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Senate Committee Passes Quasi-Public Option Amendment

First Posted: 12/01/09 05:12 AM ET Updated: 05/25/11 03:15 PM ET

Stimulus Housing Washington

The Senate Finance Committee narrowly passed an amendment Thursday from Sen. Maria Cantwell (D-Wash.) that moves the conservative panel as close as it will likely get to a public health insurance option.

The amendment creates a "federally funded, non-Medicaid, state plan which combines the innovation and quality of private sector competition with the purchasing power of the states," according to an overview.

It would be available to people with incomes above Medicaid eligibility but below 200 percent of the federal poverty level -- a very narrow window. However, Republicans fear -- and progressives hope -- that once the plan becomes law there will be pressure to expand it.

The plan would not be free. It is based on Washington state's Basic Health plan, which costs roughly 60 dollars a month, with the remainder of the premium subsidized by the state.

Private insurers would be eligible to participate in the plan, as would HMOs or other networks of health care providers.

The amendment has been gathering steam all week and was the subject of an extended private session of the finance committee Thursday afternoon before the vote, chairman Max Baucus (D-Mont.) said.

Baucus and Sen. Kent Conrad (D-N.D.), both of whom voted against public option amendments Tuesday, supported Cantwell's measure. Sen. Blanche Lincoln (D-Ark.) was the only Democrat to join each Republican in voting no. It passed 12-11.

Sen. Olympia Snowe (R-Maine) opposed the amendment, meaning that it could still be removed when Democratic leaders merge the finance bill with the previously passed health committee bill, if the purpose is to secure Snowe's support on the Senate floor.

Yet Democrats are increasingly negotiating the final details of health care reform within their own party, leaving the GOP to protest process. Republicans on the committee objected to the Cantwell amendment, arguing that there was no accompanying budget-impact estimate. On Wednesday, Cantwell and Baucus told HuffPost they were waiting for such an estimate, but Baucus decided to move ahead. "I have to use my judgment," he said before the vote.

Cantwell says that her measure -- which can be read here -- would assure coverage of 75 percent of people who are currently uninsured. If you're a Washington doctor, nurse, patient or any other resident of the state who has experience with the Basic Health Plan, let me know what you think of it either in the comments section or at ryan@huffingtonpost.com. (Please include in your e-mail whether you want your name used.)

UPDATE: The reader responses coming in, which I'll continue to read and synthesize more thoroughly tomorrow, indicate that those who are in the plan are generally happy with it, but many, many people can't get into it due to its lack of sufficient funding. Several readers noted that when you go the plan's website, you're greeted with this: "To stay within the appropriated budget, Basic Health is no longer processing incoming applications to determine eligibility and has officially implemented a waiting list. New applicants will be placed on a list behind those already waiting. When space becomes available in the future, Basic Health will release names from the list in date-received order and notify applicants."


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The Senate Finance Committee narrowly passed an amendment Thursday from Sen. Maria Cantwell (D-Wash.) that moves the conservative panel as close as it will likely get to a public health insurance opti...
The Senate Finance Committee narrowly passed an amendment Thursday from Sen. Maria Cantwell (D-Wash.) that moves the conservative panel as close as it will likely get to a public health insurance opti...
 
 
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01:46 PM on 10/03/2009
Give Cantwell credit: insuring most of the uninsured poor is a noble idea, and it is bizarre that anyone, by which I mean every single Senate Republican, can have a problem with that. It is not health care reform, because it leaves millions uninsured and does not require providers to participate, and it does not help people who have inadequate insurance but incomes above the cutoff. I guess expanding Medicaid passes for health reform in America.
07:21 PM on 10/02/2009
Flopsie, Congress, the medical industry & lobbyists in general have already totally stuck the American public. None of them care. Just so long as the graft &/or profits continue to roll in.
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HUFFPOST COMMUNITY MODERATOR
Emerald1943
03:13 PM on 10/02/2009
Rick Sanchez now on a roll about the Senators who voted down the public option as a "government takeover" but yet they all...every one of them...voted last year for "Government Run Flood Insurance" where the insurance companies get to make all that money for premiums, but if a flood happens, the taxpayers pay the bill for the damages! What a sweet deal for the insurance companies!
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HUFFPOST SUPER USER
eilish
Life ain't like a box of chocolates
09:45 PM on 10/02/2009
I wondered where that came from - out of the blue, we started getting bills every year for flood insurance. $149/month flood insurance - REQUIRED. We don't even live in the FEMA floodplain. So every year we have to fight about the flood insurance, which is in addition to our regular $125/month home insurance. I have to travel 60 miles to the county offices yearly, and get them to sign the statement and make a copy of our home on the FEMA map, proving we are NOT in the flood plain.
02:10 PM on 10/03/2009
Flood insurance passed because on Republican Senator, Trent Lott, has a house in Mississippi that was damaged in the flood and abandoned by the insurer. Actually, he's in a "Lott" of trouble for allegedly doing some unofficial, beyond-the-Senate activities to put pressure on his deadbeat insurer. When you lose your house, it's your problem. When a Republican loses his house, it's everybody's problem.
03:02 PM on 10/02/2009
Thanks to my Senator Cantwell for getting the frickin' bill out of the Finance Committee - even IF Basic Health is not a public option. Finance HAD to get something in the bill that represents something ... anything that sounds like a public option....even if it is "quasi". As another poster said ... it now has PO "language" in it. This bodes well for when the bill is laid before Obama .. it WILL have a true public option in it.
02:18 PM on 10/02/2009
I really don't think this was meant as a substitute for a Federal public option. I think it is a demonstration that there can be a Federal public option. Thank you Senator Cantwell
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HUFFPOST SUPER USER
bthechangeyouseek
11:17 AM on 10/03/2009
It sounded good when I heard it on TV. Just because it's there does not mean insurers will provide network access for the benefit to be used. Washington state is not known for it's access.
01:51 PM on 10/02/2009
This says private insurers can participate in the plan?? That sounds a lot like Medicare advantage which is ripping off American taxpayers by the billions. If we let private insurers take payments from the government then advertise their own Public advantage plans we'll lose even more money. Sounds like a horrible idea.
01:42 PM on 10/02/2009
STUDIES SHOW ---- 95% of illness cause by average diet being 50% fats

Raised a family of five and for 30 years had no medical expenses, and in that time gave lectures to hundreds. And everyone who decided to eat a low fats diet, from then on had no medical expenses.

So, should not my advise at least be given a try? For surely light always forces darkness to give way.

So it’s not that people don't see the light, but that the light is forcing their darkness to give way and they cannot tolerate it.
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HUFFPOST PUNDIT
Artemis34
"Women 4 the GOP" is like "Chickens 4 the KFC"
03:41 PM on 10/02/2009
Medical costs and behaviors are not correlated in the US.

US prisoners with public care cost $3K LESS per person per year than the general population mostly in private care plans ($4.4K for prisoners vs. $7.4K for the general population).

They are the highest risk patient group and cost LESS!

The US leads the world in smoking cessation and yet as US smoking rates plummeted, US health care costs skyrocketed! Okay, so maybe there is a negative correlation.

Other countries that have many more smokers provide health care for far LESS than the generally non-smoking US.

And have you ever seen a German meal? Don't think there is much healthy about sausages!

And have you read a French recipe? Better have the fridge full of butter if you are going to make that!

And you think the French and Germans don't drink?

Don't buy the "blame the patient" propaganda of the FRIGHT WING. They always blame their victims for the problems they actually create.
03:10 PM on 10/03/2009
That kind of thinking would be fine if lowering your risk of illness (not preventing it!) would save people a few thousand dollars over a lifetime when it worked, not prevent financial ruin or premature death from lack of access to care when they run out of money.
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01:23 PM on 10/02/2009
How about if we have 100% government run healthcare but with a twist. How about forcing every family that makes over 100,000 a year to do a HSA and tax the savings? then if you're family makes below the 100K mark, your state run insurance is already paid for by the taxes being paid on the riches HSAs?
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HUFFPOST PUNDIT
Artemis34
"Women 4 the GOP" is like "Chickens 4 the KFC"
04:20 PM on 10/02/2009
Health Savings Account or HSA is a rip-off as currently configured.

If United "Health Care" runs my HSA, and they are a criminal organization (and they have been convicted of wrongdoing many times, this is not hyperbole), then they just reject my claims that attempt to use may own savings and keep it at the end of the year.

Rather pay the tax man then give my savings to them for free.
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04:30 PM on 10/02/2009
No I am thinking that the HSA would be for the government run planned too. We would no longer have insurance companies. Although that will not happen because Obama, Pelosi. Baucas and Reid are on the payroll
03:24 PM on 10/03/2009
I agree. The HSA system is totally corrupt. The insurance companies are the problem, not the solution. Anything that involves them is bound to waste tons of money.
02:37 PM on 10/03/2009
Somehow I just don't see just because they make less than $100k per year they qualify to get free care. So someone who makes $95k would pay nothing? Also what amount of taxes do you think would be collected on the savings? Even if you taxed at 100% I bet there would not be enough to cover everyone below $100k. Might want to fire up that calculator again.
03:29 PM on 10/03/2009
Splitting it up that way is ridiculous anyway. Healthcare is so expensive, you have to be a multimillionaire to pay out of pocket for some conditions and your end of life expenses. Almost everyone needs some help from the government to subsidize their care. Reform is supposed to make sure resources are used efficiently since they are scarce.
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HUFFPOST COMMUNITY MODERATOR
Icantbelieveher
I'm for the separation of church and hate!
12:48 PM on 10/02/2009
I read that Canada's health care system began on a province by province basis, just like this. Since republicans fought so hard against the public option, and since they are so big on states' rights, this is a much faster way to end up with single payer. Colorado was already looking into doing this, but wanted to see what the federal government would come up with. If the federal government wants to add funds to a state's single payer system, more the better!

The republicans might just be wishing for just the public option!
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HUFFPOST PUNDIT
Artemis34
"Women 4 the GOP" is like "Chickens 4 the KFC"
12:57 PM on 10/02/2009
There was an amendment in the house to allow state level single-payer from Dennis Kucinich.

You are correct. Canada started province by province.
02:15 PM on 10/03/2009
You are correct. Single-payer was introduced by the premier (elected government leader) of Saskatchewan in 1965. It was so successful and popular that before the decade was out, it was in place across Canada. Republicans are right about only one thing: once Americans get a taste of single payer, there will be no going back. That is what they fear.
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HUFFPOST PUNDIT
Artemis34
"Women 4 the GOP" is like "Chickens 4 the KFC"
12:47 PM on 10/02/2009
Share your thoughts with Sen. Cantwell:

"Millions of American's are without health care coverage, and millions more have inadequate coverage. They live every day with the fear that getting sick or having an accident could spell financial ruin.

I promise to fight, and fight hard, to make sure that health care reform happens this year. But I need your help to make sure our citizens are heard. So please tell me your story. Share your experiences with the system. Share what you like or dislike about your coverage or share what it is like to live without coverage. Share your thoughts about what reforms are most important to you.

Share your thoughts on health care."

http://www.cantwell.com/action/healthcarestories/
12:13 PM on 10/02/2009
Do you all realize that states already have Health Insurance Commissioners? And guess what, it is the job of these commissioners to NEGOTIATE for better pricing. Do you think it has been working? NO! As much insurance lobbying money is funneled into States as it is federally. A solution that can be interpreted 50 different ways is not a solution, especially if you like in a pro-insurance monopoly state.
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HUFFPOST PUNDIT
Artemis34
"Women 4 the GOP" is like "Chickens 4 the KFC"
12:45 PM on 10/02/2009
Often, the employers' scam "self-insurance" administered by one the big companies is exempt form state insurance regulation and the Commissioner can do little about it because it isn't real insurance.

That right folks, you probably have FAKE insurance!

Ask your employer if they are "self insuring" AND verify with your state insurance commissioner.

You may find you actually have NO insurance at all, just an IOU from your employer which they may honor or not at their whim without consequence!

And if you don't like their findings, you often find you have to sue your own employer first (which is not going to happen if you can hang onto your job while you are sick).

These guys just live subverting the government and finding / creating loopholes.

It won't stop until we put them out of OUR misery.
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HUFFPOST PUNDIT
brt929
02:44 PM on 10/02/2009
You know, I have to disagree with you. The best medical insurance I ever had was with a company that self-insured. Nothing was declined.

It depends on the state, because those that self-insure must follow the regulations, and are required to put a specific amount of money in an account, for claims. They also usually have a third party administrator to make sure that the money is there.

If they don't do this, they don't get their tax benefit.

It used to be only really large companies, national companies, participated in self-insurance. If insurance costs continue to escalate, we will see smaller companies, that really can't afford it become self-insurers.
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HUFFPOST PUNDIT
brt929
12:45 PM on 10/02/2009
Sort of. Each state has an insurance commissioner, but he or she doesn't negotiate rates.

The strength of the Insurance Commissioners office differs in every state. In California, where he/she is an elected official, has more power and is more consumer driven than industry driven. Here in Idaho, where the Insurance Commissioner is simply a Governor appointed crony, he hasn't the interest in advocating for the consumer and is pretty much a shill for the insurance industry.

Some states have "file and use" requirements, which means that the state must approve the rate increase before the company can enact it. It is very rare to see a Commissioner deny the company the rate increase.

Oh, and the majority of the insurance lobby money is funneled into the states. In reality, they have little reason to waste it on the Federal level, because the Federal government has ceded regulation to the states. Here in Idaho, the insurance lobby absolutely owns the state legislature.
They are the reason tort reform was passed, and the reason that competition has been kept out of the state.
HUFFPOST SUPER USER
Middleclassvotingbloc
12:09 PM on 10/02/2009
This will not do for a Public Option.
HUFFPOST SUPER USER
Middleclassvotingbloc
12:09 PM on 10/02/2009
Sounds like she resolved two issues, a public option, consideration and the need to refund her own's state health plan. Very Smart for now.
HUFFPOST SUPER USER
kburlz
12:03 PM on 10/02/2009
Stop being negative nellies. Cantwell did a great thing by getting PO language in the finance commitee bill. Now all five bills have public option language. Even if this doesn't represent the promise land, it will allow millions of people who can't afford insurance to afford insurance. This could even be expanded to include more later on. But at the very least, it gets a foot in the door for the public option in the last committee, which will make it easier to get a stronger PO in the final bill. I know it's more fun to be outraged, but you have to recognize progress when you see it.
12:10 PM on 10/02/2009
If you settle for crap, you will receive crap. This is not progress, but another give away to big insurance while trying to fool voters. We don't want a foot in the door, we want a public option!
HUFFPOST SUPER USER
kburlz
01:45 PM on 10/02/2009
Who said I'm settling? Would you prefer NO PO in the finance commitee bill? Because that's what we almost had. It doesn't end with this proposal. You show very little knowledge of Senate procedures.
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HUFFPOST SUPER USER
Ken Freedom
Post-Modern Adventurer
03:56 PM on 10/02/2009
Thanks to progressive with attitudes like this we've had an entire generation grow up without access to health care. Richard Nixon attempted to pass universal health care legislation. The progressives of the time shot it down because it wasn't good enough. Because they wouldn't "settle for crap."

If it had passed, we'd all have great health care by now. Instead it's 40 years later and we
re fighting for a plan that isn't even as good as Nixon's.

I will take "crap" over another GENERATION OF NOTHING, thank you very much.
kdp59
small business owner
01:48 PM on 10/02/2009
agreed!

see my changes below and I think we have a solid bill that mets what we wanted when started.

Some will hold out of single=payer...they don't sem to understand that Pres. Obama AND the DEMOCRATS refused to put it on the table in this debate at all.

I'd say quit beating a DEAD horse, except the single-payer horse was NEVER born!
11:57 AM on 10/02/2009
STUDIES SHOW ---- 95% of illness cause by average diet being 50% fats

To those of my slow and careful thinking laboring class, the above is common horse-sense.

But to those among the intelligent middleclass, to them it makes no sense.

Problem is, unless their 30% middleclass organizes together with my 50% laboring class, by a rich ruling class we shall both forever be enslaved.
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HUFFPOST PUNDIT
brt929
12:21 PM on 10/02/2009
So is your irrelevant post stating that if we get obesity under control, if everyone eats correctly, health care need not be affordable? Everything can be fixed by changing the way people eat?

So, healthy people don't have accidents, aren't victims of random violence, and don't get cancer?

Not only is your comment a silly diversion, but it isn't even correct. The middle class is well more than 30% of the voting population- we are the majority. Oh, and the entire middle class are the laboring class- I fail to understand how you have come to a conclusion that they are two different groups with divergent interests.

Could it be that you are a one of those deluded Republicans, trying to obstruct?
12:30 PM on 10/02/2009
50% of Americans do not have 12 years of formal education. That is the laboring class

30% have college level intelligence, but not enough entelligence to be rich.

20% of Americans own 90% of our wealth and socialize with high society.
12:37 PM on 10/02/2009
I'm not saying I agree with the statement, but you need to read it more carefully - his statement didn't say to reduce obesity by 50%, it is talking about dietary fat. Obesity rates likely wouldn't drop much even if dietary fat intake dropped by 75%.

But to your rhetorical question about everything being fixed by changing the way people eat, yes, it likely could. The vast majority of diebetics could go off of insulin, and many heart problems could be cured simply with diet and exercise, and many cancers would be prevented. We are by and large a fat, lazy nation, with terrible diets. It's no coincidence that a large majority of working poor eat most of their meals from fast foot, and are them selves grossly obese, and much more likely to be smokers.
12:21 PM on 10/02/2009
There are thousands of lifestyle centers all over the world that cure people by nothing more than lowering the fats calories in their diet to 10%. Two big ones are,

Weimar Institute, Colfax, California
Yuchi Pines Institute, Seale, Alabama
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01:12 PM on 10/02/2009
Alabama,

You might want to start your work close to home, as you live in the center of the most obese population in the country, there in the deep south.
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HUFFPOST PUNDIT
brt929
01:30 PM on 10/02/2009
So what? Nobody disputes that eating well and exercise is a cornerstone of good health. It is however irrelevant.

By the way, do you understand these places may help people manage chronic illness, but they don't necessarily cure anything? Even if they did, they are not going to put doctors and hospitals out of business.

Your point is simply trivial and extraneous. People need affordable health care access, and all you are doing is reciting generic statements that may or may not change the average person's need for a doctor or hospital some day.

It is entirely irrelevant, and doesn't address the problem.