After a year of watching Congress wrangle, deal, twist and tussle over comprehensive health care reform, the Obama Administration finally released its own blueprint today. The release comes three days before a bipartisan summit on the issue that the White House is hoping will be a game changer.
The White House “plan” contains many of the same elements included in the House and Senate bills already passed by Congressional Democrats, but makes adjustments and adds provisions that were on the table when House and Senate Democrats were merging their bills shortly before Scott Brown was elected in Massachusetts.
Details on the plan are after the jump, but in essence, the Obama plan is the Senate bill with some changes that the Administration says can all be passed via reconciliation. Getting reform done would require the House to pass the Senate bill and both chambers to pass a reconciliation bill loaded with fixes, like those contained in the White House plan. The Obama plan would cost $950 billion over ten years and provide new insurance coverage for 31 million Americans.
Democrats are still miles from the finish line. House Democrats are not eager to pass the Senate bill and Republicans have promised to obstruct a reconciliation bill in the Senate. Asked on a conference call with reporters if the House and Senate leadership have signed off on the Obama plan, White House communications director Dan Pfeiffer said the plan was “informed by our discussions with House and Senate leadership…but this is the President’s proposal.” The thing is, the President can’t make laws by himself.
President Obama is hoping that by laying out a compromise health care plan that largely resembles the House and Senate bills, Congressional Democrats will be able to join together to embrace it. By releasing this plan today, three days before the health care summit, the White House is trying to frame the debate until then. The plan, just posted online here, is written in plain language.
Here are some highlights from the White House health care plan:
* New federal insurance regulation The plan includes a new federal health insurance regulatory board that will review rate increases and block those it deems unjustified. (The Obama Administration is hoping to capitalize on the recent attention on exorbitant and unpredictable increases, like those from Anthem Blue Cross hikes in California.) State insurance commissioners have the power to do this in most places, but a new federal authority could strengthen rate regulation.
* Medicaid help for states The plan would eliminate the notorious and despised Cornhusker Kickback, a special Medicaid deal awarded to Nebraska under the original Senate bill. Instead, the Obama Administration’s health care plan would increase Medicaid funding for all states. The plan would also give extra funding to states that have already expanded their Medicaid programs, even without federal prompting. This could do a lot to appease governors who have been loudly protesting the Medicaid expansion called for under Democratic reform, saying the state-federal program will eventually break their budgets.
* Weakens the Cadillac tax The plan delays the implementation of the excise tax on “Cadillac” health plans until 2018 and raises the threshold for which plans would get taxed. Beginning in 2018, individual plans with premiums above $10,200 and families plans above $27,500 would be subject to the tax. There are adjustments made for companies where costs are higher because of age and gender of workers and there is an adjustment made for workers in high-risk occupations.
* Closes the doughnut hole The plan would close the Medicare drug benefit “doughnut hole” completely by 2020. This would be paid for by an addition $10 billion in fees from drug companies.
* Increases affordability The plan increases subsidies for middle-income Americans buying their own health insurance on the open market beyond what the Senate bill called for.
* Imposes higher fees on individuals and employers who go without insurance The plan would strengthen the individual mandate by adopting the House’s higher penalties for those who opt not to buy insurance. There are still hardship exemptions and exemptions for those with income below the tax filing threshold. The fee on employers who don’t offer coverage would be $2,000 per worker, with firms with 50 or fewer employees exempted from this requirement. There is also a $40 billion infusion of tax credits available to small businesses to help them offer coverage beginning in 2010.
* National exchange, no public option and Senate abortion language The Obama plan does not mention any of these sticking points, meaning it favors the Senate exchange design (state-based exchanges rather than the House’s national exchange), the Senate’s abortion language (not the House’s Stupak language) and the Senate’s lack of a public option.
More details throughout the day as I have more time to read the White House plan.