Dems Weigh Temporary Medicare Expansion

ins.dave

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12.08.09


Deal could be part of watered-down 'public option' compromise



Emboldened key points. How can anyone read this without believing that a phase out of the private health insurance industry is paramount in their minds?

WASHINGTON - Urgently seeking a deal on President Barack Obama's health care overhaul, Democratic senators are considering opening the Medicare rolls to uninsured middle-aged people able to purchase the coverage.
The Medicare "buy-in" for people 55 to 64 would be available until government subsidies start flowing in 2014 to new health insurance markets designed for people who now have trouble getting and keeping affordable coverage.
Sen. Ben Nelson, D-Neb., said the idea is on the table as part of an emerging compromise under which liberals would back away from their demand for a new government health insurance plan to compete with private carriers. Instead of a so-called public plan, the compromise envisions private insurers operating under the auspices of the government agency that now manages the federal employee health plan — the same one that covers members of Congress.
But Maine Sen. Olympia Snow— one Republican who may vote for the Democrats' bill — raised a warning flag. "I'm not sure ultimately what is the purpose" in broadening Medicare coverage, she said.
Also under discussion is a proposal from liberals to allow early Medicare enrollment on a permanent basis for middle-age people participating in new insurance markets called exchanges in the bill. Americans who buy their own coverage or work for small businesses would be able to buy insurance in the exchanges starting in 2014, gaining access to a range of plans. Most would receive government subsidies. A Democratic official described the proposal on condition of anonymity because no decisions have been made.
The Democratic negotiators — five liberals and five moderates — are under pressure to reach at least a tentative deal by Tuesday. The 'public option' now in the bill — a government-run plan that states could opt out of — is unacceptable to moderates whose votes Majority Leader Harry Reid, D-Nev., needs to pass a bill embodying Obama's signature issue.
A companion idea also under discussion — expanding the Medicaid program to cover more low-income people — appears to have run into opposition from moderates.

Republican Leader Mitch McConnell of Kentucky ridiculed the Democrats' late-innings re-engineering, and suggested adding more people to Medicare could undermine the program's already shaky finances. He called for Democrats to scrap the bill and start over.
"Americans would rather get it right than scurry around throwing together last-minute untested experiments to get 60 votes before Christmas," McConnell said.

Medicare now covers seniors 65 and older, as well as disabled people of any age. People in their mid-50s are among the most vulnerable to losing coverage, particularly in an economy where employers are still cutting jobs. But buying into Medicare would not be cheap. A current buy-in available to those 65 and older who don't qualify because of work history costs about $550 a month.

The latest public plan idea bears little resemblance to the original proposed by liberals, and embraced by Obama, during the 2008 presidential campaign. That called for the government to sell insurance to workers and their families in competition with industry giants like UnitedHealthcare.

But instead of Medicare-for-the-masses, it would be Blue Cross Blue Shield or Kaiser Permanente, albeit with a government seal of approval from the department that handles the health plan for federal employees, including members of Congress. The — OPM — would become an instantly recognizable federal acronym, like FDA and CDC.


"It's probably the closest proposal thus far that could get the support of 60 senators. It's got legs," said Sen. Max Baucus , D-Mont., chairman of the Finance Committee.

Negotiators worked on the compromise Tuesday as the Senate debated the 10-year, nearly $1 trillion bill. A vote on an amendment to tightly restrict abortion coverage by health plans receiving federal subsidies could also happen Tuesday.

The possible deal has drawn a wary reaction from liberals, who support a Medicare-like approach.

The idea being the emerging compromise is for the government to lend its seal of approval to private plans that would be offered across the nation. The plans would be available through new state insurance markets, called exchanges. New markets would create big purchasing pools for those who now have trouble finding and keeping affordable coverage — people buying their own insurance and small businesses.
* Why can't they just help those people without needing an exchange?
Most of the 30 million consumers in the exchanges would have government subsidies to help pay premiums.
Any insurer could approach the federal personnel office to offer a plan in the exchanges, but the plan itself would have to be nonprofit.

More b.s. terminology used to gain public support. As we know, lots of "non profit" private offerings are far from inexpensive or "competitive."

Most Blue Cross plans are still nonprofit, as is Kaiser, the giant health maintenance organization. OPM and the plans would negotiate premiums and coverage terms.


No, you can't

Ron Paul 2012
 
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Wouldn't that help out small group coverage by eliminating the coverage of those 55-64 (moving them to Medicare early)?

Unless I'm mistaken, that is the age bracket with the highest percentage of claims. Remove that group, and small group rates should drop significantly and profit should rise.

I don't see that as a bad thing, but the public option needs to go.
 
Wouldn't that help out small group coverage by eliminating the coverage of those 55-64 (moving them to Medicare early)?

Unless I'm mistaken, that is the age bracket with the highest percentage of claims. Remove that group, and small group rates should drop significantly and profit should rise.

I don't see that as a bad thing, but the public option needs to go.

Well, I sure think it is a bad thing as half of the indie market and most of the real business is at that age.
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I don't see that as a bad thing, but the public option needs to go.


Stuyman, you don't specialize in the indie health end of the business?


NO, you can't.

Ron Paul 2012
 
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Well, I sure think it is a bad thing as half of the indie market and most of the real business is at that age.
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Stuyman, you don't specialize in the indie health end of the business?

Small group. I do some indie, but I hate it compared to B2B sales.
 
Small group. I do some indie, but I hate it compared to B2B sales.

Well, there you go. One man's misery is another's mystery.
Maybe I'm missing it, but i don't think that would help your cause either?
For us, that would be a huge kick in the teeth. But the reality is that incrementally, unless Barry is stopped, "healthcare reform" will not stop until ALL private health insurers are done. Except for possibly suck ass AARP, but I reckon they will get it also eventually. That is a fact so to anyone who does not already get this. Please wake up?
Stop trying to figure out what will be left for you because this is but one part of their socialist agenda. If you think this is an exaggeration, go ahead and find yourself an immigrant from a socialist country and have a chat with them. Ask them about Barry's tone and leanings during the 2008 campaign. Ask them about what they think about the expansion of government. All the dems are trying to do is get as much govt. control of healthcare as possible. They can't get a public option right now to phase out the private companies, so give us everone fron 55 on. In terms of premium dollars, that is almost as bad. The indie industry relies on that chunk of the market. What are they going to do? Sustain indie plans with all the revenue collected from 20 year olds? Once again, another vehicle to hurt, undermine private insurers. Just like everything else they are trying to push through.


NO, you can't.

Ron Paul 2012
 
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Well, there you go. One man's misery is another's mystery.
Maybe I'm missing it, but i don't think that would help your cause either?
For us, that would be a huge kick in the teeth. But the reality is that incrementally, unless Barry is stopped, "healthcare reform" will not stop until ALL private health insurers are done. Except for possibly suck ass AARP, but I reckon they will get it also eventually. That is a fact so to anyone who does not already get this. Please wake up?
Stop trying to figure out what will be left for you because this is but one part of their socialist agenda. If you think this is an exaggeration, go ahead and find yourself an immigrant from a socialist country and have a chat with them. Ask them about Barry's tone and leanings during the 2008 campaign. Ask them about what they think about the expansion of government. All the dems are trying to do is get as much govt. control of healthcare as possible. They can't get a public option right now to phase out the private companies, so give us everone fron 55 on. In terms of premium dollars, that is almost as bad. The indie industry relies on that chunk of the market. What are they going to do? Sustain indie plans with all the revenue collected from 20 year olds? Once again, another vehicle to hurt, undermine private insurers. Just like everything else they are trying to push through.

Oh there will be some type of bill before congress to expand health care every year from now on for the rest of our born days. Some people are approaching this as though it is some kind of knot-hole that you get through and then you go back to working with whatever the outcome is for the next ten years until it is revised again. Not so. The dems will back down on some aspects of the bill because they will smarten up and gain confidence that what you don't get in round one, you can just get in future add-ons. It could get worse if Obama feels that he has plenty more money to throw around but if he reaches the maximum there the government will just move toward accomplishing its goals through regulation without any funding to go with it.

Look, we are a socialist government now. That is not a smear. It is simply a fact.
 
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In this ever-changing health bill no one knows how the final bill, if we get there, will shake out.

The Medicare expansion would apply to those who are not covered and cannot get coverage in the open market due to health issues. They would pay a subsidized premium that is greater than the ones currently available for post-65's who do not qualify for "free" Medicare (part A).

As it currently stands, those that opt for under 65 Medicare will not have access to Med supps. If this market fleshes out carriers will re-file their current plans to capture a piece of the market but I would not expect a wholesale move to offer these products if/when Medicare expansion becomes reality.

And there is also the issue of finding available Medicare providers. Most PCP's limit the number of Medicare patients or refuse to accept them altogether.

Don't assume the states will roll over on Medicaid expansion. They are already bleeding red ink on Medicaid & SCHIP and really can't take on any more.

Of course if this is forced on them, look for significant tax increases at the state level.

That won't play well with the voters.
 
Good...expand Medicare to those down to age 55. Hopefully med-supp companies will offer their business down to that age bracket.

T55's anyone?

Medicare is not and will not ever go away. This country would really riot if it did. More money needs to be brought into the system to keep it from going under.

Whether Congress does something about "saving it" in the immediate future or right before it goes under is what I wonder about? I can't see them doing something about it anytime soon...at least until those in Congress are voted back in(or out).
 
Congress critters have their own idea of how to save Medicare.

1) Eliminate fraud and abuse
2) Cut reimbursements

Other than that, they have no clue. That said, they are considering lifting the wage ceiling on HI taxes. You know, soak the rich to pay for things.

At the same time they are targeting CEO pay as excessive, which, if successful, means lower collections on HI taxes.

Does anyone in Washington understand how business works?
 
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