The Center for Budget and Policy Priorities has put out a great wishlist for the final health care bill. At the top of their list is the fact that the insurance premium subsidies don't really make insurance affordable. I took the data they produced and put it in chart form, along with the premium payments under Commonwealth Care in Massachusetts. Note that in Massachusetts, there is no subsidy for households earning more than 300% of FPL; they're buying well-regulated insurance on the private market.
As you can see, the Senate HELP bill is within shouting distance of Commonwealth Care; in fact, it addresses the largest problem with the Massachusetts plan, which is the difficulty faced by households too well-off to qualify for subsidies, but not well-off enough to afford the full price of insurance. If it were to pass, its combination of new revenue and spending cuts would leave people paying premiums they could live with. A family of three earning $45,000 who pays $200 per month for insurance will feel like they're getting value for their payments; wellness checkups for their children will be covered, and they have peace of mind that they won't go bankrupt if they get sick (though they may end up paying off a four-figure deductible for a while). But the same family paying $360/month for crappier insurance, as dictated by the Finance bill, will be much less happy. The bill that emerged from the Energy and Commerce Committee is a middle ground, but it's much closer to the Finance bill. The House bill coming from the other two committees—Ways & Means and Ed-Labor— is much closer to the product that HELP produced.
Hey Nick - I read the cbpp report and am a bit confused...they discuss how the finance bill indexes premiums to the percent you actual pay for the first year, i.e. with premium based on % of income for Y1, you get a subsidy and end up paying $2,000 for a $10,000 policy. As a result, you end up paying 20%. From now on, you pay 20% of the premium costs, regardless of income or cost of premium. CBPP says that this is the same thing in the House bill. While I've been able to find the language in Finance, I can't find it for my life in the House version. I just don't understand this provision, other than the fact that it keeps subsidies down and the CBO score low. What gives? Can you explain in more detail?
One thing to keep in mind here is that Massachusetts (especially the Boston area which accounts for a large part of the population) is a rather high cost of living state. So making $25K in greater Boston isn't the same thing as making $25K in most other parts of the country.
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