose a mandate requiring people to purchase insurance, we need to provide larger subsidies to more people, and penalize people less, while recoving the costs from other people.
Various Democratic proposals reflect similar insights: the employer-based system will become less affordable over time, so we need to provide affordable options in the individual markets — via the exchange — and that will require that we provide a lot more money to make the plans available in that market affordable.
Of course, the big difference between Snowe and the Democrats is that they would offer the exchange shoppers the additional choice of a public option. She would foreclose that choice so as to shield private insurers from competition. How protecting oligopolies from competition in an administratively mandated market became a "Republican principle" is something Olympia Snowe should explain.
But the common problem Snowe shares with the Democrates is this: Where will the money come from to make the increasingly important exchange plans affordable? (Obama had nothing to say on this point in his recent tv interviews, because, astonishingly, no one pressed him.)
The money to pay for that has to come from somewhere. Snowe and the Senate Democrats seem to agree that the revenues can’t be raised from those who already need help in the exchange. The money can’t be raised from others in the exchange without creating additional affordability problems. And it can’t all be raised by the excise tax, because that has to be scaled back so as not to become a "tax on the wrong people." So who’s left?
What all of the amendments/proposals are telling us is that we need to focus new taxes on those who can afford them, so that more people get access to the exchange, exchange plans are made affordable, more people are eligible for subsidies, and the subsidies are more generous.
Every one of these problems points to the need to tax people with higher incomes, one way or another.
It can’t be said enough that the House proposal for a surtax on those with very high incomes makes a lot of sense. It taxes the "right people" and does so without all the needless (and costly) complexity of the Senate’s proposals. Now it’s clear that Senators from Snowe to Rockefeller agree with this idea in principle. They just don’t admit it.
More:
Breaking, NYT: Baucus offers $28 billion more to make the subsidies more generous and the excise tax less offensive. (Recall CBO said he had a $49 billion surplus to give away over the first 10 years.)
By contrast, the House bill does a much better job of reducing the uninsured and making exchange plans affordable (see Center for Budget and Policy Priorities comparison). And as James Kwok points out, it collects $140 billion more from the wealthiest and uses it to expand eligibility for and the size of subsidies, making insurance much more affordable for more people, while Baucus imposes an equivalent $140 billion tax on the middle class. So even with his additional $28 billion offer today, Baucus is still imposing at least $112 billion more in "taxes on the wrong people."





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“How protecting oligopolies from competition in an administratively mandated market became a “Republican principle” is something Olympia Snowe should explain.” ; YES, that would MOST interesting to hear. Becuase that is the absolute crux of the whooping and hollering about providing all U.s. citizen’s with healthcare.
And not only should Snowe explain BUT ALL ,FROM THE PRESIDENT on down explain “How protecting oligopolies from competition in an administratively mandated market” is in the best interests of the citizen’s of this country.
“can’t offer “affordable” plans” ; what a bad joke that term is, ‘affordable plans’. It is simply amazing the the true solution -single payer or what is now being called ‘Medicare for all’ just won’t be considered and we have all these hoops to jump thru and caveats to determine and write rules for taking so much time and energy. I guess people have forgotten the story of the Gordian Knot.
Thanks Scarecrow, and yeah, I see this happening.
If, this is where the left’s thinking has evolved on healthcare reform, then, we have lost the war and now we are negotiating the terms of surrender.
Bipartisan surrender.
Just stamp a barcode on our ass, give us 10 to 15 percent of our earnings for food, shelter, and clothing… and if we are lucky private insurance will give us a band-aid or a pill before we die.
God bless Blue Cross Co-opting of America.
The only thing I can say about this is, fuck!
I am agreeing with your suggestion, “folks should read through that list to see where she’s going.”
Whether you support single payer, public option one must Senator Snowe is serious about reform. Her amendments to the Baucus bill are not frivolous. They are serious.
Ezra writes: “It’s becoming pretty common for Hill and administration sources to tell me that “Olympia Snowe is more of a Democrat than some of the Democrats.” What they mean by that is that she’s pushing for a level of affordability and subsidies and consumer protections that far surpass what the Democratic swing votes are interested in.”
Now I don’t agree with her solutions, all of them, as put forward, but I will not demean her effort. By seriously stepping up to the plate and having a dialogue, exchanging ideas, I find she is being honest to herself and her principals.
If all politicians were as willing for an honest dialogue would we not be better off? Can you ask more from a politician? Over these past weeks I’ve noticed she’s grown, she’s listened to others. Now I have no idea what will become of it, but Senator Snowe is a player.
Let the whistles, hoots and hollars begin. :)
This reminds me of the guy (I don’t have the link at hand) who was being consulted on our Afghan policy. Basically we are all in the health insurance car that is being driven over a cliff and the politicians are arguing as to whether or not we should wear out seat belts. Morans.
Well, if they don’t just do away with all insurance companies then I’m just mad as a wet hen!
Tax the rich, fercrissakes. They are NOT loved in America, in case the Democrats have looked lately. And they are acting like asses, with their bonuses, hardluck stories in the NYT and WaPo, having to dismiss the backup nanny and the chauffer.
Tax them. How hard is this for Democrats?
How long will it take for Mitch McConnell to slap her back into place, though? And will she go?
If the Democrats stick together and vote to end debate, and the Massachusetts legislature and governor act timely, Harry Reid will have his magic 60 — and we won’t need Olympia’s earnest attempts at reform, will we?
um…she still shills for the corporations so i’m not quite sure that her “principals” are in anyway similar to mine and most other people in this country.
This is all so maddening!
Just wondering, how much would be saved if all hospitals, Drs, etc. used an omnibus billing form in lieu of insurer specific? Has this been discussed in any bills or should I just get another Margarita?
It’s not just for cows anymore..)
[grinning]
Thanks for making me smile!
Why build a new system when Medicare exists? This is a fundamental question no one will answer.
I don’t know if she “shills” but what I do know is I am so damned tired of the easy out used by both sides of easily referring to people as “morons” or similar slur.
And, honestly asked, is there any politician not beholding to corporations regardless of political party? Is there a Mr. Smith in the house?
ES, are you out of your freaking mind? Give you 10 or 15 of your own money? You may lease it at competitive rates?(certain rules and conditions apply. void where prohibited by law.)
I’ve just been told on national TV that we have to help President Obama get through health care reform, no matter what form it takes, as the alternative would be unthinkable. It appears that if he loses, we lose. I’m off to the health food store to stock up on chamomile tea. Along the way I think I’ll stop at the book store to pick up a few titles in the fantasy and science fiction section – I think reality might be too miserable to experience for a while
Looks like SNOWE is the only real Replublican left in the senate. The rest are just self-serving scum drones.
I wonder if we can clone SNOWE 39 times and replace the other senators. Throw a few extra clones for the HoR.
I think we’d have a pretty decent functioning government.
People are giving Snowe *way* too much credit. If you look at her priorities, the unifying principle is clearly to increase the revenue of the health care industry. A lot of her ideas would also benefit lower-income people. But when the two conflict, she always goes with what’s good for the industry: no Public Option, less access to Medicaid, weakened cost controls.
Also I think Ezra misunderstands her position on the excise tax for those 55-64 (Snowe F1) – the cap is not “permanently raised” because it’s still indexed to CPI not health care inflation – and her “defined minimum contribution” (Snowe F5) is just a euphemism for the individual mandate penalty.
AND THE KILLIN’ GOEZ ON AND ON AND…
Citizen Scarecrow and the Firepup Freedom Fighters:
Now we are gettin’ down to the nitty-gritty of all the reforms that are necessary to save our asses and our sorry economy and that is re-progressivising the income tax by removeing the cap entirely from Social Security, lowering the FICA tax by 1%, hang the “public option” on the medicare framework,recind the Bush tax cuts and push the highest bracket back up to 55-60% or whatever it was before Reagan blew it up. This solves every issue that faces us in terms of the question “how do we pay for it” and gives the political advantage back to the majority of people through their elected legislature.
Once we have services that reach everyone, from healthcare to education, there is no way that anyone can win an election by cutting taxes.
It seems to me that in the last few days we have seen movement toward a healthcare bill that not only includes a public option but sets the framework for single payer in the future…once there is a bill in the Senate there will be a “public option” in the healthcare bill that comes out of conference. The momentum for real reform has passed the threshold and now it’s gunna be damned hard for the Senate to kill the bill if the House progressives stand firm.
KEEP THE FAITH AND PASS THE AMMUNITION, FAILURE IS NOT AN OPTION AND FEAR IS JUST A FOUR LETTER WORD!!
It is a joke on the people of the United States that there could be health care reform that doesn’t eliminate the requirement for businesses to pay for health care. They pay taxes that cover health care. Everyone knows it will save them money, but the problem is, they invest in these profiteers stock, and thus have an interest.
We will never create product again in a global marketplace unless it is competitive. There are thousands of times the amount of smart people beginning to work in other countries than there are here. So what are we going to sell them they can’t make themselves? Hollywood?
On her seriousness, it’s worth comparing what she’s suggesting compared to what her Republican colleagues are asking, which range from stupid to insulting — there isn’t a single serious proposal among them. Think Progress has been compiling the list:
http://thinkprogress.org/2009/…..nt-baucus/
And KO is doing a piece on this point on Countdown. When you consider earlier reports that Snowe is under enormous pressure from her Party’s leadership not to cooperate in any way with the effort, it’s a different picture.
The “Exchanges” are simply huge pools of plans (perhaps hundreds) offered by insurers. I don’t see how those in the exchange will have any sort of “competitive advantage” over the current system. The only way to make the insurers reduce costs is if the members can pool their money to attract one insurer while denying all the others the purchase. The one with the best plan (or selection of plans) wins.
And with mandates and exchanges you merely have created a “sellers market”.
Unions usually join with the employer to negotiate health insurance that is reasonably-priced and with good services (at least in today’s market)…but Snowe seems to be eroding that with these amendments. She’s encouraging big corporations to throw their employees into the “big pond” where they lack collective power.
Then there’s Snowe’s willingness to let 5% of the population of any state basically to be hung into a land of limbo…before they are covered by a triggered “public program”. Mind you…it’s a “safety net”…not a public option (only those excluded can apply)…for anything over 5% who can’t afford plans made available on the exchange. Imagine if you are part of the 2%, 3% 4% of population ( and this could constitute a big chunk of primarily Middle-Class workers facing any sort of financial e mergency)??? Snowe has told you…no health care this year (but a fine) maybe things will get worse next year and you’ll be covered!
It is a joke on the people of the United States that there could be health care reform that doesn’t eliminate the requirement for businesses, or anyone to pay for health care. Taxes are paid to cover health care. Everyone knows it will save them money, but the problem is, they invest in the death profiteers stock, and thus have an interest in screwing us.
We will never create product again in a global marketplace unless it is competitive. Every nation that provides care is going to be more competitive. Workers live a lot longer and get treatment for illness instead of waiting to die as they do here. Does wonders for morale too. There are thousands of times the amount of smart people beginning to work in other countries than there are here. So what are we going to sell them they can’t make themselves? Hollywood?
sorry, my first one said it hadn’t gone through
You realize that most folks have never seen a wet hen. I actually have, even raised chickens as a kid, but that was about a century ago.
Profile in Courage medals are not awared to people just because they avoid being idiots.
Are wet hens mad? And if so, are they mad as in angry or mad as in insane?
Citizen Raven:
Brother Birdman, sorry but a wet hen doesn’t even come close to the madness I’m gunna experience if they don’t get the fuckers by the short hair with a public option that kills ‘em slowly and painfully.
Fine old southern saying and no one knows where it came from.
Yeah, I think there’s an interesting scenario developing — things are moving in better directions than say, before the Baucus proposal. What he’s done is to reveal the unpleasant facts (that were always there but hidden) about the mandate (there have to be penalties, or it isn’t a mandate), implicit taxes (you have buy a product you might not otherwise have purchased), and who has to pay this implicit tax — gosh, it could be a “tax” on the middle class!! Senators are running for cover.
Making those explicit has forced the Senators to move the incidence of the tax in a progressive direction, but it probably won’t be far enough.
Why not? Bush gave the Medal of Freedom to some real idiots.
The “exchange” has been misrepresented as giving the buyers market power to bargain for lower prices — even the President has made this mistake — but I don’t believe that’s correct.
Forget the exchange, and just think about the mandate. The mandate creates a large pool or people who must purchase insurance, and the regulations say no one can be denied coverage. So the effect of the mandate plus the regulation is to create a large pool of shared risks, so that the average risk for the group is spread across the pool. People with high risks of health costs are then able to buy insurance at the average pool rate, which is lower than what they otherwise would have paid in the current non-mandate market. Of course, people with low risks also pay the average, which is higher than their individual policy might have cost before.
I suppose it’s a testament to just how awful the Baucus bill is that one or two of Snowe’s proposals actually make a modicum of sense (assuming you buy the premise, which I don’t).
Citizen Scarecrow:
Go check out the post at Kos about the letter the progressives in the House sent to Pelosi…if this letter is a reflection of the muscle the House progressives just discovered they have and with the support for a “public option” in most districts at between 60% and 70%, it means that the only way real healthcare reform will get torpedoed is if the President vetoes it.
Remember that Pelosi has been feelin’ Rahm’s hot breath on her neck for six months now and Obama hasn’t seen fit to shorten up his chain so Pelsosi looks at a twofer: she gets to go down in history as the person who got public healthcare passed AND she gets rid of Rahm and Steny in the process.
Bernie Sanders. But he’s not a filibuster-proof majority.
By the way, I agree with you on Ms Snowe. I don’t necessarily agree with her on many her solutions, but she’s coming to the table and trying to contribute in an honest way. Compare her amendments to Kyl’s. His look like he came up with them while on a bad acid trip with Glenn Beck and Orly Taints (or whatever her name is).
“She would foreclose that choice so as to shield private insurers from competition. How protecting oligopolies from competition in an administratively mandated market became a “Republican principle” is something Olympia Snowe should explain.”
Why would the Dems bend over on this? Are they going to wait until the Snowe melts? to take a stand?
“She would foreclose that choice so as to shield private insurers from competition. How protecting oligopolies from competition in an administratively mandated market became a “Republican principle” is something Olympia Snowe should explain.”
“shield private insurance insurers from competition” is this the best we can get from the Republicans
Who says Dems are bending? I think there’s a misunderstanding here between acknowledging that Snowe is operating under the principle that a HealthCare reform bill will be passed and that this bill will be the one that should. I don’t care how many amendments they add to Bacaus’s bill, it’s still the worst one presented in the senate. But, like I said earlier, she’s coming to the table with amendments that will gain her support for the bill. That’s really the key. So far, Republicans are only coming with amendments to either kill the bill, appeal to their right wing base, or that won’t make a difference as far as their vote is concerned.
Ok, here is something that is going to piss everyone off, but the attitudes I have observed in comments sections of all these articles are getting way too idealogical and short-sighted. Now, I need to stress that I believe that a single payer system is what we need. I can compromise so far as to make that a public option. That said, there is a process going on that involves a lot of money, power, and ideologies. You can’t come to the debate saying “We’re not getting _____, so I’m out.” That’s what the Republican party is doing, and that’s the line a lot of YOU have drawn. We’re not getting single-payer now, it’s not going to happen. Accept that. This bill may be a step towards that someday, but it will not happen now. As far as the public option goes, it will be in the final bill, no matter what comes out of Baucus’s committee. That’s fine, because the bill has to come out of the Senate before it can be combined with the House bill which WILL have the public option.
We need a bill out of the Senate in order to get there. Calm down and realize that. If Snowe says, “I’ll support a bill under ____ conditions” well, then, fine. As long as the bill gets through the Senate so the conference committee can fix it. If everything works out, by the time the bill comes back to the Senate, Massachusetts will have filled it’s Senate seat and we can kick Snowe to the curb. If not, that’s fine too, they can use Reconciliation. But understand that Reconciliation is narrow, so the full reform bill can’t be passed in that way. There still needs to be a bill that reigns in the Insurance companies though.
CBO says that in simple terms, the price of a policy is the actuarial value plus an administrative load. What the exchange is supposed to do is to lower the admin load for individuals and small groups. That might cut the policy price by 10-20%.
“calm down” sounds like you might want to listen to your own good advice
“and we can kick Snowe to the curb.’
I am tired of all of this pandering to what Wendell Potter refers to as the “Insurance INdustry Profit Protection and Enhancement Act”
It would be nice. But first a question…
If you allow individuals to buy coverage from this or that place, then how does an employer get a group rate for their employees?
Or, is she simply saying more firms should be able to choose the public option? That sounds fine since the public option plan(s) have to be decent, but not terribly superior to other private insurers. Remember, the idea of the public option is not to simply beat them on value, but to offer an option for people to choose when they’re not satisfied with the private insurers. That it’s a not-for-profit just makes it easier to run and stay a going concern.
As we do with Dems, if you want to spend on something you must show the revenue from somewhere. What’s the complete proposal?
Sounds good to me. These are serious times and it’s time for many individuals to step up to the task. When they do I say “welcome aboard”.
Would it make you happy if the Medicare people ran the new public option?
It would certainly fulfill a prerequisite for a successful public plan as specified by Jacob Hacker. This prerequisite is not fulfilled by existing bills, for the sole, stupid reason of distancing the public plan from the supposed taint of “government.” He reiterated this prerequisite just this past April:
[italics in original; boldface added]
Do you really think you are going to tax INS. Companies to the tune of 200 billion over the next 10 yrs? What happens to this great plan when they just reduce those so called high end plans to under 21 K for families and 8k for individuals?
wow… perfect! that says it so well.
it is awesome the freakshow of wrongheaded prioritizing. And the congress and prez with their hands clapped over their ears jumping up and down screaming to avoid hearing anyone mention the SCANDALOUS WORDS “single payer.” oooooooooooooooooooooooooh.
It can’t be talked about. It can’t be argued about. If they did it would illuminate what pathetic crumbs they offer. (Like how Nader can’t be allowed to debate any of these political guys, because his honest directness, bottom line bluntness would give them and the moderators all the vapors and show the listeners who really is talking reality and what a mess we are truly in and how there is a way out, the opposite way we are going. Sigh.)
As corporate media supplies the kool aid of minimization for the collapse of our rights and benefits.