Wednesday, September 9, 2009

It's Close To Time For Another Flowchart

Update: Here's the new and improved health reform flowchart!

Dana Goldstein reuses The Flowchart to make a point about how small the Public Option is under current CBO estimates. In addition, she observes that Baucuscare is going to be quite tough on those in the range between 300% and 400% of the poverty line.

We need to be a little careful here. Baucuscare is going to be tough on those in that income bracket who are currently uninsured, or roughly four million Americans (see page 6). Another 4.5 million earn above four times the poverty line but still don't have insurance. So of the 15 million or so high-income earners who don't have employer-based insurance, 7 million--just under half--already have insurance (Note: these numbers are corrections of a previous version). In addition, most households that earn that much already enjoy employer-based insurance. Overall, of those earning more than 300% of the Federal Poverty Level, almost 90 percent are already insured. The overwhelming of majority middle-class and upper-middle-class households already have health insurance, even if they buy it on the private market. Most people in this income bracket will feel health reform either through the end of rescission, the enactment of guaranteed issue, or not at all. The dominant feature of the current health care debate is that Barack Obama's has promised "if you like your insurance, you can keep it", and so for those with good coverage--which most middle-to-upper-middle-class households have--health reform barely touches them.

Meanwhile, 38.5 million of the 47 million uninsured earn less than 300% 0f the poverty line. Five out of ever six new Medicaid benificiaries are currently uninsured. For those who earn to much to be on medicaid, but not enough to pay for insurance on their own, three-fourths such of those in the new individual insurance market are currently uninsured. As I've said before, the real action is for those somewhere between 200 and 300 percent of the poverty line, who are probably getting somewhat less help than they need. But plenty of middle-class families decide to send their kids to private schools--not Exeter, mind you, but modestly priced private schools--so purchasing health insurance is feasible for these households, if not necessarily the most pleasant experience in the world.

I'll try to express some of this in visual form, but I have a day job, and probably swine flu, so it may take a while.

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