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I understand about corporate corruption/welfare and that this bill may do little or nothing to prevent it, but I don't see how providing health care to millions that don't currently have it is all bad for the poor and middle class.

I've always supported a public option (actually it should be the only one) but, for example, last year my brother's family lost its last means of support when my sister-in-law was let go after 30 years on the job. The family lost its health insurance and now can't afford private insurance. My brother has a serious heart condition and is four years away from becoming eligible for medicare. How long can he or millions like him wait for the perfect liberal solution. People are dying as more and more lose health care.

I can swear there ain't no heaven but I pray there ain't no hell. _ Blood Sweat & Tears

by Gringo (stargazing camel at aoldotcom) on Thu Mar 18th, 2010 at 01:01:38 AM EST
[ Parent ]
Splendid!

I know that I can count on you to relay to ET the relief provided to your brother and his family by this new law, this year.  

I know that I will relay the relief provided to my family by this new law, this year. I am uninsured, too! I could no longer afford to carry BC/BS. I am ineligible for Medicaid coverage. I live with an incurable, degenerative disease! Our HH gross income is 143% of federal poverty level. That income exceeds the Baucus bill limit of 135% FPL on eligibility for Medicaid enrollment. I hope, MD adopts the new means guidelines, this year, for calculating eligibility on adjusted gross income. But my child is currently covered by SCHIP, subject to $2,100 annual deductible. I look forward to refundable tax credit(s) our government will send us to recover that expense and purchase an Essential Benefits Plan for myself four years from now. I would like a free physical exam.

Perhaps Izzy will relay the relief provided to her family by this new law, this year. And if you are a US citizen and Medicare beneficiary living somewhere in the states or US territories, I know that I would appreciate your reports on how this new law effects your medical insurance benefits.

That would be a comfort.

Diversity is the key to economic and political evolution.

by Cat on Thu Mar 18th, 2010 at 01:17:26 PM EST
[ Parent ]
Thank you for these comments.  I previously read Izzy's excellent diary on the bill and hope that both you and her will receive relief from this legislation. I realize it is only a beginning and we must not allow this bill to become the end all for health care in the US.  Much of what fairleft writes above is true.  This legislation is far from perfect, but a defeat of this effort will embolden opponents and discourage reform efforts for decades.

In case someone thinks I have a lot to gain by this personally, I would point out that I currently consider myself an insured fat cat, by luck, having more insurance than I can use.  But I am not blind to the suffering that goes on in the name of corporate profits and have seen the greed induced decay in the health care system (top to bottom) over the years.

   

I can swear there ain't no heaven but I pray there ain't no hell. _ Blood Sweat & Tears

by Gringo (stargazing camel at aoldotcom) on Thu Mar 18th, 2010 at 02:07:10 PM EST
[ Parent ]
If you ever followed NYCeve at the GOS, you know she invented the insurance FAIL pissing contest that many ET readers are familiar with. But that's not the reason I'm inviting myself to report exactly when and what kind of unexpected relief I obtain after passage of this bill, this year. Is it?

I promise to report, because I think interested ET readers might benefit from proof of popular support for Baucus bill passage --which would lock-in budget for specified provisions for the next decade. Because I am quite concerned with exactly what those specified provisions are more so than I am with so-called perfection proceeding from insurance FAIL in 2020.

I can tell you right now, for certain, given our HH income, this bill will not change my child's coverage options this year. It will not change my coverage options this year unless the MD assembly also votes in advance, this year, of federal remedy four years hence on modified income testing AND our HH income does not increase. For Medicaid eligibility currently entails no pre-existing condition exclusion.

I can tell you, it's a good thing that Baucus bill modifies Medicaid determination; doing so immediately formalizes a payment system on which uninsured indigent and working poor HH currently depend to assure emergency medical treatment at hospitals and clinics. That assurance takes uncertainty and arbitrages out of the provider payment system, regardless of patient insurance coverage. That is all.

If I secure employment tomorrow, the only option available to me will be enrolling in my employer's group plan. I will not receive a subsidy to pay a premium equivalent to the community-rated plan I had to drop last year because I could no longer afford $350/mo and also pay for HH heating.

defeat of this effort will embolden opponents and discourage reform efforts for decades

Precisely. "Opponents" to insurance regulation are not the tea baggers on Fox News. They are the representatives in Congress. Many of them will still be seated long after Mr Obama retires to Maui. They will be in the Capitol to ensure legislation enacted in this bill, this year, is not corrected. This is what something-not-nothing advocates fail to grasp today: the provisions which do indeed remediate insurance business practices and those that do not remediate insurance business practices. Those provisions that do not remediate in fact affirm discriminatory insurance practices.

They cannot imagine themselve a decade from today ineligible for Medicaid coverage and paying for maintenance of effort (that increases maybe 5% instead of 18% each year) yet personally liable for accumulating medical debts proscribed by a cost-sharing ratio defined in their "exchange-qualified" policy. Why will this be so?

The "reform" provides no mechanisms --except Medicaid and Medicare administrative "improvements"-- to capitate directly or indirectly customary fees paid by "exchange-qualified" health insurance plans. "Exchange-qualified" assignment is nothing but a government sop for insurers who are still permitted to rate payers by pre-existing conditions.

I appreciate representatives like Kucinich and Kaptur playing hard ball with the senate since Dec. Someone has to comb the nits out of "exchange-qualified" plan designs. I hope your brother does, too.


Diversity is the key to economic and political evolution.

by Cat on Thu Mar 18th, 2010 at 06:58:03 PM EST
[ Parent ]
First of all, look at the overall bill and what is likely to happen and not just one of its provisions right now, the mandate that we buy health insurance but with subsidies for the poor. Even now the mandate subsidies greatly decrease going forward, because they aren't pro-rated with the inflation of premiums. But also, I expect in the current extreme anti-deficit environment that health care subsidies will be cut back even further. End result will likely be mandated but very crappy health insurance with minimal subsidies. So, the bill becomes in the end a huge tax increase on some of the poorer members of our society.

Generally, the worst thing about the bill is that it does nothing regarding cost controls (which is exactly what one would expect of a bill largely written by the private health care industry). So costs, already outrageous, will continue to rise, while already disfunctional and costly service provision will only get worse (because worse means more profitable).

fairleft

by fairleft (fairleftatyahoodotcom) on Thu Mar 18th, 2010 at 04:12:44 PM EST
[ Parent ]
I can't disagree with what you've written.  The ultimate question is: as a result of this bill will a new health care consumer environment be created that increases the likelihood of further legislative progress, or will we allow ourselves to become further indentured to corporate greed and power.

I can swear there ain't no heaven but I pray there ain't no hell. _ Blood Sweat & Tears
by Gringo (stargazing camel at aoldotcom) on Fri Mar 19th, 2010 at 12:56:39 AM EST
[ Parent ]
The bill will make no difference, but it does help Obama out politically, a little, in the short term. That's what all the fuss and push is about.

A mass populist movement for health care that doesn't serve primarily corporate profit will either come into existence or it won't. Health care costs and quality will get steadily worse for most over the next five to ten years, because that is what the profit motive and 'the market' demand. Whether that pushes people 'over the edge' or not, who knows.

fairleft

by fairleft (fairleftatyahoodotcom) on Fri Mar 19th, 2010 at 11:01:18 AM EST
[ Parent ]

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