Will Baucus Plan Make Health Care Affordable?

Mon, 21 Sep 2009 06:06:00 -0700

Did Senator Max Baucus hear the President’s speech on October 9th?

In that speech, President Obama said, “No one should go broke because they get sick.” Indeed, health care reform should end medical bankruptcies, medical foreclosures, and avoidable deaths from going without needed health care. That means health care reform must make health care truly affordable to every American. We must get the details right.

The biggest part of the price tag for health care reform is providing subsidies to help low and moderate income families so that they can purchase insurance through the new Exchange. Because no employer is contributing, individuals and families have to pay the whole premium (averaging $4,347 for an individual and $12,145 for a family in Ohio). That’s why subsidies are critical.

All the bills create an affordability standard – caps on yearly premium and out-of-pocket costs; adequate benefits; exempting very low-income people from premiums; and narrowing the rate differences between young and old folks. Even under the standards in the HELP and House bills, many low and moderate income families will struggle to afford coverage.

But, to lower the price tag for health care reform, Senator Baucus takes a bit out of those standards. In other words, he’s saving an estimated $200 billion over 10 years off the backs of our most vulnerable citizens. The savings amount to a mere $20 billion annually – chump change for the federal budget when you think about what they spent on tax cuts to the rich, wars in Iraq and Afghanistan, bank bailouts. And when you recognize that the US spends $2.4 trillion per year on health care.

Health care is a moral issue and THE defining justice issue for our nation today. Will we finally decide, as a nation, that every American has a right to health care? Then, we must ensure that health care is affordable. Otherwise, the right will be an empty one. People who get sick will continue to go broke. People will continue to die from lack of health coverage.

Helping Ohioans with Pre-existing conditions: Will the Ohio House Side with Consumers or the Insurance Industry?

Wed, 15 Apr 2009 11:50:00 -0700

The Governor’s budget contains a modest provision to help people with pre-existing conditions buy affordable health insurance. But the insurance industry is working hard in the Ohio House to weaken or gut this proposal, which would help 52,000 Ohioans with pre-existing conditions get affordable coverage. Who will win, Ohio consumers or the insurance industry?
Ohioans not offered employer or group health insurance coverage are left to purchase insurance coverage in the individual market, where many consumers are denied coverage or charged unaffordable premiums. Ohioans hit the hardest are those with pre-existing conditions. Coverage for them is often denied or offered with exclusions for treatment for pre-existing conditions—care that people need the most.
Ohio created the Open Enrollment Program for people denied coverage in the individual market. Under Ohio law, health insurers must open enrollment annually. Insurers may not refuse anyone, regardless of pre-existing conditions, until they reach their enrollment cap. But the premiums in the Open Enrollment Program are so high that, in 2007, only 1,487 Ohioans enrolled for coverage during the open enrollment period.
Governor’s Proposed Modification to the Open Enrollment Program
HB 1, the Governor’s budget, modifies the Open Enrollment Program by lowering the cap on premiums for people with pre-existing conditions. Lowering the cap will enable a significant number of Ohioans with pre-existing conditions to afford coverage, by spreading the risk over the whole individual market. Actuaries hired by the Ohio Department of Insurance measured the impact of different premium caps (their report can be found at http://www.healthcarereform.ohio.gov/HCRDoc/LandEOpenEnrollment.pdf).
The study concluded that by capping open enrollment premiums at 1.5 times the base rate for coverage, which the Governor recommends, premiums (rates) spread across the whole individual market would increase by an average of 5.5 percent and a net of 52,000 Ohioans will obtain coverag, most of them with pre-existing conditions at rates 50 to 70% lower than the extremely high rates charged to them under the present law.
To lower the 5.5% increase across the whole individual market population, the premium cap for Open Enrollment could be raised. But that will lower the number of people with pre-existing conditions who will benefit from the proposal to 14,000, a drop of 73 percent! Here are some of the alternative findings of the actuary:

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Will Baucus Plan Make Health Care Affordable?

Helping Ohioans with Pre-existing conditions: Will the Ohio House Side with Consumers or the Insurance Industry?