Obama’s health care plan – the easy outline

General Regulation:
• Basic Health insurance will be required, like auto insurance is now
• Businesses will be required to either provide health care or ‘chip in’
• 95% of small businesses (based on profit threshold) will be exempt from the requirement to participate
• There will be a hardship waiver for those who still can’t afford coverage

Those with insurance:
• Neither employers nor individuals will be required to change plans.
• Illegal to deny coverage based on pre-existing condition
• Illegal to drop or alter coverage once you get sick
• No cap on coverage in a year or lifetime
• Cap (limit) on out-of-pocket expenses
• Insurance companies will be required to cover routine exams such as mammograms and colonoscopies at no additional charge

Those without insurance:
• Affordable coverage via exchange/marketplace which will take effect in 4 years
• Insurance companies will want to compete because of millions of potential new customers
• Those who still can’t afford will be given tax credits determined on amount of need
• Current pre-existing conditions will be offered low-cost insurance immediately if they become sick (McCain’s plan)

Rumor control
• No death panels
• Illegal immigrants will not be given health care
• No federal dollars used to fund abortions

The Public Option
• Public option preferred, but any option that guarantees some form of choice will be considered, including co-ops or trigger option
• Rationale for public option is to hold insurance companies accountable
• Public option would only be for those without insurance – those with insurance would not be required to change
• It’s projected less than 5% of people would sign up for the public option
• Public option expected to be entirely self-sufficient – no taxpayer dollars, but with reduced overhead and salaries, should still be able to provide lower cost options
• Public option expected to augment, rather than replace private system – much like public universities augment, but do not replace private universities

Paying for it
• With savings, projected 900 billion over 10 years  (less than Iraq & Afghan wars and less than tax cuts for wealthy started by Bush)
• Must add 0 to deficit over lifetime
• No money borrowed from Medicare
• No reduction in Medicare benefits
• Provision requires spending cuts if promised savings don’t materialize (sounds like trigger option)
• Reduce waste in current system including Medicare and Medicaid: fraud, unwarranted subsidies to insurance companies, communication, etc
• Create independent commission of doctors & medical experts charged with identifying additional waste and encourage best practices modeled after high performing health systems
• Revenues from drug and insurance companies: insurance companies charged a fee for their most expensive policies
• Tort reform to stop frivolous medical malpractice lawsuits (Republican proposal)

Leave a Reply