The Senate's Health Care Bill

Like all compromises necessary to garner support from fence sitters in Congress, the Senate health care bill is not as strong as progressives would like, but it does preserve a government health plan as part of the proposed health insurance exchanges. The public option is not as robust as it started out, primarily because the legislation requires reimbursement rates be negotiated with the private health insurance sector, and allows states to drop out of the program by passing their own legislation. All legal residents will be required to have health insurance by 2014 or face fines. Employers with more than 50 employees would have to pay $750 per full-time worker if any of them obtained subsidized coverage through the exchanges. By these mandates and changes to Medicare and Medicaid, the bill intends to cover 94% of Americans.

The Congressional Budget Office (CBO) expects that only one out of eight people purchasing coverage through the exchanges will enroll in the public plan. It also estimates, perhaps overly so, that seventeen states will opt out leaving only two-thirds of the population residing in states where the public plan is available. CBO expects premiums for the public plan to be slightly higher than private plans offered in the exchanges since the premiums must cover the cost of claims, administration, and a contingency reserve. The plan will have lower administration costs, but will attract "a less healthy pool of enrollees" due to "less management of utilization" by the Department of Health & Human Services. Progressives can only hope that California opts out and leads the way to a more efficient single payer system in the future. But Senator Henry Reid's version is at least half a loaf better than none. According to the rating by CBO, the plan does save the government money: $130 billion between 2010 to 2019. US Person predicts that a bill close to the Senate plan in content will come out of conference committee minus the unacceptable (and perhaps unconstitutional) limitation on private funding of abortion that House conservatives forced onto its bill as political ransom for passage.