The Finance Committee’s Work in Progress

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The Washington Post’s Ezra Klein has gotten hold of an outline of the health care reform bill that the Senate Finance Committee is working on. It gives a clue to their direction, although it is certain to change–perhaps substantially–between now and the time the committee begins formally drafting the bill after the July Fourth recess. Here’s what Ezra thinks of it:

You could write this story a couple of different ways. The first is to note is the Finance Committee has substantially retreated in the face of the $1.6 trillion price tag the Congressional Budget Office affixed to its original submission. This version of the plan is, comparatively, quite diminished.

The numbers tell the story. In that plan, subsidies [KT NOTE: for helping the uninsured purchase health coverage] reached [those earning up to] 400 percent of poverty. In this plan, they’ve been cut to 300 percent. In that plan, Medicaid eligibility was as high as 150 percent of the poverty line. In this plan, it’s 133 percent for pregnant women and children, and 100 percent for childless adults. In that plan, the “gold” coverage was 93 percent of a person’s estimated expenses, and “bronze” coverage was 68 percent. In this plan, those numbers are 90 percent and 65 percent, respectively. That means people with a low-cost plan might be covered for only 65 percent of what they’re likely to need.

Another way of looking at the plan is that it remains a significant step forward. Subsidies to 400 percent of poverty would be nice, but subsidies to 300 percent of poverty are far beyond anything we offer now. Coverage that protects against 65 percent of anticipated costs is better than no coverage at all. The co-op idea isn’t a public plan, but with federal seed money to start new co-ops, it’s a good idea on its own merits. There’s an individual mandate, state-based health insurance exchanges, and a substantial health and wellness initiative. Insurers are barred from discriminating based on health history and Medicaid is sharply expanded.