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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 06:59 PM
Original message
The American Health Choices Act (everything you wanted to know)

The American Health Choices Act

Sen. Edward Kennedy (D-MA), the chairman of the Health, Education, Labor, and Pensions Committee, is circulating draft legislation designed to overhaul the nation's health care system. This so-called "draft of a draft" is the first piece of concrete health reform legislation to emerge from Democrats in Congress. As the Washington Post notes, "(A)t least five congressional chairmen are working on health-care reform bills," and Kennedy's draft represents the Democrats' first attempt at "a partial road map for how the nation might address health coverage gaps and problems such as rising costs and inferior quality." The legislation, called the "American Health Choices Act," would provide affordable coverage to all Americans, require businesses to provide and individuals to obtain coverage, and establish a new public health care plan to compete alongside private insurers.

EVERYBODY IN, NOBODY OUT: Kennedy's bill aims to improve access to coverage by regulating insurers, expanding Medicaid and the State Children's Health Insurance Program (SCHIP), and building state-sponsored insurance Gateways (or exchanges) to help Americans find affordable coverage. Americans who like the insurance they have can keep it, but those who are dissatisfied with the porous policies of the individual market -- and those who are uninsured -- would be able to purchase affordable and adequate coverage. Under the legislation, "a group or individual health insurance plan may not impose preexisting condition exclusions." In fact, "rates cannot vary by health status, gender, class of business, or claims experience." Insurers must accept every employer and individual that applies" for coverage and must also renew their policies. The bill eliminates lifetime or annual limits on benefits and limits the cost sharing for certain preventive services and immunizations. Individuals and employers would be required to purchase insurance, but families earning up to 500 percent of the federal poverty line (FPL) -- $110,000 for a family of four -- could "buy insurance on a sliding scale with government subsidies." Anyone with incomes up to 150 percent of the FPL -- $33,000 for a family of four -- would also be eligible for Medicaid, and people up to age 26 would be able to participate in SCHIP. The new state-based insurance Gateways -- where individuals and small employers could compare plans side by side, find options with a minimum benefits package, and buy coverage -- would help applicants find and enroll in comprehensive and portable coverage and certify qualified health plans to ensure they "provide a level of standard benefits."

A MUSCULAR PUBLIC OPTION: The new public health plan would provide all Americans under 65 the choice of public coverage, restore competition into the consolidated health insurance market, lower health care premiums across the board, lead the way in innovation, and improve health quality. As CAPAF Senior Fellow Peter Harbage and Director of Health Policy Karen Davenport argue in a recent report about the public plan, "In the face of tremendous consolidation in the health insurance market, employers and individuals have a shrinking set of health insurance options. Private insurers have used this market power to boost their profits." Harbage and Davenport add, "By including a public health insurance plan as another insurance option and creating a health insurance exchange that delivers transparency and accountability to the market, we can assure both viable competitors and real competition." A new public plan has the potential "to drive improvements in the health care system" and set the standard for developing new payment models and investing in preventive care and care coordination. Critics of the public option, including the insurance industry and most Republicans, argue that a public plan could not compete fairly with private insurers because its lower reimbursement rates would "crowd out" private coverage and spell death for the private insurance industry. But as health care economist Uwe Reinhardt explains, "If the new public plan had to negotiate its own prices, then it would not have a competitive advantage any more 'unfair' than is the ability of large insurers -- such as Aetna and Wellpoint -- to negotiate lower prices with hospitals and physicians than these providers charge smaller insurers. For some reason, no one has ever called this form of price discrimination 'unfair.'" Under Kennedy's bill, the new public option would reimburse providers 10 percent above current Medicare rates. It would not have to negotiate its own rates, but could piggyback off of Medicare's considerable reach. Using "Medicare plus 10" rates, rather than the prevailing market rates, would lower costs and allow the plan to charge lower premium rates.

'HEALTH CARE REFORM BY OCTOBER': President Obama "is preparing an intense push for legislation that will include speeches, town-hall-style meetings and much deeper engagement with lawmakers," the New York Times reports. In Saturday's radio address, Obama argued that "fixing what's wrong with our health care system is no longer a luxury we hope to achieve -- it's a necessity we cannot postpone any longer. ... Today, at this historic juncture, even old adversaries are united around the same goal: quality, affordable health care for all Americans." The radio address kicked off a "50-state grass-roots effort that Organizing for America, the president's political group, began Saturday to promote a health care overhaul." The push also follows Obama's letter to Kennedy and Senate Finance Committee chairman Max Baucus (D-MT), in which he reiterated his support for the public health plan and committed to "fully offset the cost of health care reform by reducing Medicare and Medicaid spending by another $200 to $300 billion over the next 10 years" and "by enacting appropriate proposals to generate additional revenues." The Washington Post's Ezra Klein, who obtained a timeline of Congress's legislative schedule for passing health reform, reports that the Senate -- which is expecting a separate bill from the Senate Finance Committee on June 17 -- will vote on a single health bill during the last two weeks of July, and the House is expected to move a bill to the floor in "the last week of July." "The overarching goal is to get health care reform to the president's desk by Oct. 1," Klein writes.


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HopeOverFear Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 07:21 PM
Response to Original message
1. k and r
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Thrill Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 07:24 PM
Response to Original message
2. This sounds so good. Hopefully the conservative Dems leave it alone
Edited on Mon Jun-08-09 07:27 PM by Thrill
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mecherosegarden Donating Member (434 posts) Send PM | Profile | Ignore Mon Jun-08-09 07:27 PM
Response to Original message
3. Can someone clarify for me, please
If I am covered under my husband's insurance, do I still have to buy insurance? If I don't, will I be penalized?
If I am a contractor, how does that work?
Any link where I should go to read and get more information?

Thanks!
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DrToast Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 07:34 PM
Response to Reply #3
5. If you're covered under another plan, you won't have buy insurance
Edited on Mon Jun-08-09 07:36 PM by DrToast
If you're a contractor you'd have to buy insurance. There are subsidies for those who don't make enough money to buy insurance.
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mecherosegarden Donating Member (434 posts) Send PM | Profile | Ignore Mon Jun-08-09 07:45 PM
Response to Reply #5
6. Thanks! N/T
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DrToast Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 07:34 PM
Response to Original message
4. Nice summary...One thing I expect we'll have to give up
I think the Medicare + 10% rate won't end up sticking, which is okay. I actually have no problem with the public plan negotiating rates.
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avaistheone1 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 07:47 PM
Response to Original message
7. I don't understand the income eligibility requirements of the Kennedy program.
Edited on Mon Jun-08-09 07:47 PM by avaistheone1
Can someone explain it?
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DrToast Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:23 PM
Response to Reply #7
14. The sliding scale subsidies?
Edited on Mon Jun-08-09 08:23 PM by DrToast
If you're at or below the poverty level, you'll get a certain amount of money to buy insurance.

If you earn twice the level of poverty you'll get less than the guy in poverty, but you'll still get a subsidy.

And so on until you're at 5 times the poverty level.
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avaistheone1 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:39 PM
Response to Reply #14
21. Talking dollars and sense
What is currently the poverty level?
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DrToast Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:43 PM
Response to Reply #21
22. Federal poverty levels
It depends on how many people are in the family: http://aspe.hhs.gov/poverty/09poverty.shtml
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inna Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 12:32 AM
Response to Reply #14
27. in other words, more subsidies to the insurance industry; fucking awesome. (not)

:hugely disappointed:
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inna Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 12:37 AM
Response to Reply #27
28. actually, "insurance industry" is a total oxymoron.

sorry guys, it's not an "industry".


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Baby Snooks Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 01:25 AM
Response to Reply #14
29. So how much will the insurance cost?
Telling someone they will get a subsidy without telling them how much they will still have to pay is like, well, telling people that deregulation will lower their utility bills. Remember that one?

The only reform that will reform our health care system is one which creates one health care system managed by the government. Period.

As for this plan, talk to people in Massachusetts. It is a disaster.

Kennedy finally has something in common with the Clintons. He believes the health insurance industry should be the priority. And of course the priority of the health insurance industry is profit.

Medicare/Medicaid is not perfect. But it is much better than what we have. And much better than this. It should simply be used as the foundation to expand upon and provide care for everyone.

And this 10% more than Medicare is curious. A doctor will be able to bill 10% more for someone who is 64 than for someone who is 65?

Let's see some actual figures with regard to what it will cost - some actual tables showing what it will cost for different income levels.

We have heard the "trust us, this will lower the cost" once before with energy deregulation and most of us have seen how it did not lower the cost at all every summer and every winter.

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Sebastian Doyle Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 07:47 PM
Response to Original message
8. Mandatory corporatist healthcare is NOT an acceptable solution to anything.
Teddy, this sucks. I know you haven't had the best year, but I expected better from you than fucking RomneyCare III.
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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 07:49 PM
Response to Reply #8
9. "The new public health plan would provide all Americans under 65 the choice of public coverage"
When your said mandatory, were you refering to choice?

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Sebastian Doyle Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:07 PM
Response to Reply #9
10. It sounds like the so called "public option" is still controlled by the corporations
Which means the motive is still what's profitable. It's a RomneyHillaryCare rehash, and it's not good enough.

Because once everyone is forced into corporate coverage, they can claim "problem solved", and we'll never have a REAL reform to this fucked up system.

HR 676 is where we should be. The public option, as Howard Dean has described it in his plan, is the minimum of what can be considered acceptable.

Anything else is just more corporatist horseshit, and it WILL be the deal breaker for millions of Americans as far as the future of the Democratic party is concerned.
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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:11 PM
Response to Reply #10
11. That's the biggest bunch of nonsense I've ever read.
You sound like someone who just wants to complain.


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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Mon Jun-08-09 08:30 PM
Response to Reply #11
15. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
Name removed Donating Member (0 posts) Send PM | Profile | Ignore Mon Jun-08-09 08:36 PM
Response to Reply #15
18. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
DrToast Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:17 PM
Response to Reply #10
13. This IS what Howard Dean was talking about.
Good job.
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Sebastian Doyle Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:31 PM
Response to Reply #13
16. Not by a long shot.
Howard Dean is talking about a public option that competes with the corporations. NOT subsidizing the greedy bastards.
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DrToast Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:34 PM
Response to Reply #16
17. What the hell do you think this is?
Edited on Mon Jun-08-09 08:40 PM by DrToast
Did you even bother reading the article? Or did you just reflexively bitch?

Here. Let's go to the source:


CHOICE

Americans deserve the right to choose their own healthcare. Congress must act to give Americans more choices for their personal healthcare by allowing universal availability of a public healthcare option like Medicare. Limiting choice to for-profit insurance only, is the same broken healthcare system we have right now.


http://standwithdrdean.com/faq

Now from Kennedy's plan:


A MUSCULAR PUBLIC OPTION: The new public health plan would provide all Americans under 65 the choice of public coverage, restore competition into the consolidated health insurance market, lower health care premiums across the board, lead the way in innovation, and improve health quality.


Still confused?
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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:37 PM
Response to Reply #17
19. The know nothing, know-it-alls.
Good grief.

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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:39 PM
Response to Reply #16
20. Clue:
The subsidies are for people (qualified by income) who want to remain with the insurance companies. Everyone has the option to choose the public plan.

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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 09:35 PM
Response to Reply #20
34. And what if we don't want to pay subsidies for corporate crap for other people?
Given that 70% of the people in medical bankruptcy thought they were insured, how do they know they won't wind up there themselves?
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andym Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:15 PM
Response to Original message
12. This sounds very good.
The devil will be in the details and how much gets diluted.
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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 09:35 PM
Response to Reply #12
23. Yes, it does. n/t
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SpartanDem Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 11:13 PM
Response to Original message
24. K&R
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rhett o rick Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 11:40 PM
Response to Original message
25. R & K
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donco Donating Member (717 posts) Send PM | Profile | Ignore Mon Jun-08-09 11:51 PM
Response to Original message
26. Maybe Im wrong but isnt
the current Medicare advantage plans (private insurance, that people on Medicare can choose once a year in certain areas) dont they receive your Medicare + 10% in exchange for your coverage? Some of them in this area cover prescription drugs, dental and glasses (very limited) plus a gym membership. Coventry Advantra if anyone wants to look it up.

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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 01:46 AM
Response to Original message
30. "Affordable coverage" my ass
"Affordable coverage" = absolutely worthless bullshit that empties your pocket to the tune of thousands of dollars before they pay a single bill.
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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 04:45 PM
Response to Reply #30
31. Your ass?
You'll choose the public option, will you not?

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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 09:33 PM
Response to Reply #31
33. Not f they don't fund it and treat it like a garbage dump for sick people n/t
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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 10:37 PM
Response to Reply #30
40. I notice all the synopsis talks about is "access to coverage"
I want access to health care.
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asteroid2003QQ47 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 11:51 PM
Response to Reply #30
43. and it only took 64 years you ingrate!
Rome wasn't built overnight, given another 64 years . . .
----------------------------------------------------------------------------

The time has arrived to help millions of Americans living without a full measure of opportunity to achieve and enjoy good health . . .
and protection . . . against the economic effects of sickness.
--Harry S. Truman, September 19, 1945
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annabanana Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 04:48 PM
Response to Original message
32. Would Health care providers be able to refuse to "take" the
public option.. the way they can with private insurers?
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Honeycombe8 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 09:42 PM
Response to Reply #32
36. I would think so. That's the way it is with Medicare. nt
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Honeycombe8 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 09:41 PM
Response to Original message
35. I don't understand! Is this the same thing as the DODD plan that was just posted about?
The Dodd plan doesn't sound good. It focused on "reducing costs" (codespeak for computerizing all of our medical histories...which is what Bush adn the ins. cos. have been pushing for years...you DO want any prospective employer reviewing your past treatment for the clap or a vaginal infection, don't you?) It also focused on a public option "on a level field" with private insurers (codespeak for not cheaper, so not competitive?). It didn't sound like a true public option. It sounded more like a fallback for those who can't get insurance any other way.

Oh, and it also focuses on preventive...meaning you have to have a physical so they can chart your initial health and get it into that computerized system.

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SpartanDem Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 09:51 PM
Response to Reply #35
37. It was an incomplete draft
Edited on Tue Jun-09-09 09:52 PM by SpartanDem
The Health, Education, Labor, and Pensions Committee released an early version (PDF) of their health reform legislation today, which, as I noted before, is silent on the crucial questions of the employer mandate and a public health insurance option.

All that, though, will be settled in the coming days and, by the end of the week or early next week the finalized version of the proposal will be released, public option and all. The committee released today's language in order to meet a deadline: next Tuesday, the legislation will be marked up and today's announcement fulfills a commitment to release the language a week in advance.

But early reports and leaks indicate that it will include robust language, and all indications suggest that the HELP bill will propose broader reform than the Finance Committee's bill, expected to be unveiled in the next couple weeks. And it's worth pointing out that by releasing the most progressive language later rather than sooner, liberals and reformers won't have to spend the next week fending off attacks on the bill in advance of the mark-up

http://tpmdc.talkingpointsmemo.com/2009/06/key-health-r...
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JimWis Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 10:12 PM
Response to Original message
38. I just got off the online chat with Howard Dean an hour ago.
Edited on Tue Jun-09-09 10:14 PM by JimWis
It was a question/answer chat. He said the Dodd/Kennedy bill was still a work in progress. Apparently they will post the transcript of the chat on his web site tomorrow morning some time. They didn't specify a time. Here is the link if anyone is interested.


http://www.standwithdrdean.com/livechat

Edit - I just checked - it is on there already. You might find it interesting.
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mvd Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 10:20 PM
Response to Reply #38
39. Thanks!
The Kennedy bill isn't perfect, but it would be a TRUE compromise - and a bill that Obama would enthusiastically sign.
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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 10:43 PM
Response to Reply #39
41. You don't start bargaining with what you're willing to settle for
you start by asking for more than you know you can get. By the time Congress is done with this and it goes to the floor for a vote it will be even worse than it is now. But I'm sure it will be signed enthusiastically as long as the insurance companies and campaign bribes are still protected and the public can be told we have "reform" so we can STFU about the insurance company crooks.


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mvd Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 11:05 PM
Response to Reply #41
42. I agree, actually
I want single payer. I don't think the insurance companies should be anywhere near needed care. But I know there are obstacles. Anything less than the Kennedy bill, though, and I urge Obama to veto and have Congress start over. We need him to stand for a strong public plan.
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