Democrats Agree Tentatively Trade Opt-Out For Trigger, Medicare Buy In, And More (TPM UPDATE)

[jefferson_dem]

Democrats Agree Tentatively Trade Opt-Out For Trigger, Medicare Buy In, And More
Brian Beutler | December 8, 2009, 10:19PM

An aide briefed on the negotiations among the gang of 10 offers up the rundown of the most important aspects of the public option compromise being sent to CBO.

If this trade-off carries the day, the opt out public is gone.

In its place will be many of the alternatives we've been hearing about, including a Medicare expansion and a triggered, federally-based public option.

As has been widely reported, one of the trade-offs will be to extend a version of the Federal Employees Health Benefits Plan to consumers in the exchanges. Insurance companies will have the option of creating nationally-based non-profit insurance plans that would offered on the exchanges in every state. However if insurance companies don't step up to the plate to offer such plans, that will trigger a national public option.

Beyond that, the group agreed--contingent upon CBO analysis--to a Medicare buy in. That buy-in option would be available to uninsured people aged 55-64 in 2011--before the exchanges open. For the period between 2011 and 2014, when the exchanges do open, the Medicare option will not be subsidized (and so will likely be quite expensive). However, after the exchanges launch, the Medicare option would be on the exchanges, where people could pay into it with the exchanges.

It looks as if liberals lost out on a Medicaid expansion that would have opened the program up to everybody under 150 percent of the poverty line. That ceiling will likely remain at 133 percent, as is called for in the current bill.

In addition to the new insurance options, the group has tentatively agreed to new, and strengthened insurance regulations, which the aide could not divulge at this time. Now it's a question of what the CBO says, and then, will Joe Lieberman object to the trigger. He's said he'd object to anything like it in the past.

http://tpmdc.talkingpointsmemo.com/2009/12/democrats-trade-opt-out-for-trigger-medicare-buy-in-and-more.php

[Phoebe Loosinhouse]

1. What happens to people between 2010 and 2011?

They just die untreated?

Medicare exists already and was up and running initially within 6 months. What would cause the delay for any buy in?

[kelly1mm]

8. No silly, they can buy-in for $800+ per month per person if 55+! Yeah! nt

[neshanic still]

10. They key is here maybe. The insurance companies have this figured out....

"For the period between 2011 and 2014, when the exchanges do open, the Medicare option will not be subsidized (and so will likely be quite expensive). However, after the exchanges launch, the Medicare option would be on the exchanges, where people could pay into it with the exchanges."

[Phoebe Loosinhouse]

22. Where did that figure come from? $1600 a MONTH for a couple over 55$!

19K a year is an affordable option for those without coverage? In whose world?

Please tell me where that figure came from.

[kelly1mm]

26. It came from extrapolating a few facts

1) the buy in is supposed to be unsubsidized at least till 2013
2) the "cost" per beneficiary right now for each medicare participant to the government is about $650 per person per month (not including the 100-300 in fees to the participant)
3) while 55-64's are younger and thus should have less medical problems, the restriction to those without coverage for several years coupled with (maybe) a pre existing condition requirement bump the numbers back up.

The key is that it is unsubsidized at least till 2013. A link to that is here:


http://tpmdc.talkingpointsmemo.com/2009/12/democrats-trade-opt-out-for-trigger-medicare-buy-in-and-more.php

[tsuki]

15. Yeppers. It's only 122 people a day. Might help the unemployment problem. nt

[ProSense]

2. I'll wait for the real announcement because

while some elements (Federal Employees Health Benefits Plan) of this are OK, it basically sucks:

As has been widely reported, one of the trade-offs will be to extend a version of the Federal Employees Health Benefits Plan to consumers in the exchanges. Insurance companies will have the option of creating nationally-based non-profit insurance plans that would offered on the exchanges in every state. However if insurance companies don't step up to the plate to offer such plans, that will trigger a national public option.

Trigger? Screw that!

[Parker CA]

4. +1. How in the world did we get back to the trigger?? Garbage.

[jgraz]

20. Get back to? We never left the trigger.

Rahm and his pet president have been pushing it since day one.

[Clio the Leo]

11. Why does that bother you? NT

[polichick]

3. We wouldn't be talking about this bill if the trigger hadn't already been pulled. nt

[Pirate Smile]

5. Trying to kill it gets cheered around here. Let's wait another 15 years.

Sherrod Brown and Jay Rockefeller are corporate shills. :eyes:

Thanks for the post, Jeff Dem. :)

[Sebastian Doyle]

12. Well I don't know about Sherrod Brown, but what's Jay's last name again?

He might be one of the more tolerable members of his family, but he's still John D. Rockefeller IV. Without corporatism, he wouldn't exist.

I will give him credit for being honest about the fact that rich people like his family aren't paying enough taxes though.

[andym]

6. The success of this will come down to how tightly regulated

the new non-profits are. Strong regulations= premium caps etc would go a long way to helping.
What they really need is a non-profit basic health plan-- where the insurers (whoever they are) are non allowed to profit (like Switzerland.

[Blasphemer]

14. Exactly. If the regulations are Swiss-style, then they really have something... nt

[frazzled]

7. Actually, the tradeoffs sound better than the crappy, weak public option

Though I'd also like to see increased subsidies, and would have liked to have seen Medicaid expanded to 150% of the PL from 133.

But here is what is good:

1. Buy in to Medicare for 55-64. This is the hardest hit group of all uninsureds. This is going to be very popular, if it isn't too expensive for people.

2. The FEHBP model, with nonprofits to choose from. That is an improvement over an exchange with no public option and no nonprofits.

3. Most importantly: "New, and strengthened insurance regulations."


If it passes, this will be better than the status quo. The status quo is insupportable.

[amandabeech]

13. Medicare at $800+ is going to be too expensive for many of those

in the age group who cannot get coverage.

You can count me in that group.

The regs won't get written until after the bill is passed, and they will undoubtedly reflect the insurance company's preferences when at all possible and then some.

[Misskittycat]

17. Same here. I need this right away, but that price tag is way too high. n/t

[amandabeech]

19. There are lots of us out here, to be sure. n/t

[frazzled]

18. Did someone say the price tag is going to be $800?

Well, try getting private market insurance at age 55+ for that. If you could get it. Almost everyone over 55 has some kind of pre-existing condition, no matter how small: and they will use that to deny you or charge you a fortune.

At any rate, as I understand it, it would kick in right away, but the subsidies wouldn't become available until the exchange is up in a few years. Then you would get subsidies to choose the Medicare option.

[GoCubsGo]

25. Where is this $800 number coming from?

Link, please?

[HughMoran]

9. Lieberman. - - - - - Shiv in America's back.

Hate. Him. :mad:

[jgraz]

21. Are you really unaware of the overtones of what you just said?

http://en.wikipedia.org/wiki/Stab-in-the-back_legend

Hey, I hate Lieberman as much as anybody, but this is a pretty loaded term to use on a Jewish person. Even someone as odious as Holy Joe.

[LittleBlue]

16. If public option is out, so am I!

They can look to their insurance company patrons for votes and $$$ because they won't be getting mine.

[harun]

23. It isn't completely out, and I would be with you if it wasn't for this

"Insurance companies will have the option of creating nationally-based non-profit insurance plans that would offered on the exchanges in every state."

If they really put something like this in there I would be for it. There would hopefully be so many nationally based non-profit plans available that the for-profits would be neutralized. It is one step in a process, not all bad in my opinion.

[Life Long Dem]

24. Tell me it's not up to Lieberman's vote again?

:banghead: Say it's not so Joe!