In response to my friends (and my mother!) who think we should just kill the health care bill: The Center on Budget and Policy Priorities has been a vigorous advocate for low- and moderate-income people for decades. I think it's important that CBPP believes that even though the bill requires us all to buy insurance in the ugly private insurance market, the subsidies that the bill gives to families with up to $88,000 in income, plus the promise of coverage regardless of preexisting conditions, plus the other provisions in the bill, make it worthwhile. I'm
reproducing excerpting their most recent analysis below.
Believe me, this is not what I wanted. Hell, I'm right now fighting with Regence because they won't cover my checkups with my glaucoma doctor! But the way the system controls costs now is by denying people insurance. If this bill fails that process will accelerate. Bring everybody under the tent, making the government responsible for subsidizing costs for lower-income people, paying for it at least in part with a progressive reform to the Medicare tax ... I don't see how we can say 'no.'
Reforms Expand Coverage and Make Insurance More Affordable
The health reform legislation would expand coverage to 32 million uninsured people through a significant expansion of Medicaid, as well as premium and cost-sharing credits for low- and moderate-income individuals and families who do not have employer-based insurance and who do not qualify for Medicaid or Medicare.
Premium and Cost-Sharing Credits for Low- and Moderate-Income People
Individuals and families who have incomes above the level needed to qualify for Medicaid but below 400 percent of the poverty line would receive “premium credits” to help them purchase health insurance in the new health insurance exchanges (discussed below). For example, under the health reform legislation, a family of three earning $32,000 (175 percent of the poverty line for a family of that size) would receive a credit that would limit its annual premium to about $1,500 (if the health reform bill were in effect in 2010). In addition, the legislation would provide additional cost-sharing subsidies (that is, assistance with deductibles and copayments) to people earning less than 250 percent of the poverty line to ensure that they can actually afford to see a doctor and seek care. The maximum out-of-pocket costs a family of three earning $32,000 would have to pay each year (in addition to the insurance premiums) would be about $2,000.
Expanded Medicaid Eligibility for the Lowest-Income People
The plan would expand Medicaid up to 133 percent of the poverty line for all children and adults younger than 65 who are lawfully residing in the United States and not eligible for Medicare. This would mean that millions of low-income parents, as well non-disabled low-income adults who do not have dependent children (and who are generally ineligible for Medicaid today except in a small number of states with waivers), would become newly eligible for health coverage through Medicaid. The federal government would pick up 100 percent of states’ Medicaid costs related to this expansion for three years, with that percentage phasing down to 90 percent for 2020 and subsequent years. Recognizing the need for increased capacity to serve new enrollees, the plan would also increase primary care provider payments to 100 percent of Medicare rates during 2013 and 2014, with the federal government covering the full cost of these rate increases.
Medicaid is the most cost-effective way to provide comprehensive and affordable coverage to people with very low incomes and thereby ensure that the low-income uninsured gain coverage. Medicaid beneficiaries generally do not pay premiums and are required to pay only modest co-payments. Medicaid covers a broad array of services and supports well-suited to the needs of low-income people (especially children and people with disabilities), who are more likely than people with higher incomes to be in fair or poor health. Medicaid is also significantly less costly, on a per-beneficiary basis, than private insurance (after adjusting for health status), largely due to its lower provider rates and administrative costs.
[Editor's note: Original post contained entirety of CBPP's analysis, including a bunch of broken navigation. Read the rest here.]