Monday, September 7

Mike Pence Endorses HR 3200 and the Kennedy Help Bill - Kinda

On This Week Republican Mike Pence made a Startling Statement.

Pence: There's not a Public Option in the Federal Employee Benefits plan. The reality is that Federal Employees, all 10 Million of us, get to choose between five different private insurance plans. And they're affordable because Federal Employees are permitted to buy insurance on a Nation-wide basis

Yeah, if we could only give people what Federal Employees have...

Rep Pence - for once - is exactly correct. What he doesn't seem to realize is the ability to match what Federal Employees currently have with a Nation-Wide Health Insurance Exchange - is already in HR 3200!

From HR 3200


(a) Establishment- There is established within the Health Choices Administration and under the direction of the Commissioner a Health Insurance Exchange in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option.


(a) Access to Coverage- In accordance with this section, all individuals are eligible to obtain coverage through enrollment in an Exchange-participating health benefits plan offered through the Health Insurance Exchange unless such individuals are enrolled in another qualified health benefits plan or other acceptable coverage.

(b) Definitions- In this division:

(1) EXCHANGE-ELIGIBLE INDIVIDUAL- The term `Exchange-eligible individual' means an individual who is eligible under this section to be enrolled through the Health Insurance Exchange in an Exchange-participating health benefits plan and, with respect to family coverage, includes dependents of such individual.

(2) EXCHANGE-ELIGIBLE EMPLOYER- The term `Exchange-eligible employer' means an employer that is eligible under this section to enroll through the Health Insurance Exchange employees of the employer (and their dependents) in Exchange-eligible health benefits plans.

In the Kennedy HELP Bill this is called a "Gateway".

What Rep Penee fails to understand or is willfully misrepresenting - among many things - is that the Public Option would simply be one plan in addition to the others in the Exchange, so when he talks about the possibility of Employers dropping coverage and forcing their employees into the Public Option he simply doesn't know what he's TALKING about. If Employers drop coverage (ala Walmart), their employees can join the exchange themselves as individuals, meanwhile the employer would have to pay an 8% payroll tax which would go to subsidizing those employees who can't afford to buy in own their own with the same buying power that their employer had.

Watch Harold Ford take Rudy Fooliani Apart.

Pence like Rudy (Their gonna Pull-the-Plug On Grandma!) Guiliani and Sarah (Death Panels for my Baby!) Palin seem to continue to hang onto the canard that limits on Malpractice Payouts (Tort Reform) will bring down costs, but there are many logical fallacies with this. Doctors pay for Malpractice Insurance, not patients. Many states which have introduced such reforms haven't seen any savings from them. Studies by the GAO and CBO have also found that such efforts do not reduce costs, in contrast to claims from private studies.


GAO: Because this study was focused on only one condition and on a hospital setting, it cannot be extrapolated to the larger practice of medicine. Given the limited evidence, reliable cost savings estimates cannot be developed.

CBO: When CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts.

Another thing that has driven the Deathers/Screamers crazy is the fact that Federal Employees, people on Medicare and the VA are excluded from the Exchanges. (Which they confuse with the Public Option and then they scream - Why doesn't Congress have to join the Public Death Option?) But the fact is they don't have to join the Exchange because the Federal Employee Benefits System already IS an Exchange and that a Public Option available to the exchange would also be available to Federal Employees in their existing system.

It's an Option - not a Requirement.

Contrary to what Sen Dole says, the argument that private insurance will need Five Years to remove Pre-existing conditions and other impediments to good care is simply a non-starter. Such practices are Banned on Day One under HR 3200.


A qualified health benefits plan may not impose any pre-existing condition exclusion (as defined in section 2701(b)(1)(A) of the Public Health Service Act) or otherwise impose any limit or condition on the coverage under the plan with respect to an individual or dependent based on any health status-related factors (as defined in section 2791(d)(9) of the Public Health Service Act) in relation to the individual or dependent.

They are also banned from terminating your policy simply because you get sick.


The requirements of sections 2711 (other than subsections (c) and (e)) and 2712 (other than paragraphs (3), and (6) of subsection (b) and subsection (e)) of the Public Health Service Act, relating to guaranteed availability and renewability of health insurance coverage, shall apply to individuals and employers in all individual and group health insurance coverage, whether offered to individuals or employers through the Health Insurance Exchange, through any employment-based health plan, or otherwise, in the same manner as such sections apply to employers and health insurance coverage offered in the small group market, except that such section 2712(b)(1) shall apply only if, before nonrenewal or discontinuation of coverage, the issuer has provided the enrollee with notice of non-payment of premiums and there is a grace period during which the enrollees has an opportunity to correct such nonpayment. Rescissions of such coverage shall be prohibited except in cases of fraud as defined in sections 2712(b)(2) of such Act.

As we move closer to Wednesday's big speech it seems that the big argument isn't about any of these provisions, it's about whether have a public option immediately or we have one automatically triggered somewhere down the road.

To me that's a Win/win.

As was shown during the Clinton attempt at Health Care reform - Simply the Threat of a Public Based system to compete with the current private insurance companies was enough to significantly drive down Health Care costs. It doesn't even have to be implemented to bring the costs down because Hillary care didn't even pass - but it worked.

Here's the proof.

In 1996, after several years of Capital Hill Battles, the rate of Inflation for Health Care actually dropped below the rate of inflation for Wages and the Consumer Price Index. That is what our trigger should be. In fact let's make this simple and take Olympia Snowe's idea and match it with Anthony Weiner's - let's require Private Insurance to get their inflation rate down to and below the CPI and general Wage inflation rate (around 2-3%) within one or two years And KEEP IT THERE or the following year that state has the option to allow all it's citizens - regardless of age - to BUY-IN to Medicare if they want to.

If you listen to Bob Dole - who I suspect is On Medicare right now - that seems like an idea that even some Republicans actually might go for. Even Conserva-Dem Ben Nelson has expressed support for it.

The question is - will Progressives be willing to wait a year or two if we get just about everything we want in the meantime? The Good is not always the Enemy of the Perfect.


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