House Democrats unveil healthcare bill
The proposal includes a divisive government insurance option, among other reforms.
By Noam N. Levey
9:34 PM PDT, June 19, 2009
Reporting from
Washington --
Senior House Democrats on Friday introduced their plan for reshaping
the nation's healthcare system, calling for a new government insurance
option, a new mandate on employers to provide coverage and a new
guarantee of subsidized healthcare for the poor.
The
draft
-- the fullest presentation so far of congressional liberals' vision
for overhauling medical care -- offered few indications of how such a
plan would be financed. The price tag is expected to top $1 trillion.
The bill's authors said they would detail their plan to cover the costs in coming weeks.
"We're going to pay for this bill," said House Energy and Commerce Committee Chairman Henry A. Waxman (D-Beverly Hills).
Options under consideration include cuts in Medicare and Medicaid
as well as new taxes -- including the possibility of taxing some
employees for job-based insurance.
The blueprint drew swift praise from President Obama. "This
proposal would improve the affordability, availability and quality of
healthcare and represents a major step toward . . . our goal of fixing
what is broken about healthcare while building on what works," he said
in a statement.
But representatives of the insurance industry immediately attacked the
proposal to offer a government medical plan that consumers could choose
as an alternative to private coverage.
The industry says any such government option would have advantages that private companies could not compete with.
"While the discussion draft addresses many of the critical steps
needed to transform our healthcare system, these important reforms are
overshadowed by the proposed creation of a government-run health plan
that would jeopardize the coverage of the 160 million people who
receive their benefits through their employers today," said Scott P.
Serota, president of the Blue Cross and Blue Shield Assn.
On the other side of the Capitol, some senior Senate Democrats had
already begun backing away from the so-called government option, seeing
it as an obstacle in terms of cost and building bipartisan support.
When Sens. Edward M. Kennedy (D-Mass.) and Christopher J. Dodd
(D-Conn.) recently introduced their version of healthcare reform, they
did not include the government-option provision.
Under the House bill unveiled Friday, the government's insurance
program would offer consumers a benefit package including preventive
health services, mental health services, dental and vision care for
children and annual caps on the amount of money subscribers would have
to pay.
"Choice is the key," Waxman said. "Choice is the key for consumers
to pick which plan they want, whether it's a private insurance plan or
a public insurance plan."
The bill envisions that Americans earning up to 400% of the federal
poverty level -- or $88,000 for a family of four -- could qualify for
credits to help them buy insurance. It would also provide new federal
dollars to open up the Medicaid program to Americans earning up to 133%
of the federal poverty level and raise reimbursement levels for doctors
and hospitals participating in the program. Currently, Medicaid, which
is administered by state governments, is often limited to poor families
and, in some states, pays providers so little that many refuse to give
care.
Nearly all Americans would be required to get insurance.
For doctors, the House lawmakers pledged an end to the annual
threat of dramatic cuts in Medicare reimbursement rates. And for
seniors, the bill would close the so-called doughnut hole in Medicare
Part D drug benefits that socks many with high bills for prescription
medications.
But the proposal for a new public insurance program, which Waxman
said could initially pay Medicare rates, will almost certainly generate
opposition from physician groups. Drug makers, whom Waxman and other
Democrats accused of reaping windfalls from the government's drug
purchasing, may become another obstacle.
And business leaders are already fighting proposals being
discussed in the Senate to mandate that employers provide coverage or
pay a fee to the government. The draft House legislation puts that fee
at 8% of payroll, though senior Democrats said that could change as the
legislation is debated.
In the Senate, Democrats spent much of last week trying to hold
together the consensus behind the healthcare push. Outside Washington,
the political battle is also intensifying, as liberal political groups
step up their efforts to pressure congressional Democrats not to back
away from plans to create a new government insurance program.
The grass-roots powerhouse
MoveOn.org began airing a radio ad
targeting Sen. Mary L. Landrieu of Louisiana, a moderate Democrat who
has expressed reservations about a new so-called public plan.
And Health Care for America Now, which has been helping lead the charge for a public plan, began airing a
television ad in 10 states that casts the proposal as a way to give consumers more choice in selecting health insurance.
Critics of a government insurance program say it could drive private
insurers out of business, leaving consumers with less choice.
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