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.

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