I keep seeing "it would expand coverage to all but 6% of Americans" can someone tell me who those 6% of Americans would be and why they wouldn't be eligible?
@veronykah: Probably above the threshold for Medicaid but would rather take the penalty than buy insurance. If you let people opt out of programs (even if they incur a fee), you'll have these folks.
Blood on the Senate floor indeed--the blood of all the people in Texas and North Carolina who are going to die from lack of health insurance when their states opt out.
@queenjulie: Seriously. Those won't be the only two states, by any stretch. And the irony is the states who opt out are the states with the most people who NEED the public option.
Stupak's got your number
and Stupak ain't your friend
Reconciliation
Won't bring this to an end.
Blood is on the Senate floor
Reid is on the knife
Harry's got your number
And Harry says its right.
Come on, Harry Reid. Don't wimp out. If Lieberman effs with you, STRIP HIS DAMN COMMITTEE CHAIRMANSHIPS and make him sit in the corner. Then ignore him, because Droopy Dawg hates being ignored and you know it.
@Maritsa: Interesting bit of news. Haven't read the article yet, but I wonder if that means major surgery like face lifts, or does it also include minor procedures like IPL laser treatments to get red of those pesky sun spots?
@Maritsa: I'd say that's smart, given that one of the most common objections I hear regarding health insurance is that "money is wasted on cosmetic surgery!" (Never mind that I've never seen a plan that covers elective cosmetic surgery.)
@la.donna.pietra: I'm LOLing at the idea of my insurance company, which just fought me on a benefit whose coverage is (1) clearly in my plan and (2) mandated by state law, paying for a boob job or face lift.
@la.donna.pietra: My roommate used to work in Hollywood. She said that a lot of actor's health plans covered elective plastic surgery as a necessity for their careers. Women would marry actors specifically for the insurance so they could get some plastic surgery done. Weird.
@angryyoungwoman: I have serious difficulty believing that. I've worked for a number of companies managing their insurance plans and reviewing possible new plans, and I've never seen a plan that covered elective plastic surgery. While the Screen Actors Guild does have health insurance, it's notoriously bare-bones. Your roommate sounds a mite naive.
@la.donna.pietra: Well, it's been a long time since she was an actress (or auditioning for shows and dating actors, more accurately), so I could see that a lot of things have probably changed. She's also crazy, so there is that . . .
You know, I wish the Republicans had been so outspoken about spending public funds on controversial issues when it came to the Iraq war. I vehemently disagreed with that, and yet I still had to pay for it. But when it comes to taking care of women over here (or at all, really), the Republicans have made it perfectly clear that they don't give a damn about what's best for us, only what they think is best for us. Interestingly, I wonder how many women and family members of men in the RNC were directly affected when they dropped their abortion coverage a couple of weeks ago. (Answer: all.)
@Ack: Honestly, this whole idea that taxpayers should not be forced to pay for things they find morally reprehensible is such bullshit. My tax dollars pay for the war in Iraq, the war on drugs, capital punishment and Viagra prescriptions for senators who like to wear diapers during sex. Where's my opt-out language?
@Ack: Yes, it is crazy-making. I mean, I totally agree, but we maybe have to save that particular fight for another day. I am fully supportive of having that fight, I hasten to add - to me, it's part of the ideological war that the Left have been losing for decades. I hate all the bitching about the Dems and then, when Obama steps up and says he's not even going to bother with Fox News because it isn't a 'news' channel - a fact that any sane person knows - people start bitching about how he shouldn't have said that! I'm like, wtf? What, you should be afraid to speak the truth? That's how they win.
@whynotshesaid: There should be a conscience clause on our tax forms! It would say "I refuse to pay for the following things because I have a conscience:"
Edited by Alys Brangwin has a huge talent at 11/19/09 2:12 PM
Alys Brangwin has a huge talent was starred
Alys Brangwin has a huge talent was unstarred
@Alys Brangwin: It can be like when you go to the DMV and you have the option to donate $2 for glaucoma awareness or something!
I would also like to ask for an option that says, "Please give all my tax money to schools, social services, science research and the establishment of wildlife refuges." This is fun! No wonder all the anti-choice loonies love it so much!
@whynotshesaid: I semi-seriously heard this suggested on my local NPR before the last elections. Some dude (it's always a dude) waxing lyrical about letting tax payers check boxes on their tax forms to designate percentages of their tax money spent on stuff. He swore that even if education was severely underfunded one year, it would be a self-correcting problem--same with all other tax-run stuff. Yeah. Except the job loss/hiring boom cycle every year. Or the part where roads might not get paved and kids not educated.
@AuburnPonytail: Because its an end run around how things are supposed to work in Congress. Its a way to pretty much get anything you want passed without any hope of debate or a vote on the matter.
@Khuldrim: Except that the filibuster isn't how things are supposed to work in the Senate either. The filibuster was never meant to require 60 votes on every bill. It was supposed to be a rare threat, and now it has become procedure and reconciliation is the only way out of the 60 votes.
@AuburnPonytail: It is a legislative short-cut that allows a budget bill to pass the Senate with a simple majority and no threat of a filibuster.
W used it to pass all 3 of his hideous tax cuts to the rich.
He also tried to use it to open the Arctic National Wildlife Refuge to oil drilling but failed.
The biggest problem I have with this is letting states opt out. Texas, where I currently reside, has the most amount of people uninsured in the entire nation. And I can pretty much predict that Texas with its dumb government-is-always-evil and spending-is-always-bad mentality will opt out. And then, 5.8 million people will still go without health insurance, and that's just if ONE state opts out.
This does not solve the problem. It helps the people who live in states that are willing to help their people. Having the ability to opt out means this will fail. We all have to be in it to make it work .
@L'Adelina: Tom Perry's too busy building the fanciest glass castle to house the first family and John Cornyn is tied up in supporting militias like Blackwater and blood money from oil interests to care about the over-educated and underemployed, the poor, the indigent, etc. My insurance premiums are $370/mo now.
@maggiethecat: The basic care I mentioned includes optics and pregnancy care, which is just included under general health for women. It's not separate.
I wish I could just transfer our health care to you guys! I mean, it has its problems (needs more funding) but damn, we're doing okay. (Unless you live in Queensland, then you're fucked.)
@L'Adelina: The ironic thing is that the states who will undoubtedly chose to opt out are states whose residents would most benefit from opting in.
It is suggested that the states would be too embarrassed to opt-out as it would mean cutting benefits.
Andrew Sullivan on this: The genius of the opt-out is that it coopts the states' rights argument (just as ending the prohibition on marijuana does); it has the potential to make "liberalism' popular again; it has easily demonized opponents - the health insurance industry; and it forces Republicans not to rail against socialism in the abstract but to oppose actual benefits for the working poor in reality.
At his last job, my husband and I were paying $650 per month for really good coverage- included dental and such- with very low co-pays/ deductibles. (His company paid the same, BTW, so the total cost to cover two people was $1300 per month.) He changed jobs and we're now paying about $250 per month (again, they match, so the total is $500), but we have no dental and our co-pays/ deductibles are huge. For instance, our insurance only covered about 20% of the anaesthia bill for a small surgery I had to have this summer. Both of us are in perfect health with no pre-existing conditions or risk factors, BTW.
One of the issues for us is joint coverage. Our insurer has two plan types: single person and family. If we had two or six or twenty kids under 18 we'd be paying the same we are now; if my company offered insurance, my husband's single coverage would cost about 40% of what we pay for both of us. There's just no "couple" coverage. I guess they figure were dinks (double income, no kids) and so we can afford to pay more than singles or parents, but it seems a little unfair.
"There is a conscience clause that makes it perfectly acceptable for insurance companies to deny that coverage or health care providers to refuse carrying out the procedure. But the bill also requires each exchange to offer one plan that provides abortion coverage and one that doesn't"
Can someone help an English expat get her head around this - what is an 'exchange'? And if your healthcare comes with your job, you still get to choose a plan with abortion, right? Or does your employer choose? Also, side issue, this 97% thing - who are the 3% who won't get the option for free healthcare?
@Diziet_Sma: They will have the option but are likely to opt out. They will not be penalized for doing so.
Here you go:
c) Exceptions-
`(1) DEPENDENTS- Subsection (a) shall not apply to any individual for any taxable year if a deduction is allowable under section 151 with respect to such individual to another taxpayer for any taxable year beginning in the same calendar year as such taxable year.
`(2) NONRESIDENT ALIENS- Subsection (a) shall not apply to any individual who is a nonresident alien.
`(3) INDIVIDUALS RESIDING OUTSIDE UNITED STATES- Any qualified individual (as defined in section 911(d)) (and any qualifying child residing with such individual) shall be treated for purposes of this section as covered by acceptable coverage during the period described in subparagraph (A) or (B) of section 911(d)(1), whichever is applicable.
`(4) INDIVIDUALS RESIDING IN POSSESSIONS OF THE UNITED STATES- Any individual who is a bona fide resident of any possession of the United States (as determined under section 937(a)) for any taxable year (and any qualifying child residing with such individual) shall be treated for purposes of this section as covered by acceptable coverage during such taxable year.
`(5) RELIGIOUS CONSCIENCE EXEMPTION-
`(A) IN GENERAL- Subsection (a) shall not apply to any individual (and any qualifying child residing with such individual) for any period if such individual has in effect an exemption which certifies that such individual is a member of a recognized religious sect or division thereof described in section 1402(g)(1) and an adherent of established tenets or teachings of such sect or division as described in such section.
1. An exchange is a system where different insurance companies can sell their plans to people who don't have employer coverage and some proposals will also let small businesses purchase through the exchange. It will have rules limiting what types of plans can be offered and how premiums can be determined.
2. If your health care comes with your job, you often have no choice at all. Many employers offer just one plan and you take it or leave it. Other employers offer a choice of 2-4 plans that cost different amounts. But your employer is choosing the plans offered and often, they don't understand what they are doing and just taking what the insurance broker tells them is in their price range.
3. Health reform is not providing 97% of Americans with free health care. Only people with extremely low incomes will get free health care. Everybody else will have to pay or have their employer pay. Most employers only pay a portion of the health premium. It can easily cost people $400 or $500 or even more a month to insure their families through their employer plan. The reform proposals will offer government subsidies to people with low incomes, but many will get subsidies that only pay for part of the cost.
4. The reason some people won't get coverage is that they still have to pay for it and they won't or can't pay for it, that some states won't have exchanges so affordable coverage won't be available, or they are undocumented immigrants who don't have employer coverage.
@winner: Thank you. But when you say, "They will have the option but are likely to opt out. They will not be penalized for doing so," do you mean employers can choose a plan for you that doesn't include abortion, so that if you needed one, you would have to pay for it? Sorry, am a little confused.
@Lymed: Thanks for taking the time to explain it so well in plain English! If I could heart you again, I would.
Now I understand it more, I don't get why we're celebrating this. It seems like in many cases, a woman's access to abortion will still be in someone else's hands - her employer's.
@Diziet_Sma: Oh, no. I'm saying that specific people will have the option to opt out without penalization. The religious objection, for example; undocumented workers are NOT included in that 3%.
@Diziet_Sma: Oh, also, 2/3rds of private insurers cover elective abortion. That wouldn't change. Apparently, you can ask your employer for additional insurance options but I'm not sure how often this happens.
Insurance you have through the military has never covered elective abortion. Through Medicaid, only a few states offer coverage beyond life endangerment, incest or rape.
This is a great tool, click on the links to the left to see the key difference in the bills: [www.nytimes.com]
But you're right - we're "celebrating" this because Reid is a Mormon and our expectations were low...
So does anyone else think the progress on this is due in large part to the internet and forums just like this that manage to EXPLAIN what these douchebags are doing? Which makes it possible for us to hold their feet to the fire - the first thing I did this morning was respond to an email from one of my reps on this issue.
@sybann: I definitely think the internet is making people more politically aware, informed and active. We've already seen how powerful that can be - I doubt Obama would be president now if it hadn't been for all the online organizing. So, Yay!
@sybann: While I'm sure that was a part of it, remember the President has been out of the country engaging in mostly mostly behind-closed-doors talks and otherwise staying out of the news, so for political news organizations, the health care debate has been literally the only show in town.
While their coverage may be more inflammatory than explanatory, I think the fact that Congress has been debating this bill in the public eye, rather than as a footnote to news coverage of the executive office, probably had a significant effect on bringing both parties closer to their base in the discussions.
@Cardbross: I refuse to give any credit to traditional media anymore - I think in their pursuit of ratings/profits over truth in reporting they've betrayed their audience/real customers - us - and I'm unwilling to forgive them for it. And I'm IN the media.
@sybann: I'm with you there. I'm no fan of traditional media (does TV count as traditional? what does that make newspapers?). I just think, in this instance, and regardless of what their actual stories where, they were dragged into mentioning the healthcare debate by a lack of other stories, and that probably had a beneficial effect by virtue of creating incidental accountability.
alright, i'm going to just rant because i can't take this anymore!
I REFUSE TO CONGRATULATE AN ELECTED OFFICIAL FOR "ALLOWING" WOMEN CONTINUED ACCESS TO A FUCKING LEGAL MEDICAL PROCEDURE!!!!!!!!
i'm sorry, but i am not under any illusions that Reid did this out of concern for women and their right to choose. he is anti-choice. 29% NARAL rating. he's voted for all sorts of heinous bills that want to restrict the right to abortion until its meaningless. this is a 100% political calculation and i do not doubt for a second that he will compromise on this in order to pass healthcare reform.
also, how the hell is this guy the top Dem in the Senate?! did he not read the party platform? ugh.
@cantankasaurus rex: Hearted. This? "I REFUSE TO CONGRATULATE AN ELECTED OFFICIAL FOR "ALLOWING" WOMEN CONTINUED ACCESS TO A FUCKING LEGAL MEDICAL PROCEDURE!!!!!!!!"
Is exactly how I feel about most of our government. It's like how people give dads accolades when they are merely present for the raising of their children. It's like, WTF? How are these things considered above and beyond?
Yesterday I read to my partner the thing about the 18 year old getting an award for an act of extreme humanity (or something) for calling the cops about the gang rape in CA. He was like, "That's nice. But it's fucked up that calling the cops about a fucking gang rape is considered an "extreme" act of humanity."
Harry Reid didn't stab insurers with an excise tax. He stabbed Americans and small businesses. The excise tax on so-called Cadillac plans won't just be absorbed by insurance companies. It means union workers who gave up wage increases for health benefits will have those benefits cut by legislation that is supposed to increase coverage. It means small businesses that employ high cost employees, perhaps because they employ people with HIV or who are undergoing a transplant, will have insurance rate increases. You can take two equal benefit plans offered by the same insurance company and one plan will be taxed and the other won't. How does that make sense?
He is also ripping the exchange to shreds by creating an exchange in every state rather than one national exchange. So people who live in Maine, Rhode Island and Delaware won't have the opportunity to participate in an exchange with as large a pool as people who live in California and New York.
@Lymed: As far as I know, employers will not be required to offer coverage and it is large companies who will be taxes but only when the government is subsidizing coverage for their employees.
And two equal benefit plans offered by the same company will not be taxed similarly; the more expensive - PPO for example as opposed to HMO - will be taxed.
This is my understanding of Reid's bill - I'm still reading...
@Lymed: I've done a bit more research and it appears, at least in an older Senate bill, that states can join into regional gateways/exchanges. So the exchanges can still have a larger pool if the state chooses. I wouldn't be surprised to see New England states come together, for example.
@winner: The excise tax is a tax on insurance companies who offer high cost health insurance plans. If an employer purchases an insurance plan for its employees that costs more than $8,000 per year for single coverage or more than $21,000 per year for family coverage, the insurance company has to pay a tax. The expectation by economists is that those plans will stop being offered and people will get more pay instead. But that means people will get benefit cuts.
It is not just that a PPO is more expensive than an HMO. A PPO in Maine or Southern Texas will probably be more expensive than the exact same PPO in California. Because health care costs more in Maine and Southern Texas. The exact same PPO will cost more to an employer who happens to employ multiple people with HIV or people getting transplants than it does to an employer who employs primarily health individuals averaging about 30 years in age. Insurance charges more if the people use the insurance more.
@Lymed: I'm with ya - Firefighters often have really expensive medical benefits but it's not just for shits and giggles, it's because of the dangers of the job. Also, we've negotiated for better healthcare instead of bigger raises. So yeah. We are also concerned about this at my work. I understand the reasoning, but there are some flaws.
@Lymed: In my experience, there is increasingly little (if any) difference in benefits or services for high-end PPO plans and lower-end HMO plans. The premium / deductible / copay is the only difference in plans at my firm.
But I see what you're saying and I found this and read a bit more:
[T]he Finance Committee... approved a 40% excise tax on insurance companies that offer "Cadillac" health plans that cost more than $8,000 for individuals.
Labor unions and other critics say the Cadillac tax would hit too many middle-income consumers whose health premiums are high because they live in high-cost areas, not because the plans offer luxury benefits.
Reid, who is facing a tough reelection campaign with the strong backing of organized labor, is exploring ways to scale back the Cadillac tax. He is considering the Medicare payroll tax hike to make up for the revenue that would be lost if the Cadillac tax applied to fewer plans.
@Lymed: Of course all this is relative to the importance of containing health care costs, which has been ditched as a goal in favor of coverage because coverage is sexy and heroic and cost control is for nerds. The House bill doesn't contain costs, really. Everything I've read considers what tiny cost containment measures it included to be pretty piddly, and the CBO said it wouldn't bend the cost curve in the long run.
As far as I can tell, wonks feel like costs can be contained by one or both of these things: consumer spending and delivery reform. Consumer spending advocates are under the impression that many employer-covered folks spend too much on health care (not the ones in the trouble zone) because they have a tax-free health care piggy bank. Non-group types have to pay taxes on insurance, so each dollar of income they would allocate to health care is worth less. This Cadillac tax thing was an attempt to capture these alleged people with posh plans so they won't order them anymore and thereby stop inflating prices.
But now, this was just a poor man's attempt at yanking away the employer tax exemption, which creates this imbalance in purchasing power and keeps people chained to their jobs. It would have a consumption effect by catching all the "Cadillac" types, leave the non-group people no worse off, and would level the consumer playing field, freeing people from their jobs' group plans to pursue the public plan (pleasepleaseplease). What I gathered was if employees, union or sick or otherwise, get hosed by this tax, you lob some subsidies at them. And as with the mandate, all its possible flaws aside, this revocation would drum up some tax income for the program. But oh, Barack Obama must never impose any sort of tax on anyone making less than $250k or the universe will explode.
I know you and I disagreed (amicably, happy to say) about this earlier because you are in favor of total-market tax exemption (non-group people included, that is), thereby liberalizing the consumer market and saving the high cost types from getting hosed. As I recall, you said the entire bill would be paid for, tax-wise, with wealthy income tax hikes. But then, nothing is done about consumer spending, so in theory no cost-curve bending and no increased efficiency. We'll be playing millionaire tax-hike catch-up with the cost curve until we run out of rich people.
So okay, fine, maybe I'll entertain the idea that consumer spending has little to do with rising costs, but that means the legislature has to pass another bill following this one focusing on cost reduction. Maybe some of the stuff this Leonhardt guy proposes will be on the menu.
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I don't get people.
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and Stupak ain't your friend
Reconciliation
Won't bring this to an end.
Blood is on the Senate floor
Reid is on the knife
Harry's got your number
And Harry says its right.
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/random Glengarry movie reference
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[www.nytimes.com]
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#tips
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#tips
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But not David Vitter. I'd make him sit in his wet diaper until he was covered in a rash. Because he sucks that hard.
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And thanks for the image...lol
11/19/09
I would also like to ask for an option that says, "Please give all my tax money to schools, social services, science research and the establishment of wildlife refuges." This is fun! No wonder all the anti-choice loonies love it so much!
#tips
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W used it to pass all 3 of his hideous tax cuts to the rich.
He also tried to use it to open the Arctic National Wildlife Refuge to oil drilling but failed.
Turn around is fair play, I say.
11/19/09
This does not solve the problem. It helps the people who live in states that are willing to help their people. Having the ability to opt out means this will fail. We all have to be in it to make it work .
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mine does not include pregnancy care, dental, eyeglasses, or alternative therapies, etc. glad to have it but damn bcbs goes up every year- about $100.
11/19/09
I wish I could just transfer our health care to you guys! I mean, it has its problems (needs more funding) but damn, we're doing okay. (Unless you live in Queensland, then you're fucked.)
11/19/09
It is suggested that the states would be too embarrassed to opt-out as it would mean cutting benefits.
Andrew Sullivan on this: The genius of the opt-out is that it coopts the states' rights argument (just as ending the prohibition on marijuana does); it has the potential to make "liberalism' popular again; it has easily demonized opponents - the health insurance industry; and it forces Republicans not to rail against socialism in the abstract but to oppose actual benefits for the working poor in reality.
11/19/09
At his last job, my husband and I were paying $650 per month for really good coverage- included dental and such- with very low co-pays/ deductibles. (His company paid the same, BTW, so the total cost to cover two people was $1300 per month.) He changed jobs and we're now paying about $250 per month (again, they match, so the total is $500), but we have no dental and our co-pays/ deductibles are huge. For instance, our insurance only covered about 20% of the anaesthia bill for a small surgery I had to have this summer. Both of us are in perfect health with no pre-existing conditions or risk factors, BTW.
One of the issues for us is joint coverage. Our insurer has two plan types: single person and family. If we had two or six or twenty kids under 18 we'd be paying the same we are now; if my company offered insurance, my husband's single coverage would cost about 40% of what we pay for both of us. There's just no "couple" coverage. I guess they figure were dinks (double income, no kids) and so we can afford to pay more than singles or parents, but it seems a little unfair.
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#tips
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Can someone help an English expat get her head around this - what is an 'exchange'? And if your healthcare comes with your job, you still get to choose a plan with abortion, right? Or does your employer choose? Also, side issue, this 97% thing - who are the 3% who won't get the option for free healthcare?
11/19/09
Here you go:
c) Exceptions-
`(1) DEPENDENTS- Subsection (a) shall not apply to any individual for any taxable year if a deduction is allowable under section 151 with respect to such individual to another taxpayer for any taxable year beginning in the same calendar year as such taxable year.
`(2) NONRESIDENT ALIENS- Subsection (a) shall not apply to any individual who is a nonresident alien.
`(3) INDIVIDUALS RESIDING OUTSIDE UNITED STATES- Any qualified individual (as defined in section 911(d)) (and any qualifying child residing with such individual) shall be treated for purposes of this section as covered by acceptable coverage during the period described in subparagraph (A) or (B) of section 911(d)(1), whichever is applicable.
`(4) INDIVIDUALS RESIDING IN POSSESSIONS OF THE UNITED STATES- Any individual who is a bona fide resident of any possession of the United States (as determined under section 937(a)) for any taxable year (and any qualifying child residing with such individual) shall be treated for purposes of this section as covered by acceptable coverage during such taxable year.
`(5) RELIGIOUS CONSCIENCE EXEMPTION-
`(A) IN GENERAL- Subsection (a) shall not apply to any individual (and any qualifying child residing with such individual) for any period if such individual has in effect an exemption which certifies that such individual is a member of a recognized religious sect or division thereof described in section 1402(g)(1) and an adherent of established tenets or teachings of such sect or division as described in such section.
11/19/09
1. An exchange is a system where different insurance companies can sell their plans to people who don't have employer coverage and some proposals will also let small businesses purchase through the exchange. It will have rules limiting what types of plans can be offered and how premiums can be determined.
2. If your health care comes with your job, you often have no choice at all. Many employers offer just one plan and you take it or leave it. Other employers offer a choice of 2-4 plans that cost different amounts. But your employer is choosing the plans offered and often, they don't understand what they are doing and just taking what the insurance broker tells them is in their price range.
3. Health reform is not providing 97% of Americans with free health care. Only people with extremely low incomes will get free health care. Everybody else will have to pay or have their employer pay. Most employers only pay a portion of the health premium. It can easily cost people $400 or $500 or even more a month to insure their families through their employer plan. The reform proposals will offer government subsidies to people with low incomes, but many will get subsidies that only pay for part of the cost.
4. The reason some people won't get coverage is that they still have to pay for it and they won't or can't pay for it, that some states won't have exchanges so affordable coverage won't be available, or they are undocumented immigrants who don't have employer coverage.
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Now I understand it more, I don't get why we're celebrating this. It seems like in many cases, a woman's access to abortion will still be in someone else's hands - her employer's.
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Insurance you have through the military has never covered elective abortion. Through Medicaid, only a few states offer coverage beyond life endangerment, incest or rape.
This is a great tool, click on the links to the left to see the key difference in the bills: [www.nytimes.com]
But you're right - we're "celebrating" this because Reid is a Mormon and our expectations were low...
11/19/09
Bravo Latoya and Jez.
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While their coverage may be more inflammatory than explanatory, I think the fact that Congress has been debating this bill in the public eye, rather than as a footnote to news coverage of the executive office, probably had a significant effect on bringing both parties closer to their base in the discussions.
11/19/09
11/19/09
#tips
11/19/09
Please or please, just this once, let reasonable compromise and sensible thought prevail in my country's government.
Amen,
-BB
11/19/09
I REFUSE TO CONGRATULATE AN ELECTED OFFICIAL FOR "ALLOWING" WOMEN CONTINUED ACCESS TO A FUCKING LEGAL MEDICAL PROCEDURE!!!!!!!!
i'm sorry, but i am not under any illusions that Reid did this out of concern for women and their right to choose. he is anti-choice. 29% NARAL rating. he's voted for all sorts of heinous bills that want to restrict the right to abortion until its meaningless. this is a 100% political calculation and i do not doubt for a second that he will compromise on this in order to pass healthcare reform.
also, how the hell is this guy the top Dem in the Senate?! did he not read the party platform? ugh.
11/19/09
Is exactly how I feel about most of our government. It's like how people give dads accolades when they are merely present for the raising of their children. It's like, WTF? How are these things considered above and beyond?
Yesterday I read to my partner the thing about the 18 year old getting an award for an act of extreme humanity (or something) for calling the cops about the gang rape in CA. He was like, "That's nice. But it's fucked up that calling the cops about a fucking gang rape is considered an "extreme" act of humanity."
All these things are basic human decency.
11/19/09
He is also ripping the exchange to shreds by creating an exchange in every state rather than one national exchange. So people who live in Maine, Rhode Island and Delaware won't have the opportunity to participate in an exchange with as large a pool as people who live in California and New York.
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11/19/09
11/19/09
And two equal benefit plans offered by the same company will not be taxed similarly; the more expensive - PPO for example as opposed to HMO - will be taxed.
This is my understanding of Reid's bill - I'm still reading...
11/19/09
11/19/09
It is not just that a PPO is more expensive than an HMO. A PPO in Maine or Southern Texas will probably be more expensive than the exact same PPO in California. Because health care costs more in Maine and Southern Texas. The exact same PPO will cost more to an employer who happens to employ multiple people with HIV or people getting transplants than it does to an employer who employs primarily health individuals averaging about 30 years in age. Insurance charges more if the people use the insurance more.
11/19/09
11/19/09
11/19/09
But I see what you're saying and I found this and read a bit more:
[T]he Finance Committee... approved a 40% excise tax on insurance companies that offer "Cadillac" health plans that cost more than $8,000 for individuals.
Labor unions and other critics say the Cadillac tax would hit too many middle-income consumers whose health premiums are high because they live in high-cost areas, not because the plans offer luxury benefits.
Reid, who is facing a tough reelection campaign with the strong backing of organized labor, is exploring ways to scale back the Cadillac tax. He is considering the Medicare payroll tax hike to make up for the revenue that would be lost if the Cadillac tax applied to fewer plans.
[www.latimes.com]
I still think Reid's bill is superior to the House bill as a whole. And it's reassuring to know that he's working toward an even better bill.
11/19/09
11/19/09
As far as I can tell, wonks feel like costs can be contained by one or both of these things: consumer spending and delivery reform. Consumer spending advocates are under the impression that many employer-covered folks spend too much on health care (not the ones in the trouble zone) because they have a tax-free health care piggy bank. Non-group types have to pay taxes on insurance, so each dollar of income they would allocate to health care is worth less. This Cadillac tax thing was an attempt to capture these alleged people with posh plans so they won't order them anymore and thereby stop inflating prices.
But now, this was just a poor man's attempt at yanking away the employer tax exemption, which creates this imbalance in purchasing power and keeps people chained to their jobs. It would have a consumption effect by catching all the "Cadillac" types, leave the non-group people no worse off, and would level the consumer playing field, freeing people from their jobs' group plans to pursue the public plan (pleasepleaseplease). What I gathered was if employees, union or sick or otherwise, get hosed by this tax, you lob some subsidies at them. And as with the mandate, all its possible flaws aside, this revocation would drum up some tax income for the program. But oh, Barack Obama must never impose any sort of tax on anyone making less than $250k or the universe will explode.
I know you and I disagreed (amicably, happy to say) about this earlier because you are in favor of total-market tax exemption (non-group people included, that is), thereby liberalizing the consumer market and saving the high cost types from getting hosed. As I recall, you said the entire bill would be paid for, tax-wise, with wealthy income tax hikes. But then, nothing is done about consumer spending, so in theory no cost-curve bending and no increased efficiency. We'll be playing millionaire tax-hike catch-up with the cost curve until we run out of rich people.
So okay, fine, maybe I'll entertain the idea that consumer spending has little to do with rising costs, but that means the legislature has to pass another bill following this one focusing on cost reduction. Maybe some of the stuff this Leonhardt guy proposes will be on the menu.
[www.nytimes.com]
11/19/09