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Pass the damn bill now.
Author: Raine    Date: 03/15/2010 12:59:05

Most likely this is going to be a big week for health care reform. I know you are tired not just of hearing about it everywhere, but from reading about it here. I'm tired too.

Here is an updated whip count from The Hill. Please keep making calls. Even if your representative is on that list, they still need to hear from you. Tell them you stand with fellow progressives like:

Sherrod Brown
Howard Dean
Pete DeFazio
Barney Frank
Al Franken
Alan Grayson
Stephainie Miller
Markos Moulitsas
Bernie Sanders
Ed Schultz
Lynn Woolsey

There are others, of course, and please feel free to add them to the list. You have to know this week millions of dollars will descend upon DC from the Insurance Industry to try to kill this bill. One minute we have the votes, the next it's unclear. The reality is this, covering 31 million of the 47 million uninsured in this country is a far better scenario that we have now, and if you are worried about the cost cutting controls -- and the lack of the public option in the Senate bill please read this blog. From the Senate bill:


‘‘(A) REQUIREMENT.—Beginning not later than January 1, 2011, a health insurance issuer offering group or individual health insurance coverage (including a grandfathered health plan) shall, with respect to each plan year, provide an annual rebate to each enrollee under such coverage, on a pro rata basis, if the ratio of the amount of premium revenue expended by the issuer on costs described in paragraphs (1) and (2) of subsection (a) to the total amount of premium revenue (excluding Federal and State taxes and licensing or regulatory fees and after accounting for payments or receipts for risk adjustment, risk corridors, and reinsurance under sections 1341, 1342, and 1343 of the Patient Protection and Affordable Care Act) for the plan year (except as provided in subparagraph (B)(ii)), is less than—
‘‘(i) with respect to a health insurance issuer offering coverage in the large group market, 85 percent, or such higher percentage as a State may by regulation determine; or
‘‘(ii) with respect to a health insurance issuer offering coverage in the small group market or in the individual market, 80 percent, or such higher percentage as a State may by regulation determine, except that the Secretary may adjust such percentage with respect to a State if the Secretary determines that the application of such 80 percent may destabilize the individual market in such State.

What does that all mean?
The language is convoluted but the result is simple, insurance companies can no longer make money by ensuring people who don't make claims.

Under the current business model of private insurers the goal is to recruit insurees who in all likelihood won't make claims, while denying those who are certain to either because of pre-existing conditions or simply by falling sick. The bill directly outlaws those practices but under 2718 they wouldn't have the desired effect anyway. Take the hypothetical case where your entire risk pool is made up of healthy young adults whose claims are mostly limited to broken bones from skiing or biking accidents. Under 2718 unless those claims across the risk pool don't add up to 80% or 85% depending the insurer has to rebate the extra premium. At the extreme the company would have to rebate the entire premium and so go out of business having no revenue to even pay employees. Under the new model the only ways to increase profits are one, to compete on the basis of volume, or two to reduce administrative costs, which is a 180 from the current model of hassling claimants into dropping coverage or simply finding excuses to rescind coverage.


This language is not in the House Bill, at least not with the same effect, and we can expect that insurance companies will start working on the usual suspects to kill the bill on final (the language is still in the bill as of 3/13/10). Which in my mind is reason to just get this bill signed to nail 2718 into law.

Because on its own it has many of the same benefits on the overall system that the Public Option was supposed to deliver.
Let's put it another way: Let's say a Private insurance company makes $3.6 billion annually in charges to customers. Under this "Golden Bullet", at least 80% of that would have to be used to pay out claims. This rule goes into effect on January 1. Don't think for a minute they aren't raising rates like crazy now for no reason. The longer this bill sits around waiting to pass, the more money they will gouge from Americans. If the bill was as damn terrible as some would have you believe , so many powered interests wouldn't be fighting so hard to kill the bill.



UPDATE: New York's labor-backed Working Families Party, a major state player whose ballot line is a prized asset to Democratic candidates, will deny its endorsement to any member of Congress who votes "no" on health care legislation, party officials said.

UPDATE II:In what seems intended as a shot across the bow of House Dems wavering on health reform, top officials with the labor powerhouse SEIU have bluntly told a Democratic member that they will pull their support for him — and will likely field a challenger against him — if he votes No on the Senate bill.

34 comments (Latest Comment: 03/16/2010 03:29:11 by clintster)
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