Thursday, April 06, 2006

The New Health Bill: A Band-Aid, Not a Cure

I recently wrote a diary on Daily Kos on Mitt Romney and the new health bill. Like a lot of you, I fear that if Democrats aren't proactive on the issue, Romney will be able to steal it in a 'look at what I've done' moment. Since it was always about politics for him - neither about the tens of thousands without insurance in Massachusetts nor the hundreds and hundreds of thousands struggling to afford it - we can't let him take this issue and thrust it on his soap box, at least without Democrats in this state getting their proper credit. However, when I wrote about the issue, something strange happened: so-called progressives began attacking me on my diary for even supporting the proposal (despite the fact that even then I called it a band-aid approach).

It seems to me that there were some things I didn't know about this bill. Apparently, the new healthcare proposal leaves several large gaps in its safety net. From a commenter on my dailykos diary:

you don't have every-one insured...the self employed and most especially farmers are specifically excluded from the safety net programs, except that they will now have to pay fines to support them. THAT is the basis of my hostility.

Now, I'll admit, I'm not an expert on the new health care bill. I only know that more coverage is better than less. I also knew that over the next few years, with a more progressive governor, we could reduce the individual cost of the health care packages (which run at more than $300 a month per individual) and increase the amount of assistance families could get to afford it.

However, with the news that farmers can't get these state options even if they wanted to pay for it and would have to opt for more expensive, private programs instead, it became extremely obvious that Massachusetts can't wait a few years to change the bill. We need to fix it within the next year to include everyone. Why would there be exceptions? It's not as if farmers and the self-employed need health insurance any less than the rest of us. It's a small part of the population, let's not leave them behind, especially if Mitt Romney is going to gloat across America that Massachusetts has universal coverage when it clearly doesn't.


The Globe has a great article today about this topic.

The state will pay the entire premium for individuals and families who earn less than 100 percent of the poverty level and will subsidize premiums for those who earn between 100 and 300 percent of the federal poverty level; 300 percent is about $30,000 for a single person and $50,000 for a family of three.

But the amount of those subsidies has not been determined, and the higher the premiums of health plans, the more the state will have to chip in to keep plans affordable.

It seems a little scary to commit to subsidizing premiums without actually committing to subsidize them. How much are we actually going to contribute and will it be meaningful. However, this quote is just as scary:

Uninsured residents with incomes over 300 percent of the poverty level, about 200,000 people, will be on their own to pay the full cost.
A family of three making $50,000 isn't an especially wealthy family. If they're paying approximately $600 or more for health insurance, that's going to take a big dent out of their income, even if it's pretax. Massachusetts is an expensive place to live. Greater Boston is statistically more expensive than anywhere else in America. It seems reasonable to subsidize a fair amount up to 400% of the poverty level, or $64,000 for a family of three. While that family won't be poor, they certainly could use the additional money, especially when the premiums are going to be more expensive than initially reported (over $325 compared to $200 per person).

Update: A further look at the political ramifications of Romney's stake in this reform. Although, it's not all good. Conservative attack dogs are going after Good 'ol Mitt.

Perhaps worst of all, the plan relies on threats of "fees" -- that's Mr. Romney's euphemism for giving up existing tax breaks -- in the amount of $295 for employers and $150 for individuals who fail to comply. Companies hapless enough to employ insurance-less "free riders" who run up big hospital bills must pay anywhere between 10 percent and 100 percent of bills over $50,000. These fees -- sure to make people and employers take the law seriously -- will distort the state's economy and do little or nothing to harness market forces. ~Washington Times

LOL! I have to tell ya, I actually feel bad for Mitt Romney. I'm not even being sarcastic. He's sacrificed children (who can no longer be adopted via Catholic Charities), his own respect (by going back on just about every moderate social stance he had when he ran for Governor) and for what? To be called a Massachusetts liberal.

What caused such ire? A measly $295 penalty for businesses that don't provide health insurance, "sure to make... employers take the law seriously." Laughible! You don't get that sort of absurdity from the Democratic party, some party leaders may be inept, but that Washington Times editorial is just absurd.


Sachem Head said...

I'm sympathetic to the claim that farmers and the self-employed may be unfairly squeezed by this compromise. And I'm very familiar with the east v. west resentment that commenter farmerchuck voiced to your dKos commentary. It's as real here in western Massachusetts as it is in Kansas. The Community Health Center of Franklin County has been working on health care and the plight of the rural poor for some time, setting up clinics in regional high schools and visiting migrant farm workers. I agree that the new compromise is not a cure. But I'd like to think, rather than a Band-Aid (meant to cover up a problem), it is a prescription that may ease some symptoms and allow for further treatment. I'm skeptical of the individual mandate as well, but a broad-based solution meant bringing as many people to the table as possible, to give them incentive to help make the system work. The employer mandate is part of that incentive, too.

Ryan Adams said...

I'm not fundamentally opposed to the personal mandate, but it would stand to reason that the businesses who aren't providing health insurance aren't going to start doing so until a mandate of their own would compel them. It would have to be balanced with the costs of health insurance versus the PR hit of not giving their employees health insurance and the cost of a penalty.

I think that if the penalty were along the lines of 30-50% of the cost of a basic health insurance, it would go a long way toward making sure the state can afford to actually have to increase access... and it would force businesses to actually pay their fair share or face still consequences.

Charley on the MTA said...

Ryan, I say if Mitt signs a bill that covers more people, give him credit. If the personal mandate turns out to be horrible (and the self-employed people I know will find it very difficult), then he'll get blame.

A bunch of Massachusetts libs saying Romney did something right isn't exactly going to endear him to the right-wing peanut gallery. :)

Ryan Adams said...

You're right. He deserves some credit, for good or bad. I just don't think we should let him campaign on it and pretend he was a great governor because of this one big bill that came at the end of his term.

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