The Wyden - Bennett Healthy Americans Act: Why Not Just Say Yes?
I don't get it.
Two weeks ago, I wrote a column offering advice to Democrats and the White House that they could achieve a broad bipartisan consensus on health care by supporting S. 334, the "Healthy Americans Act" ("HAA"), introduced last year by liberal Democratic Sen. Ron Wyden of Oregon and conservative Republican Senator Bob Bennett of Utah.
Then last week Sen. Max Baucus, after months of working with the bipartisan "gang of six" Democrats and Republicans on the Senate Finance Committee, introduced a bill that did not attract a single Republican and more than a few Democratic dissenters.
Yet, as I wrote two weeks ago, the Wyden-Bennett measure already had such Democratic co-sponsors as Debbie Stabenow (Michigan), Tom Carper (Delaware), Bill Nelson (Florida), Maria Cantwell (Washington), and Dan Inouye (Hawaii); and Republican Senators Lamar Alexander (Tennessee), who is No. 3 in the Senate leadership; Judd Gregg (New Hampshire), ranking member of the Senate Budget Committee; and Mike Crapo (Idaho), a member of Senator Baucus's Finance Committee and a Harvard Law graduate. Republican Senator Lindsey Graham was quoted in the Washington Post that he could vote for the HAA.
And what exactly does the HAA accomplish that could possibly attract such broad, bipartisan support from left-to-right in the U.S. Senate?
* Universal health insurance coverage for every American - the goal of most Democrats since President Harry Truman first tried to introduce a national health care bill more than 60 years ago, including requiring insurance companies to ensure all, regardless of pre-existing conditions or status of the individual.
* Reliance on choice and competition in the private market place - core principles of conservatism.
* Immediate deficit neutrality in the first two years, and then surplus revenues in the years thereafter - i.e., reducing the budget deficit - according to a May 1, 2008, letter sent jointly by the Congressional Budget Office and Joint Committee on Taxation - co-signed by none other than Peter Orszag, then head of the CBO and now President Obama's OMB Director.
* Cost containment measures, using tax incentives and disincentives as well as state-based regulations, to squeeze savings out of the waste and inflated $2.5 trillion that Americans will spend on health care this year - enough to pay a doctor $200,000 a year to do nothing but care for every seven families in the nation - savings also attested to by the CBO/Joint Tax Committee letter.
Here's an oversimplified explanation of how the HAA accomplishes all of the above:
* It requires every American to purchase a health insurance policy.
* Any employee whose employer provides health insurance would receive a cash payment equal to the cost of his or her insurance policy (with a comparable tax deduction, so no increased tax liability should result) and from that time on, would be required to use all or part of that extra compensation to purchase his or her own health insurance.
* All other uninsured Americans would be required to purchase insurance, but those at or below the poverty level would receive 100 percent subsidy to pay for all of the premiums, and those up to 400 percent of the poverty level would receive subsidies on a sliding scale. These subsidies would be paid from a variety of enhanced tax revenues resulting from passage of the HAA.
* All Americans would purchase their insurance from plans listed on state-administered public "Health Agencies" or "exchanges" - with at least one on the public exchange at least as good as the plan available to all federal employees, including members of Congress. And coverage would be mandatory for everyone, including those with pre-existing conditions.
The details are complicated, the core principles are that simple.
Ezra Klein, a blogger formerly of the American Prospect and now with The Washington Post, has written a series of articles in the last year praising the Wyden-Bennett plan.
"[Senators Wyden and Bennett and their supporters] have spent years working with the Congressional Budget Office to get the budget hawks seal of approval," he wrote earlier this year. "They have brought the legislation before academics and interest groups, before politicians and business leaders. They have heard concerns and incorporated new features. They have put in the hours. And it was hard, and it took time. But the work was necessary. And it is done."
Last June, the Wall Street Journal's highly respected Colin Levy wrote, "The idea, Mr. Wyden says, is to harness the Democratic desire to get everyone covered to the Republican interest in markets and consumer choices. "
In August 2009, David Leonhardt, the New York Times' economics weekly columnist, wrote: "The only bill introduced in Congress with real choice is the Healthy America Act. The immediate advantage would be that people could choose a plan that fits their own preferences, rather than having to accept a plan chosen by human resources. You would be able to carry your policy from one job to the next or hold onto it if you found yourself unemployed. You would never have to switch doctors because your employer switched insurance plans. The long-term advantage would be that health insurance would become fully subject to the brutal and wonderful forces of the market. Insurers that offered better plans, plans that drew on places like the Mayo Clinic to offer good, lower cost care, would win more customers."
Two weeks ago, on Sept. 4, David Brooks praised the HAA in his New York Times Republican-tilted column because it made "consumers accountable for spending, price information transparency, and reward[ed] health care, not health services" and addressed the "structural problems instead of papering over them. "
And in a New York Times op-ed just last Thursday, Senator Wyden summarized the combination of liberal and conservative ideas that makes his and Senator Bennett's proposal the most likely to win passage with broad bipartisan support:
"According to one estimate, injecting this kind of competition into the employer-based system would save people and businesses more than $360 billion over 10 years. At the same time it would improve the quality of healthy care. Americans could take advantage of this change, or ignore it if they like; it would not be forced on them by government mandate. Ultimately, by empowering people to select the health insurance that makes the most sense for them and their family, we could end up with a system that works better for everyone."
In the next two weeks, I will explain in detail how the HAA works - first, the structural reforms in creating universal coverage; and the following week how the HAA accomplishes this while ultimately, according to the CBO, producing surplus revenues, reducing the deficit and creating higher quality health care for all Americans.
Stay tuned.
Lanny J. Davis, a Washington lawyer and former special counsel to President Clinton, served as a member of President George W. Bush's Privacy and Civil Liberties Oversight Board. He is the author of "Scandal: How 'Gotcha' Politics is Destroying America."
This piece appears today, September 21, 2009, in the Washington Times in Mr. Davis's regular column, "Purple Nation." Mr. Davis is also interviewed most Mondays about his column for that day on Sirius/XM's POTUS Press Pool, with Joe Mathieu, usually between 12-1 pm. His columns are also posted at http://pundits.thehill.com, www.HuffingtonPost.com, www.Newsmax.com, and sometimes on www.Foxnews.com.
Loading comments…
Want to reply to a comment? Hint: Click "Reply" at the bottom of the comment; after being approved your comment will appear directly underneath the comment you replied to
"subsidies would be paid from a variety of enhanced tax revenues resulting from passage of the HAA."
Well, unless the bill includes the "enhancements", I don't see how the passage of HAA will have any effect on tax revenues.
If the bill includes increased or new taxes,where is that mentioned in the blog? This seems far too important a part of the whole reform issue to just blithely mention it in a throw away sentence. So I am extremely suspicious out of the gate.
On principle, I refuse to buy private insurance. I would rather just set fire to 30% of what the cost of insurance would be and use the other 70% to pay the fine.
See milesz's Profile
Say Lanny, who, or what, contains the private market from raising insurance premiums when they want to and at whatever level they want to? So notwithstanding anything you are saying, what the conservatives want is just another dose of "screwing" American consumers, huh?
insurance premiums have doubled since 1999. will double again by 10 years.
and the writer wants to trust them to "fix" this problem? even when they have shown time and time again, that they will not do so?
this is not just blind faith. this is foolish in light of the evidence about the history of the insurance industry.
it's reckless, and gullible. it's dangerous and represents a delusional and altered state of mind.
what a horrible idea.
Lanny,
Please address this concern with the HAA plan. Larger employers generally self-insure. While they may still offer multiple plans to their employees that are administred by insurance providers, they pay substantially less for that service than the cost of "insurance". The insurance provider bares no risk, so the company gets a substantial discount. So if he employer's only reimburses the employee for the company's cost of insurance, its unlikely the employee could buy a comparable plan for the same price as what he was being compensated. The employee's cost of getting insurance would have to include an additional premium to compensate for that additional risk.
It seems the only way to get back to that same "self-inurance" level of cost is to enable the Federal Govt. to "self-insure" its citizens. If the HAA plan include a public option, that would do it. Without it, its just another plan to add profits to the insurance companies.
has anyone googled this writer?
please do. eye-opening
Get one thing straight. There is no compromise on the public health option. The Wyden bill puts lipstick on the pigs (insurance companies) but they will still be pigs, only fatter.
So, we have a plan that depends 100% of taking your tax dollars and sending them directly to the insurance companies. Way to make what is already the world's most expensive health care system even more expensive!
"Reliance on choice and competition in the private market place - core principles of conservatism."
We've "relied" upon these twin forms of conservative fairy dust for 50 years which is why we're in the hole we're in now. Advocated further reliance upon them requires deep delusion or monumental dishonesty.
Add a public insurance option open to everyone and put some beefy boots on the necks of insurers, though, and it's pretty close to perfect.
Then it would be a large mangy rabid dog with a pretty tail.
If Lanny Davis, The Wall Street Journal, some Blue Dog Democrats, David Brooks and Lindsay Graham are for this bill, excuse me while I run swiftly and purposefully in the opposite direction. Just because a bill can be passed doesn't mean it should be: that doesn't make it a good bill. Consider DOMA, the Patriot Act and Medicare Part D: they are the embodiment of bigotry, an effront to civil liberties, and a boondoggle for private interests, respectively. They were each passed. This bill's name is the only correct response to it: "HAA!"
Show me a bill that Barney Frank, The New York Times, The Nation, SEIU, and Bernie Sanders support. THEN you'll have my interest and my full attention. Otherwise, as a wise poet said, "You're just wastin' my precious time."
Well said and excellent examples of bills that never should have been passed!
and the AFL-CIO.
The problem with the bill is that the insurance companies would get a windfall from the consumer and the government. The bill does nothing to control out of pocket expenses, it puts no regulations or restrictions on insurance companies. It allows people to purchase insurance in other states leaving them vulnerable to relaxed rules and charlatain organizations, and the cost shift to the consumer regarding out-of-area or out-of-network coverage because the consumer gets sick in their state and is unable to go to the state where they purchased cheap insurance. In regards to Medicare it reduces the payout to insurance companies in regards to the Advantage programs which is limited to at most 3 insurance providers leaving the overall Medicare system full of abuse and fraud and insurance company kick backs. I'm not at all surprised that the list of supporters are blue dogs and republicans who's biggest contributors are the medical industry. Trying to pass this plan off as the cure for reform is ridiculous, this bill doesn't even address it.
"* It requires every American to purchase a health insurance policy."
Lost me. Every time I hear this, its followed up with a fine or other penalty for not having insurance. Oh but don't worry, you're reimbursed by a tax credit or tax subsidy at the end of the year. If you couldn't afford insurance before, who says you can afford it under penalty? Whether or not you're reimbursed at the end of the year, you're still out of pocket at the beginning of the year.
As a test case, Texas has tort reform and wide competition of insurance carriers in the state. With the competition and lowered malpractice insurance we have:
the largest uninsured pool (25.1%)- http://www.star-telegram.com/news/story/1604772.html
and some of the costliest healthcare - http://www.forbes.com/2009/08/10/health-care-plan-lifestyle-health-obama-health-care-bill_slide_2.html?thisspeed=25000 see also http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande
This in a state with a fairly strong economy, low cost of living, and no state income tax so workers have more more in their pocket, relatively speaking. Forcing people to buy insurance they cannot afford already then punishing them for it will be bad news down the road.
I did find the Senate bill 360 on Thomas on the internet. I will be printing it out and reading it. From what it sounds like it is so much better than anything I've heard or read about that has been put together this year.
Thank you for bringing this to my attention. I hope everyone else takes a look at it, too.
Well, it's "better" in the sense that it's pure corporate welfare instead of being "adulterated" with a shred of good for the people.
Sounds too good to be true. Where can I get a copy of the Bill and why hasn't it been presented to the President's staff for review? I agree with Barry S. We should all have the opportunity to select any policy that government workers, including our congress people who don't appear to work. Choices are what matter.
I drive a Chevy Malibu, I want to have the option to buy a Ferrari 360 Modena. Oh wait, I already do, but still cannot afford it.
The moral of the above? You can buy any of the number of plans available to federal workers. Its not like its a mystery, google it. If as an individual you said, "gimme what he has" you're paying a lot more than a Congressmember or even the congressional janitor because you're not part of one of the largest risk pools. Perhaps this exchange program will bring enough unrelated people together into a single pool, but that will eventually (cross fingers, hopefully) bring the per-plan price down. The plan won't start cheap because maybe in 5 years, a large number of people will have it and pay into it. That's why most insurance co-ops fail, which is almost what this exchange sounds like.
It's "been presented to the president" in the form of "It's what we do now only with more government subsidies to the insurance industry."
what if I don't want to buy insurance? What if I am a young/healthy person that believes he is invincible and I don't want to waste my money buying insurance I don't need? This plan requires me to purchase insurance but this isn't like the auto insurance requirement where I choose to drive and in return for that privledge I have to prove I know how and have the ability to pay for it if I mess up. I don't have a choice to live. And what if I refuse to pay the tax for not buying insurance? How long is the prison sentence for not buying health insurance going to be?
Since companies cannot discriminate based on pre-existing conditions why not buy insurance from the cheapest company out there that offers very limited choices and poor service then, once you get sick, dump that insurance and buy into the insurance plan that offers the most comprehensive coverage with the best service? Should this bill become law how long would it be before we had fake insurance companies in existance for just that reason? To offer low-cost "coverage" and once you get sick even help you fill out the forms to a real insurance company with good coverage?
no, that's why there will be minimum coverage requirements to be an acceptable plan at the three levels. also, like medicare and private insurance, you can only change plans once a year. So, you gamble within your level of coverage.
Medicare part D has minimum requirements to be an eligible plan. So will these exchange plans. Since the maximum liability is capped, there will only be a few thousand dollar incentive if you get "really" sick. That is what you are gambling with. Time to read the real information, not the FOX interpretation.
BTW, "RighWing Marine", you already have socialized medicine, government paid, government-paid doctors, government paid facilities in the marine corps. How about you giving it up and get free enterprise medical care. I cant wait to see the expression on your face when Aetna or Cigna says that your IED wounds are pre-existing conditions..
There is no prison sentence for not buying insurance - merely a fine. And, just don;t pay your income taxes and see what happens. They will get the money by garnishing.Jail is only for fraud.
So we should just accept that people that don't want this service will be forced to buy it or go to prison? (try not paying your taxes either this one or your income tax, men with guns will come to force you to pay or take you to prison) What if I'm one of those people earning less than $250K/yr, what happened to Obamas promise that I would not see my taxes increase by one dime? Is the fine going to be nine cents?
This plan offers subsidies to person that earn up to 400% more than the poverty level. What of those people that are too young for medicare, too rich for the subsidy and so sick that insurance costs more than they can afford? Do they pay the no insurance tax just once a year?
There are wild claims that this plan will pay for itself because Obama will eliminate waste, fraud and abuse. Is this the same waste, fraud and abuse that Carter, Reagan, Bush I, Clinton and Bush II promised to eliminate? If it can be done so easily and painlessly why don't we do it know? Why tie it to health care reform? If we don't pass the reform does that mean we elect to keep the waste, fraud and abuse?
BTW, there are no pre-existing conditions on federal exchange, no recisions are allowed, so no new rules would be required. The enforcement would be easy - delisting for 20 years: end of their business for those rip-off artists. There already is plenty of choice for those elite select. This would save 10's if not 100's of billions for people and for US companies. If the insurance companies "cry" that they will lose money, well it means they were selling insurance to congresspeople below cost: thus admitting to bribing them and Atty Gen. Holder should get to work.
how about requiring that ALL the policies on the federal exchange be on these anemic "state" exchanges and at a price no more than 10% above the federal cost [or $10/month extra for billing - whichever is less]. But no. we let the insurance companies bribe congress by offering cheap policies for them and junk policies to the rest of us. No computer reprogramming necessary - just call every one else an employee of "USA taxpayers." Then, when the government "negociates" for a better price, they get it and we get a good price too. And, any company not willing to provide these policies are obviously trying to bribe congress, so they shouldn't be able to be in the federal exchange for 20 years once disqualified. Now that would provide some competition.
You must be logged in to comment. Log in or connect with
